Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.
Clin Exp Dermatol. 2021 Oct;46(7):1223-1229. doi: 10.1111/ced.14592. Epub 2021 Jul 23.
The human microbiome project addresses the relationship between bacterial flora and the human host, in both healthy and diseased conditions. The skin is an ecosystem with multiple niches, each featuring unique physiological conditions and thus hosting different bacterial populations. The skin microbiome has been implicated in the pathogenesis of many dermatoses. Given the role of dysbiosis in the pathogenesis of inflammation, which is prominent in dystrophic epidermolysis bullosa (DEB), we undertook a study on the skin microbiome.
To characterize the skin microbiome in a series of patients with DEB.
This was a case-control study of eight patients with DEB and nine control cases enrolled between June 2017 and November 2018. The skin of patients with DEB was sampled at three different sites: untreated wound, perilesional skin and normal-appearing (uninvolved) skin. Normal skin on the forearm was sampled from age-matched healthy controls (HCs). We used a dedicated DNA extraction protocol to isolate microbial DNA, which was then analysed using next-generation microbial 16S rRNA sequencing. Data were analysed using a series of advanced bioinformatics tools.
The wounds, perilesional and uninvolved skin of patients with DEB demonstrated reduced bacterial diversity compared with HCs, with the flora in DEB wounds being the least diverse. We found an increased prevalence of staphylococci species in the lesional and perilesional skin of patients with DEB, compared with their uninvolved, intact skin. Similarly, the uninvolved skin of patients with DEB displayed increased staphylococcal content and significantly different microbiome diversities (other than staphylococci) compared with HC skin.
These findings suggest the existence of a unique DEB-associated skin microbiome signature, which could be targeted by specific pathogen-directed therapies. Moreover, altering the skin microbiome with increasing colonization of bacteria associated with nonchronic wounds may potentially facilitate wound healing in patients with DEB.
人类微生物组计划旨在研究细菌菌群与健康和患病状态下的人体宿主之间的关系。皮肤是一个具有多个小生境的生态系统，每个小生境都具有独特的生理条件，因此栖息着不同的细菌种群。皮肤微生物组与许多皮肤病的发病机制有关。鉴于菌群失调在炎症发病机制中的作用，而炎症在营养不良性大疱性表皮松解症（DEB）中尤为突出，我们对皮肤微生物组进行了研究。
描述一系列 DEB 患者的皮肤微生物组。
这是一项病例对照研究，纳入了 2017 年 6 月至 2018 年 11 月期间的 8 例 DEB 患者和 9 例对照病例。从 DEB 患者的三个不同部位采集皮肤样本：未治疗的伤口、皮损周围皮肤和正常外观（未受累）皮肤。从年龄匹配的健康对照者（HCs）前臂采集正常皮肤。我们使用专门的 DNA 提取方案分离微生物 DNA，然后使用下一代微生物 16S rRNA 测序进行分析。使用一系列先进的生物信息学工具分析数据。
与 HCs 相比，DEB 患者的伤口、皮损周围和未受累皮肤的细菌多样性降低，DEB 伤口的菌群多样性最低。与未受累的完整皮肤相比，我们发现 DEB 患者皮损和皮损周围皮肤中葡萄球菌属的比例增加。同样，DEB 患者的未受累皮肤的葡萄球菌含量增加，微生物组多样性（除葡萄球菌属外）显著不同，与 HC 皮肤相比。
这些发现表明存在独特的 DEB 相关皮肤微生物组特征，可通过针对特定病原体的治疗方法进行靶向治疗。此外，通过增加与非慢性伤口相关的细菌定植来改变皮肤微生物组，可能有助于 DEB 患者的伤口愈合。
