Castillo C R, Alishahedani M E, Gough P, Chaudhary P P, Yadav M, Matriz J, Myles I A
Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA.
Skin Health Dis. 2021 Sep;1(3). doi: 10.1002/ski2.41. Epub 2021 May 7.
While patients and families struggling with atopic dermatitis (AD) have documented concerns for a contributory role of skin care products in AD pathology, nearly all the skin microbiome studies to date have asked participants to avoid topical products (such as soaps or select medications) for the preceding days to weeks prior to sample collection. Thus, given the established role of the microbiome in AD, the interactions between topical exposures, dysbiosis and AD remains underrepresented in the academic literature.
To address this knowledge gap, we expanded our previous evaluations to test the toxicological effects of a broader range of common chemicals, AD treatment lotions, creams and ointments using both health- and AD-associated strains of and spp.
Use of in vitro culture techniques and mouse models were deployed to identify chemicals with dysbiotic or pre-biotic potential. A proof-of-concept study was subsequently performed in healthy volunteers to assess global microbiome shifts after exposure to select chemicals using dermatologic patch testing.
Numerous chemicals possessed antibiotic properties, including many not marketed as anti-microbials. Through targeted combination of potentially beneficial chemicals, we identified combinations which promoted the growth of health-associated isolates over disease-associated strains in bacterial culture and enhanced microbe-specific outcomes in an established mouse model of AD; the most promising of which was the combination of citral and colophonium (often sold as lemon myrtle oil and pine tar). Additional studies would likely further optimize the combination of ingredients use. Similar results were seen in the proof-of-concept human studies.
Our results could offer a systematic, multiplex approach to identify which products carry dysbiotic potential and thus may guide formulation of new topicals to benefit patients with AD.
虽然患有特应性皮炎（AD）的患者及其家属已记录了对护肤品在AD病理中所起作用的担忧，但迄今为止，几乎所有的皮肤微生物组研究都要求参与者在样本采集前的数天至数周内避免使用局部产品（如肥皂或某些药物）。因此，鉴于微生物组在AD中的既定作用，局部暴露、生态失调与AD之间的相互作用在学术文献中仍未得到充分体现。
为填补这一知识空白，我们扩展了之前的评估，以测试更广泛的常见化学品、AD治疗乳液、乳膏和软膏对健康相关和AD相关的 菌和 菌菌株的毒理学影响。
采用体外培养技术和小鼠模型来识别具有生态失调或益生元潜力的化学品。随后在健康志愿者中进行了一项概念验证研究，以通过皮肤贴片试验评估接触选定化学品后全球微生物组的变化。
许多化学品具有抗生素特性，包括许多并非作为抗菌剂销售的化学品。通过有针对性地组合潜在有益化学品，我们确定了在细菌培养中能促进健康相关分离株相对于疾病相关菌株生长，并在既定的AD小鼠模型中增强微生物特异性结果的组合；其中最有前景的是柠檬醛和松香（通常作为柠檬桉油和松焦油出售）的组合。进一步的研究可能会进一步优化成分组合的使用。在概念验证人体研究中也观察到了类似结果。
我们的结果可能提供一种系统的、多重的方法来识别哪些产品具有生态失调潜力，从而可能指导新型局部用药的配方，使AD患者受益。
