Distinct Skin Microbiota Imbalance and Responses to Clinical Treatment in Children With Atopic Dermatitis

Abstract

Background: Atopic dermatitis (AD) is a common cutaneous disease, associated with imbalances in the skin microbiota. Objective: To explore the characteristics of the cutaneous microbiota and its dynamic changes during clinical treatment. Methods: Cutaneous swab samples were collected from 51 AD patients before treatment, and 40 AD patients remained after a 2-week treatment with mometasone and mupirocin. Results: AD patients exhibited significant enrichments of Prevotella and Desulfovibrio as well as obvious reductions of Corynebacterium, Streptococcus and Parabacteroides. Based on the proportion of Staphylococcus aureus, the AD patients were further classified into S. aureus-predominant group (AD.S) and S. aureus-non-dominant (AD.ND) group. The AD.S group exhibited lower skin microbial diversity and higher atopic dermatitis (SCORAD) index. In the AD.S group, the cutaneous microbial diversity significantly increased from 2.9 ± 0.8 to 3.7 ± 1.0, while the relative abundance of S. aureus decreased from 42.5 ± 20.7 to 10.3 ± 28.4 after treatment. In contrast, no significant skin microbiota changes were detected in the AD.ND group. Conclusions: AD patients with predominant S. aureus had higher disease severity and lower microbiota diversity compared to patients in the AD.ND group. Mometasone and mupirocin therapy had significant effects on skin microbiota in AD.S patients, but had a paradoxical response in the AD.ND patients.

Comparison of the skin microbiota of patients with acne vulgaris and healthy controls

“…Enrichment of Lachnospiraceae and Clostridiales has been reported under ultraviolet-B radiation exposure (17), while Moraxellaceae have been found to contribute to mucosal inflammation (18). In a previous study, significant enrichment of Prevotella was observed in the skin microbiota in patients with atopic dermatitis (19). Zhang et al reported Lactococcus garvieae to be a potential pathogenic cause of skin ulceration syndrome outbreak (20).…”

Effect of treatments on skin microbiota in patients with atopic dermatitis: a protocol for systematic review

“…9 However, the impact of treatment on skin microbiota among patients with AD remained unclear and the results remained controversial across studies. [12][13][14][15] Therefore, it is warranted to summarise the available studies to understand the role of skin microbiota in the treatment and prognosis of AD. We will systematically review studies focusing on the effect of treatments on skin microbiota among patients with AD, including topical therapy, phototherapy, systemic treatment, etc.…”

“…For patients with AD with specific characters, the abovementioned changes were not observed in patients after treatment; such phenomena may be associated with low abundance of S. aureus in these patients. 15 Additionally, to the best of our knowledge, there is no systematic review to evaluate the effect of treatments on skin microbiota in patients with AD. It is, therefore, warranted to summarise the available studies for understanding the role of skin microbiota in the treatment and prognosis of AD.…”

Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics

“…Regarding WHO region, the majority of studies were conducted in the European Region (n = 50, 55%), followed by the Western Pacific Region (n = 21, 23%), the Region of the Americas (n = 16, 18%) and the African Region and the Eastern Mediterranean Region (both n = 1, 1%). Investigated characteristics included the following categories: skin barrier function (n = 15), [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] serum blood cell types and markers (n = 23), 9,18,23,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] serum Ig levels and sensitization (n = 15), 20,22,25,51,54-64 microbial colonization (n = 10), 15,[65][66][67][68][69][70][71][72][73] DNA mutations (n = 14), 10,51,…”