Controlling skin microbiome as a new bacteriotherapy for inflammatory skin diseases

Abstract

The skin serves as the interface between the human body and the environment and interacts with the microbial community. The skin microbiota consists of microorganisms, such as bacteria, fungi, mites, and viruses, and they fluctuate depending on the microenvironment defined by anatomical location and physiological function. The balance of interactions between the host and microbiota plays a pivotal role in the orchestration of skin homeostasis; however, the disturbance of the balance due to an alteration in the microbial communities, namely, dysbiosis, leads to various skin disorders. Recent developments in sequencing technology have provided new insights into the structure and function of skin microbial communities. Based on high-throughput sequencing analysis, a growing body of evidence indicates that a new treatment using live bacteria, termed bacteriotherapy, is a feasible therapeutic option for cutaneous diseases caused by dysbiosis. In particular, the administration of specific bacterial strains has been investigated as an exclusionary treatment strategy against pathogens associated with chronic skin disorders, whereas the safety, efficacy, and sustainability of this therapeutic approach using isolated live bacteria need to be further explored. In this review, we summarize our current understanding of the skin microbiota, as well as therapeutic strategies using characterized strains of live bacteria for skin inflammatory diseases. The ecosystem formed by interactions between the host and skin microbial consortium is still largely unexplored; however, advances in our understanding of the function of the skin microbiota at the strain level will lead to the development of new therapeutic methods.

Staphylococcus Infection: Relapsing Atopic Dermatitis and Microbial Restoration

“…For example, where water loss is relatively high (dry) and follicle density (inner forearm) low, fungal species (Malassezia) predominate; in moist regions (folds), bacteria species (Staphylococcus and Corynebacterium) hold sway and where follicle density and skin surface area are highest (Sebaceous) (head, neck, and chest) lipophilic Propionibacterium species dominate. Finally, various fungal (Aspergillus, Cryptococcus, Rhodotorula, Malassezia, and Epicoccum) species can be found in the feet [86]. Numerous therapeutic approaches, including endolysins, bacteriocins (Nisin Z, Lacticin 3147), small molecule inhibitors (2-aminoimidazole), bacteriophages, and nanoparticles or combinations thereof, can be used to prevent SA biofilm formation [80,88].…”

“…However, these interactions can be perturbed by environmental conditions (skin infection or trauma), providing opportunities for other species, such as SA, that are adept at prioritizing overgrowth and biofilm formations [86,87], leading to prolonged barrier and immunological dysfunction. Of the many SA strains residing on the skin, the clonal complex 1 (CC1) takes precedence during severe AD, whereas CC30 is prominent on the skin of asymptomatic AD individuals.…”

An Altered Skin and Gut Microbiota Are Involved in the Modulation of Itch in Atopic Dermatitis

“…Looking at the great role of microbiota on AD, we can hypothesize that microbiota-based therapies are needed to restore a healthy skin and gut microbiota in AD patients. Some therapies include probiotics treatment, repopulating AD lesions with beneficial commensals, phage therapies, small molecules and peptides that counteract S. aureus colonization, humanized monoclonal antibodies that target bacterial toxins, quorum sensing inhibitors that block virulence factors, bacteriotherapy, and the excimer light treatment [ 91 , 92 , 93 , 94 ].…”

From gut to skin: exploring the potential of natural products targeting microorganisms for atopic dermatitis treatment

“…[14][15][16][17] To address the impact of microbiota dysbiosis on AD development, therapeutic strategies targeting skin and gut microbiota have been emphasized and applied. 18,19 However, the population structure of microorganisms is shaped substantially by their living environment. 20 It can be challenging to ensure consistent quality across the products generated by microorganisms.…”