Abstract
The microbiome plays an important role in a wide variety of skin disorders. Not only is the skin microbiome altered, but also surprisingly many skin diseases are accompanied by an altered gut microbiome. The microbiome is a key regulator for the immune system, as it aims to maintain homeostasis by communicating with tissues and organs in a bidirectional manner. Hence, dysbiosis in the skin and/or gut microbiome is associated with an altered immune response, promoting the development of skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris, dandruff, and even skin cancer. Here, we focus on the associations between the microbiome, diet, metabolites, and immune responses in skin pathologies. This review describes an exhaustive list of common skin conditions with associated dysbiosis in the skin microbiome as well as the current body of evidence on gut microbiome dysbiosis, dietary links, and their interplay with skin conditions. An enhanced understanding of the local skin and gut microbiome including the underlying mechanisms is necessary to shed light on the microbial involvement in human skin diseases and to develop new therapeutic approaches.
Highlights
The mechanism of the Western diet, or high-fat diet (HFD) relies on the resulting intestinal dysbiosis, leading to an increase in the ratio of Firmicutes to Bacteroidetes. The mechanism for this phenomenon is outlined by Guo et al, who found that, in mice, HFD leads to a decreased release of antimicrobial peptides (AMPs) in the small intestine, which is followed by changes in the composition of the gut microbiota and subsequent alterations in serological inflammatory cytokine levels [56]
A population-based cohort study with 50,000 Danish rosacea patients could identify a higher prevalence of celiac disease, Crohn’s disease (CD), ulcerative colitis (UC), Helicobacter pylori infection (HPI), small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS) among the rosacea subjects compared to the control subjects [274,275]
The skin diseases as discussed in this manuscript result from a complex interaction between genetic susceptibility, lifestyle, and the immune system
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. About 60 tons of food is estimated to pass through the gut in a lifetime, all of which have a big impact on human health [3] Both the gut and skin are immensely immersed with microbiota as it is estimated that the skin has about 1012 microbial cells while the gut accounts for 1014 microbial cells [4,5]. The microbiome refers to the genomes present in a certain environment, meaning the accumulation of all their genetic material (i.e., DNA and RNA). Both organs are characterized by a low microbial diversity at the phylum level but high diversity at the species level [6]. A summary of recent findings in the skin and gut microbiome in multiple skin disorders is given in this review, highlighting some potential mechanisms underlying the gut–skin axis
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