Microbioma cutáneo, disbiosis y su rol en dermatitis atópica

Palabras clave: dermatitis atópica, disbiosis, microbiota, eccema, staphylococcus

Resumen

El microbioma cutáneo está compuesto por una variedad extensa de microorganismos, este se ve modificado por diversos factores y es dinámico, ya que existen variaciones a lo largo de la vida. Los microorganismos y el huésped viven bajo una relación de simbiosis, en el momento que este sistema se rompe, se produce la disbiosis y esta tiene una influencia importante en la dermatitis atópica. Se reporta que existe un alta colonizacion de los pacientes enfermos por el Staphylococcus aureus y esto concuerda con la mayoría de los estudios donde se determina el microbioma de piel lesional y no lesional de pacientes con dermatitis atópica. Otros factores como las mutaciones en la proteína filagrina aumentan la susceptibilidad de colonización por S.aureus.  Por otro lado, también se han encontrado agentes microbianos con capacidades inhibitorias sobre los microorganismos patógenos y se les ha atribuido un rol protector; este hallazgo motivó a algunos autores a utilizarlos como tratamientos alternativos e inclusive en uso combinado con terapia tópica como los emolientes. Adicionalmente, se reporta el restablecimiento de la microbiota con tratamientos convencionales como los humectantes, corticoesteroides, inhibidores de calcineurina y fototerapia. Múltiples estrategias se han estudiado con el fin de restablecer la biodiversidad cutánea en un intento de buscar tratamientos eficaces que actúan sobre la modificación de los procesos de disbiosis asociados con esta enfermedad.

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Biografía del autor/a

Dra. Daniela Ruiz Guzmán, Hospital México, San José, Costa Rica

Médico especialista en Dermatología y Pediatría. cod. MED9468 . Correo: drskincr@gmail.com

Dr. Daniel Esteban Barquero Orias, Investigador independiente, San José, Costa Rica

Médico general, graduado de la Universidad de Ciencias Médicas (UCIMED), Investigadora independiente.
cod. MED16047 . Correo: daniel.barquero95@hotmail.com

Citas

Musthaq S, Mazuy A, Jakus J. The microbiome in dermatology. Clinics in Dermatology. 2018 05;36(3):390-398. https://doi.org/10.1016/j.clindermatol.2018.03.012

Powers CE, McShane DB, Gilligan PH, Burkhart CN, Morrell DS. Microbiome and pediatric atopic dermatitis. The Journal of Dermatology. 2015 09 21;42(12):1137-1142. https://doi.org/10.1111/1346-8138.13072

Yamazaki Y, Nakamura Y, Núñez G. Role of the microbiota in skin immunity and atopic dermatitis. Allergology International. 2017 Oct;66(4):539-544. https://doi.org/10.1016/j.alit.2017.08.004

Stefanovic N, Flohr C, Irvine AD. The exposome in atopic dermatitis. Allergy. 2019 08 19;. https://doi.org/10.1111/all.13946

Thomas C, Fernández-Peñas P. The microbiome and atopic eczema: More than skin deep. Australasian Journal of Dermatology. 2016;58(1):18-24. https://doi.org/10.1111/ajd.12435

Kong HH, Segre JA. The Molecular Revolution in Cutaneous Biology: Investigating the Skin Microbiome. Journal of Investigative Dermatology. 2017 05;137(5):e119-e122. https://doi.org/10.1016/j.jid.2016.07.045

Schoch J, Monir R, Satcher K, Harris J, Triplett E, Neu J. The infantile cutaneous microbiome: A review. Pediatric Dermatology. 2019;36(5):574-580. https://doi.org/10.1111/pde.13870

Lynde C, Andriessen A, Bertucci V, McCuaig C, Skotnicki S, Weinstein M et al. The Skin Microbiome in Atopic Dermatitis and Its Relationship to Emollients. Journal of Cutaneous Medicine and Surgery. 2015;20(1):21-28.

https://doi.org/10.1177/1203475415605498

Lee S, Lee E, Park Y, Hong S. Microbiome in the Gut-Skin Axis in Atopic Dermatitis. Allergy, Asthma & Immunology Research. 2018;10(4):354. https://doi.org/10.4168/aair.2018.10.4.354

Nakatsuji T, Gallo RL. The role of the skin microbiome in atopic dermatitis. Annals of Allergy, Asthma & Immunology. 2019 03;122(3):263-269. https://doi.org/10.1016/j.anai.2018.12.003

Olesen CM, Clausen M, Andersen PS, Agner T. The Skin Microbiome in Atopic Dermatitis—a Potential Treatment Target?. Current Dermatology Reports. 2018 Nov 08;7(4):199-208. https://doi.org/10.1007/s13671-018-0245-6

Stalder J, Fluhr J, Foster T, Glatz M, Proksch E. The emerging role of skin microbiome in atopic dermatitis and its clinical implication. Journal of Dermatological Treatment. 2018;30(4):357-364. https://doi.org/10.1080/09546634.2018.1516030

Kim J, Kim H. Microbiome of the Skin and Gut in Atopic Dermatitis (AD): Understanding the Pathophysiology and Finding Novel Management Strategies. Journal of Clinical Medicine. 2019;8(4):444. https://doi.org/10.3390/jcm8040444.

