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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.
Highlights
Atopic dermatitis (AD) is a chronic, relapsing and pruritic inflammatory skin disease, with a prevalence of 10–20% in children worldwide (Weidinger and Novak, 2016)
AD patients were recruited from the Department of Dermatology, Beijing Children’s Hospital of Capital Medical University with the following inclusion criteria for study subjects: (I) between 2 and 12 years old; (II) clear clinical manifestations of AD according to Williams criteria (Williams, 2005); and (III) moderate and severe AD patients were selected when their scoring atopic dermatitis index (SCORAD) exceeded 25 (Taieb and Stalde, 1993)
healthy children (HC) were selected from those who passed physical examinations of Beijing Children’s Hospital of Capital Medical University with the following standards: (I) between 2 and12 years old; and (II) no allergic history. Both AD patients and HC were excluded from the study if: (I) they had been exposed to bleach bath, corticosteroid, antibiotic, probiotic, or proton pump inhibitor within 4 weeks before skin sample collection; (II) known hereditary disease; (III) known metabolic or autoimmune disease
Summary
Atopic dermatitis (AD) is a chronic, relapsing and pruritic inflammatory skin disease, with a prevalence of 10–20% in children worldwide (Weidinger and Novak, 2016). 60% develop AD before 1 year old (Illi et al, 2004), and flare-ups occur in 85% within the first 5 years of life (Sampson, 1999). There is a clear genetic predisposition to Characteristics of Skin Microbiota in AD Patients disease (Wollenberg et al, 2018), AD flare-ups have been associated with environmental factors, including allergen exposure, skin barrier defects, cutaneous and intestinal microbiota characteristics, as well as seasonal rhythms (Hulshof et al, 2017). One possibility is that immune imbalances leading to AD are mediated by a changing human microbiota, which is especially important during the early years of life (Blaser, 2017). Atopic dermatitis (AD) is a common cutaneous disease, associated with imbalances in the skin microbiota
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