Studies show the pathogenic bacteria Staphylococcus aureus is associated with eczema in 90% of patients.
Our skin is the outermost barrier that divides us from the external environment and protects us from pathogenic foreign invaders. This barrier contains an ecosystem composed of over a trillion microorganisms (bacteria, fungi, mites, and viruses), most of which are completely harmless and many of them protect us and keep us healthy. However, sometimes pathogenic bacteria can take hold and drive disease states.
Recent developments in sequencing technology have provided new insights into the structure and function of skin microbial communities. And according to some of the latest research, pathogenic Staphylococcus aureus is the driving force behind a chronic state of dysbiosis in 9 out of 10 eczema patients.
In addition, this dysbiosis includes a decrease in diversity at the phylum level, as observed in atopic dermatitis. This one-two punch of having too many ‘attackers’ (S. aureus) and too few commensal ‘defenders’ (S. epidermidis, R mucosa, S hominis) creates a chronic cycle of inflammation.
To better understand this chronic state of dysbiosis, we have compiled a list of the latest research published by top scientists in the field.
First, here is some foundational research on the skin microbiome that will link you to the full articles. We have summarized the findings. Please click on the title links to go to that published article.
What is the skin microbiome?
(2011) The skin microbiome
Dr. Elizabeth and Dr Julie Segre are experts on the skin microbiome. In this article, they share the topographical distribution of bacteria on different skin sites, showing the skin is home to a vast array of microbial ecosystems.
Grice EA, Segre JA. The skin microbiome [published correction appears in Nat Rev Microbiol. 2011 Aug;9(8):626]. Nat Rev Microbiol. 2011;9(4):244-253.
(2022) The Skin Microbiota: Balancing Risk and Reward
Flowers L, Grice EA. The Skin Microbiota: Balancing Risk and Reward. Cell Host Microbe. 2020;28(2):1920-200. doi:10.1016/j.chom.2020.06.017
Pathogenic skin microbiota: Staphylococcus aureus
Next, here is the leading research on Staphylococcus aureus and eczema.
(2017) Skin Colonization by Staphylococcus aureus Precedes the Clinical Diagnosis of Atopic Dermatitis in Infancy
Meylan P, Lang C, Mermoud S, et al. Skin Colonization by Staphylococcus aureus Precedes the Clinical Diagnosis of Atopic Dermatitis in Infancy. J Invest Dermatol. 2017;137(12):2497-2504. doi:10.1016/j.jid.2017.07.834
(2017) Staphylococcus aureus density on lesional and nonlesional skin is strongly associated with disease severity in atopic dermatitis
Tauber M, Balica S, Hsu CY, et al. Staphylococcus aureus density on lesional and nonlesional skin is strongly assosiated with disease severity in atopic dermatitis.
J Allergy Clin Immunol. 2016;137(4):1272-1274.e3.
(2017) Evidence that Human Skin Microbiome Dysbiosis Promotes Atopic Dermatitis
Williams MR, Gallo RL. Evidence that Human Slin Microbiome Dysbiosis Promotes Atopic Dermatitis. J Invest Dermatol.2017;137(12):2460-2461.
(2017) Staphylococcus aureus: Master Manipulator of the Skin
Williams MR, Nakatsuji T, Gallo RL. Staphylococcus aureus: Master Manipulator of the Skin. Cell Host Microbe. 2017;22(5):579-581. doi:10.1016/j.chom.2017.10.015
(2013) Staphylococcus δ-toxin induces allergic skin disease by activating mast cells
Nakamura Y., Oscherwith L., Cease, K. et al. Staphylococcus δ-toxin induces allergic skin disease by activating mast cells. Nature 503, 397-401 (2013). https://doi.org/10.1038/nature12655
(2022) Controlling skin microbiome as a new bacteriotherapy for inflammatory skin diseases
Colonization with specific skin commensals provides beneficial responses.
Ito, Y., Amagai, M. Controlling skin microbiome as a new bacteriotherapy for inflammatory skin diseases. Inflamm Regener 42, 26 (2022).
According to some of the latest science, Staph aureus bacterial overgrowth is the driving force behind a chronic state of dysbiosis in 9 out of 10 eczema patients. For this reason, top scientists Dr. Richard Gallo from UC San Diego and Dr Ian Myles from the NIH are working on transplants as the possible future of eczema therapy.
You can read more about the potential for eczema treatment transplants here and here.
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