Department of Pediatrics, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Pediatrics, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Immunobiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Ann Allergy Asthma Immunol. 2020 Dec;125(6):628-638. doi: 10.1016/j.anai.2020.08.025. Epub 2020 Aug 25.
To discuss the skin microbiome modulates immunity by interactions between skin immunology with keratinocytes to combat pathogens. Allergic disorders are classified by immunoglobulin E sensitivity and aberrant T2 cell responses, and an increasing number of studies have described the associations with skin microbiome fluctuations. In this review, we discuss commensal-epidermal homeostasis and its influence on allergic disease.
All included references were obtained from the PubMed database.
Studies addressing relevant aspects of commensal-epidermal homeostasis, skin microbiome dysbiosis, microbiome-targeted therapeutics, and prevention in allergy were included.
Homeostasis between the commensal microbiome and the epidermis is important in protecting against allergic disease. Commensals promote antiallergic T1 and T17 immunophenotypes within the skin and induce keratinocytes to secrete antimicrobial peptides and alarmins that enhance barrier function and antagonize proallergic organisms. Perturbations in this homeostasis, however, is associated with allergic disease development. Atopic dermatitis is associated with decreases in skin commensals and increases in the pathogen, Staphylococcus aureus. Fluctuations in the skin microbiome contributes to decreased barrier dysfunction, allergic sensitization, and T2 cytokine secretion. Little is known about how the skin microbiome affects food allergy, allergic rhinitis, and asthma, and it is poorly understood how cutaneous inflammation influences systemic allergic responses. Therapies are targeted toward maintenance of the skin barrier, replacement of healthy commensals, and anti-T2 biologic therapy.
Although the effects of commensal-epidermal homeostasis on allergy within the skin are becoming increasingly clear, future studies are necessary to assess its effects on extracutaneous allergic disorders and explore potential therapeutics targeting the skin microbiome.
讨论皮肤微生物组通过皮肤免疫学与角质形成细胞相互作用来调节免疫，以对抗病原体。过敏疾病分为免疫球蛋白 E 敏感性和异常 T2 细胞反应，越来越多的研究描述了与皮肤微生物组波动的关联。在这篇综述中，我们讨论共生表皮稳态及其对过敏疾病的影响。
所有纳入的参考文献均来自 PubMed 数据库。
纳入了涉及共生表皮稳态、皮肤微生物组失调、微生物组靶向治疗以及过敏预防相关方面的研究。
共生微生物组与表皮之间的稳态对于预防过敏疾病很重要。共生体促进皮肤内抗过敏 T1 和 T17 免疫表型，并诱导角质形成细胞分泌抗菌肽和警报素，增强屏障功能并拮抗促过敏生物。然而，这种稳态的破坏与过敏疾病的发展有关。特应性皮炎与皮肤共生体减少和病原体金黄色葡萄球菌增加有关。皮肤微生物组的波动导致屏障功能下降、过敏致敏和 T2 细胞因子分泌增加。关于皮肤微生物组如何影响食物过敏、过敏性鼻炎和哮喘知之甚少，也不清楚皮肤炎症如何影响全身过敏反应。治疗方法旨在维持皮肤屏障、替代健康共生体和抗 T2 生物治疗。
尽管共生表皮稳态对皮肤过敏的影响越来越清楚，但仍需要进一步研究评估其对皮肤外过敏疾病的影响，并探索针对皮肤微生物组的潜在治疗方法。
