Horev Amir, Brandwein Michael, Vaknin Avraham, Motro Yair, Moran-Gilad Jacob
Pediatric Dermatology Service, Soroka University Medical Center, Yitzhak Rager Ave., P.O. Box 151, Beer Sheva 8410101, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410101, Israel.
J Clin Med. 2023 Oct 10;12(20):6435. doi: 10.3390/jcm12206435.
Epidermolysis bullosa (EB) is a group of rare hereditary skin disorders characterized by the formation of painful blisters, erosions, and ulcers. In addition, the wounds can easily become infected with different pathogens. Therefore, the dynamics in the microbial populations across the various stages of EB can shed light on pathophysiology, the effect of treatment, and the factors involved in its recovery, but they are understudied. We thus sought to characterize the skin microbiome among patients with EB over time.
A prospective study conducted in the pediatric dermatology clinic at Soroka Medical Center, Beer-Sheva, Israel. Children (0-18) with simplex and recessive dystrophic EB were sampled at two different time points: before a therapeutic regimen and 90 days (±14 days) later. Samples were obtained from lesional skin (wound), healthy, non-lesional skin, and seborrheic skin (forehead). Samples were subject to 16S amplicon sequencing. Analyses performed included comparisons of relative abundance at the phyla and genera taxonomic levels, alpha and beta diversity comparisons, and differential abundance.
32 children with EB were enrolled, for whom 192 skin microbiome samples were obtained. Lesional skin samples harbored significantly less and before the initiation of treatment. Following topical dressing, we observed more and less in lesional skin samples than healthy and seborrheic skin samples. In addition, was significantly more abundant in lesional samples than in non-lesional and seborrheic samples following treatment.
Our study recaptured the reduced bacterial diversity and increased staphylococcal carriage in EB patients, showing a potential effect of topical dressing either directly on the wound microbiome or indirectly through the contribution towards skin healing. The detection of in general, and specifically, commensurate with the application of a wound dressing may warrant the use of additional treatment methods to facilitate wound healing. Future studies in these patients should prospectively correlate the temporal changes in the microbiome associated with various treatment modalities in order to optimize the care of EB patients.
大疱性表皮松解症（EB）是一组罕见的遗传性皮肤病，其特征是形成疼痛性水疱、糜烂和溃疡。此外，伤口很容易感染不同的病原体。因此，EB不同阶段微生物群落的动态变化可以揭示其病理生理学、治疗效果以及恢复过程中涉及的因素，但目前对此研究不足。因此，我们试图随时间推移对EB患者的皮肤微生物群进行特征描述。
在以色列贝尔谢巴索罗卡医疗中心的儿科皮肤科诊所进行了一项前瞻性研究。对患有单纯型和隐性营养不良型EB的儿童（0 - 18岁）在两个不同时间点进行采样：治疗方案开始前和90天（±14天）后。样本取自病变皮肤（伤口）、健康的非病变皮肤和脂溢性皮肤（前额）。样本进行16S扩增子测序。进行的分析包括在门和属分类水平上的相对丰度比较、α和β多样性比较以及差异丰度分析。
招募了32名EB患儿，共获得192份皮肤微生物群样本。在治疗开始前，病变皮肤样本中的[具体细菌名称1]和[具体细菌名称2]明显较少。局部换药后，我们观察到病变皮肤样本中的[具体细菌名称1]比健康和脂溢性皮肤样本更多，而[具体细菌名称2]更少。此外，治疗后病变样本中的[具体细菌名称3]比非病变和脂溢性样本中的明显更丰富。
我们的研究重现了EB患者细菌多样性降低和葡萄球菌携带增加的情况，表明局部换药可能直接对伤口微生物群产生影响，或通过对皮肤愈合的促进作用间接产生影响。一般情况下[具体细菌名称4]的检测，特别是[具体细菌名称5]的检测，与伤口敷料的应用相关，这可能需要使用额外的治疗方法来促进伤口愈合。未来对这些患者的研究应前瞻性地关联微生物群随时间的变化与各种治疗方式，以优化EB患者的护理。
