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Hülpüsch, C. ; Rohayem, R.* ; Reiger, M. ; Traidl-Hoffmann, C.

Exploring the skin microbiome in atopic dermatitis pathogenesis and disease modification.

J. Allergy Clin. Immunol., DOI: 10.1016/j.jaci.2024.04.029 (2024)
DOI PMC
Inflammatory skin diseases, like atopic eczema (atopic dermatitis, AD), affect children and adults globally. In AD, the skin barrier is impaired on multiple levels. Underlying factors include genetic, chemical, immunological, and microbial components. Increased skin pH in AD is part of the altered microbial microenvironment that promotes overgrowth of the skin microbiome with Staphylococcus aureus (S. aureus). The secretion of virulence factors, like toxins and proteases, by S. aureus further aggravates the skin barrier deficiency and additionally off-balances the already skewed immune response. Skin commensal bacteria, however, can inhibit the growth and pathogenicity of S. aureus through quorum sensing systems. Therefore, restoring a healthy skin microbiome could contribute to remission induction in AD. This review discusses direct and indirect approaches to targeting the skin microbiome through modulation of the skin pH, UV treatment, and pre-, pro-, and postbiotics. Furthermore, exploratory techniques like skin microbiome transplantation, ozone therapy, and phage therapy are discussed. Finally, we summarize the latest findings on disease and microbiome modification through targeted immunomodulatory, systemic treatments and biologicals. We believe that targeting the skin microbiome should be considered a crucial component of successful AD treatment in the future.
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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Atopic Dermatitis ; Atopic Eczema ; Inflammation ; Microbiome ; Microbiota ; Skin Barrier ; Skin Microbiome ; Therapy
ISSN (print) / ISBN 0091-6749
e-ISSN 1097-6825
Journal The journal of allergy and clinical immunology
Publisher Elsevier
Publishing Place Amsterdam [u.a.]
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Environmental Medicine (IEM)