Kim Han Bi, Alexander Helen, Um Ji Young, Chung Bo Young, Park Chun Wook, Flohr Carsten, Kim Hye One
Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Dermatology & Population Health Science, St John's Institute of Dermatology, King's College London, London, United Kingdom.
Allergy Asthma Immunol Res. 2025 Mar;17(2):165-180. doi: 10.4168/aair.2025.17.2.165.
Atopic dermatitis (AD) is a chronic inflammatory skin disorder affecting both children and adults, characterized by pruritus, eczematous lesions, and compromised skin barrier function. A key feature of AD is dysbiosis of the skin microbiome, marked by reduced microbial diversity and the overgrowth of in lesional skin. exacerbates skin barrier dysfunction and immune dysregulation, leading to recurrent infections and disease flares. In contrast, commensal bacteria such as and may exert protective effects by inhibiting colonization and modulating immune responses. Beyond microbial composition, microbial metabolites play a crucial role in AD pathophysiology. Short-chain fatty acids, indole derivatives, and other bacterial metabolites influence cutaneous immune responses, lipid metabolism, and skin barrier integrity. Altered metabolite profiles, including reduced levels of beneficial microbial metabolites, are associated with AD severity and disease progression. Notably, overabundance correlates with disruption in lipid metabolism, further compromising the skin barrier. This review explores recent advances in understanding the relationship between microbial metabolites and AD pathogenesis and examines the therapeutic potential of microbiome-targeted interventions. Strategies such as probiotics, prebiotics, and topical microbiome transplantation aim to restore microbial diversity and rebalance metabolite production, ultimately improving clinical outcomes in AD patients. Future therapeutic approaches focusing on commensal-derived metabolites offer promising avenues for alleviating symptoms and modulating disease severity in AD.
特应性皮炎(AD)是一种影响儿童和成人的慢性炎症性皮肤病,其特征为瘙痒、湿疹样皮损以及皮肤屏障功能受损。AD的一个关键特征是皮肤微生物群失调,表现为病变皮肤中微生物多样性降低和某些菌过度生长。这会加剧皮肤屏障功能障碍和免疫失调,导致反复感染和疾病发作。相比之下,诸如[具体细菌名称1]和[具体细菌名称2]等共生细菌可能通过抑制[特定有害菌]定植和调节免疫反应发挥保护作用。除了微生物组成外,微生物代谢产物在AD病理生理学中也起着关键作用。短链脂肪酸、吲哚衍生物和其他细菌代谢产物会影响皮肤免疫反应、脂质代谢和皮肤屏障完整性。代谢产物谱的改变,包括有益微生物代谢产物水平降低,与AD严重程度和疾病进展相关。值得注意的是,[某种物质]过量与脂质代谢紊乱相关,进一步损害皮肤屏障。本综述探讨了在理解微生物代谢产物与AD发病机制之间关系方面的最新进展,并研究了针对微生物群的干预措施的治疗潜力。益生菌、益生元及局部微生物群移植等策略旨在恢复微生物多样性并重新平衡代谢产物生成,最终改善AD患者的临床结局。未来聚焦于共生菌衍生代谢产物的治疗方法为减轻AD症状和调节疾病严重程度提供了有前景的途径。