The Intestinal and Skin Microbiome in Patients with Atopic Dermatitis and Their Influence on the Course of the Disease: A Literature Review

Abstract

Bacteria inhabiting the digestive tract are responsible for our health. The microbiome is essential for the development of the immune system and homeostasis of the body. Maintaining homeostasis is very important, but also extremely complicated. The gut microbiome is related to the skin microbiome. It can therefore be assumed that changes in the microbes inhabiting the skin are greatly influenced by the bacteria living in the intestines. Changes in the composition and function of microbes (dysbiosis in the skin and intestines) have recently been linked to changes in the immune response and the development of skin diseases, including atopic dermatitis (AD). This review was compiled by collaborating Dermatologists specializing in atopic dermatitis and psoriasis. A comprehensive review of the current literature was performed using PubMed and limited to relevant case reports and original papers on the skin microbiome in atopic dermatitis. The inclusion criterion was that the paper was published in a peer-reviewed journal in the last 10 years (2012–2022). No limitations on the language of the publication or the type of study were made. It has been shown that any rapid changes in the composition of the microflora may be associated with the appearance of clinical signs and symptoms of the disease. Various studies have proven that the microbiome of many systems (including the intestines) may have a significant impact on the development of the inflammatory process within the skin in the course of AD. It has been shown that an early interaction between the microbiome and immune system may result in a noticeable delay in the onset of atopic diseases. It seems to be of high importance for physicians to understand the role of the microbiome in AD, not only from the pathophysiological standpoint but also in terms of the complex treatment that is required. Perhaps young children diagnosed with AD present specific characteristics of the intestinal microflora. This might be related to the early introduction of antibiotics and dietary manipulations in breastfeeding mothers in the early childhood of AD patients. It is most likely related to the abuse of antibiotics from the first days of life.

A Multifaced Approach on Psoriasis Pathogenesis

“…All these actions are mediated through different mechanisms, including specific G protein coupled receptor family (GPCR) and epigenetic effects [78][79][80][81]. Disruptions in gut microbiome balance and the further, activation of T-cells via interactions with pa ern recognition receptors and Toll-like receptors triggers an inflammatory process and induces autoimmune conditions such as rheumatoid arthritis [82], inflammatory bowel disease [83], systemic lupus erythematosus [84], multiple sclerosis [85], psoriasis [56,[65][66][67][68][69][70][71][72], as well as other skin alterations, such as atopic dermatitis [86] and vitiligo [87].…”

The Role of the Microbiota in the Pathogenesis and Treatment of Atopic Dermatitis—A Literature Review

“…Therefore, it is recommended to promote the development of the physiological intestinal flora from childhood through min. breastfeeding, the use of probiotics with the aim of preventing the development of atopy [ 67 , 68 , 69 ]. In AD patients, there is a significant depletion of the intestinal microbiota, ex.…”

“…In AD patients, there is a significant depletion of the intestinal microbiota, ex. Lactobacillus and Bifidobacterium , with a concomitant overrepresentation of Escherichia coli and Clostridium difficile and, importantly, as in the case of the skin microbiota, an abundant occurrence of S. aureus [ 68 , 69 , 70 ]. The mycobiota, the fungal part of the microbiota, is also altered in atopy: there is a reduced occurrence of Malassezia with Saccharomycetales , Rhodotorula , and Candida increase [ 71 , 72 , 73 ].…”

“…breastfeeding, the use of probiotics with the aim of preventing the development of atopy [67][68][69]. In AD patients, there is a significant depletion of the intestinal microbiota, ex.…”

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“…Disruption of the microbiome is associated with susceptibility to a range of diseases such as cancer, diabetes, allergy, obesity, and infection [3,4], and also in cancer, Alzheimer's disease [5], and inflammatory disease [6]. Other studies have suggested an association between the gut microbiome and the development of psoriasis [7], atopic dermatitis [8], hidradenitis suppurativa, acne, and rosacea [9]. Microbiota can also have an impact on ageing.…”