Epidermal lipid composition, barrier integrity and eczematous inflammation are associated with skin microbiome configuration.

Hansjörg Baurecht, Malte C Rühlemann, Elke Rodríguez, Frederieke Thielking, Inken Harder, Anna-Sophie Erkens, Dora Stölzl, Eva Ellinghaus, Melanie Hotze, Wolfgang Lieb, Sheng Wang, Femke-Anouska Heinsen, Andre Franke, Stephan Weidinger
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Journal of allergy and clinical immunology
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Genomic approaches have revealed characteristic site-specificities of skin bacterial community structures. In addition, in children with atopic dermatitis (AD), characteristic shifts were described at creases and in particular during flares, which have been postulated to mirror the disturbed skin barrier function and/or cutaneous inflammation.We sought to comprehensively analyse microbial configurations in AD across body sites, and to explore the impact of distinct abnormalities of epidermal barrier function.The skin microbiome was determined by bacterial 16S rRNA sequencing at 4 nonlesional body sites as well as acute and chronic lesions of 10 AD patients and 10 healthy controls matched for age, sex and FLG mutation status. Nonlesional sampling sites were characterized for skin physiology parameters including chromatography-based lipid profiling.Epidermal lipid composition, in particular levels of long-chain unsaturated free fatty acids, strongly correlated with bacterial composition, in particular Propionibacteria and Corynebacteria abundance. AD displayed a distinct community structure with increased abundance and altered composition of staphylococcal species across body sites with the strongest loss of diversity and increase of S. aureus seen on chronic lesions, and a progressive shift from nonlesional skin to acute and chronic lesions. FLG deficient skin showed a distinct microbiome composition partly resembling the AD-related pattern.Epidermal barrier integrity and function impact the skin microbiome composition. AD shows an altered microbial configuration across diverse body sites, which however is most pronounced at sites of predilection and atopic dermatitis. Eczematous affection appears to be a more important determinant than body site.