Evidence that Human Skin Microbiome Dysbiosis Promotes Atopic Dermatitis

Abstract

Patients with atopic dermatitis are frequently colonized by Staphylococcus aureus. If S. aureus is present, then the subject tends to have more severe disease. However, it is unclear if S. aureus is a cause of atopic dermatitis or a consequence of the abnormal epithelial environment. In this issue of the Journal of Investigative Dermatology, Meylan et al. present evidence from a prospective clinical trial that shows that S. aureus colonization precedes onset of atopic dermatitis in children. These observations suggest that S. aureus may cause atopic dermatitis in some individuals.

Figure 1. Cells that participate in skin health and disruption during atopic dermatitis

Interactions among the skin microbiome (bacteria, fungi, and viruses), resident cells in the skin (keratinocytes, fibroblasts, adipocytes, neural elements, and vasculature), and bone marrow-derived cells of the immune system (dendritic cells, lymphocytes, are granulocytes) are essential for homeostasis in healthy skin. Each box denotes some of the responsible molecules and functions for each of these three cellular systems. In atopic dermatitis, molecular or cellular defects in these systems are associated with disease (indicated in red). Disease may manifest from individual or a combination of defective functions. S. aureus, Staphylococcus aureus.