Paller AS, Kong HH, Seed P, Naik S, Scharschmidt TC, Gallo RL, Luger T, Irvine AD. The microbiome in patients with atopic dermatitis. Journal of Allergy and Clinical Immunology. 2019 01;143(1):26-35. https://doi.org/10.1016/j.jaci.2018.11.015

Dou J, Zeng J, Wu K, Tan W, Gao L, Lu J. Microbiosis in pathogenesis and intervention of atopic dermatitis. International Immunopharmacology. 2019;69:263-269. https://doi.org/10.1016/j.intimp.2019.01.030

Byrd AL, Belkaid Y, Segre JA. The human skin microbiome. Nature Reviews Microbiology. 2018 01 15;16(3):143-155. https://doi.org/10.1038/nrmicro.2017.157

Weyrich L, Dixit S, Farrer A, Cooper A, Cooper A. The skin microbiome: Associations between altered microbial communities and disease. Australasian Journal of Dermatology. 2015;56(4):268-274. https://doi.org/10.1111/ajd.12253

Odell ID, Flavell RA. Microbiome: Ecology of eczema. Nature Microbiology. 2016 08 26;1(9). https://doi.org/10.1038/nmicrobiol.2016.135

Shi B, Bangayan N, Curd E, Taylor P, Gallo R, Leung D et al. The Skin Microbiome Differs with Age in Atopic Dermatitis. Journal of Allergy and Clinical Immunology. 2016;137(2):AB407. https://doi.org/10.1016/j.jaci.2015.12.1263

Totté J, Pardo L, Fieten K, Vos M, Broek T, Schuren F, Pasmans S. Nasal and skin microbiomes are associated with disease severity in paediatric atopic dermatitis. British Journal of Dermatology. 2019 07 11;181(4):796-804. https://doi.org/10.1111/bjd.17755

Hsiong David C. Healthy Caregivers and Atopic Dermatitis Patients Share Similar Skin Microbiome. Journal of Allergy and Clinical Immunology. 2018;141(2):AB402. https://doi.org/10.1016/j.jaci.2017.12.946

Choi M, Seo IC, Kim DH, Choi J, Park JM, Oh JW. Microbiome Profile of Psoriasis and Atopic Dermatitis Using Transcriptome Analysis. Journal of Allergy and Clinical Immunology. 2019 02;143(2):AB434. https://doi.org/10.1016/j.jaci.2018.12.982

Iwatsuki K, Yamasaki O, Morizane S. Microbiome, Dysbiosis, and Atopic Dermatitis. Evolution of Atopic Dermatitis in the 21st Century. 2017;:141-155. https://doi.org/10.1007/978-981-10-5541-6_12

Wollina U. Microbiome in atopic dermatitis. Clinical, Cosmetic and Investigational Dermatology. 2017;Volume 10:51-56. https://doi.org/10.2147/CCID.S130013

D'Auria E, Banderali G, Barberi S, Gualandri L, Pietra B, Riva E et al. Atopic dermatitis: recent insight on pathogenesis and novel therapeutic target. Asian Pacific Journal of Allergy and Immunology. 2016;34(2):98-108.

Williams MR, Gallo RL. The Role of the Skin Microbiome in Atopic Dermatitis. Current Allergy and Asthma Reports. 2015 09 24;15(11). https://doi.org/10.1007/s11882-015-0567-4

Altunbulakli C, Reiger M, Neumann A, Garzorz-Stark N, Fleming M, Huelpuesch C et al. Relations between epidermal barrier dysregulation and Staphylococcus species-dominated microbiome dysbiosis in patients with atopic dermatitis. Journal of Allergy and Clinical Immunology. 2018;142(5):1643-1647.e12.https://doi.org/10.1016/j.jaci.2018.07.005

Brunner PM, Leung DY, Guttman-Yassky E. Immunologic, microbial, and epithelial interactions in atopic dermatitis. Annals of Allergy, Asthma & Immunology. 2018 01;120(1):34 41. https://doi.org/10.1016/j.anai.2017.09.055

Seite S, Bieber T. Barrier function and microbiotic dysbiosis in atopic dermatitis. Clinical, Cosmetic and Investigational Dermatology. 2015;:479. https://doi.org/10.2147/CCID.S91521

Clausen M, Agner T, Lilje B, Edslev SM, Johannesen TB, Andersen PS. Association of Disease Severity With Skin Microbiome and Filaggrin Gene Mutations in Adult Atopic Dermatitis. JAMA Dermatology. 2018 03 01;154(3):293. https://doi.org/10.1001/jamadermatol.2017.5440

Williams M, Gallo R. Evidence that Human Skin Microbiome Dysbiosis Promotes Atopic Dermatitis. Journal of Investigative Dermatology. 2017;137(12):2460-2461. https://doi.org/10.1016/j.jid.2017.09.010

Gonzalez M, Schaffer J, Orlow S, Gao Z, Li H, Alekseyenko A et al. Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis. Journal of the American Academy of Dermatology. 2016;75(3):481-493.e8. https://doi.org/10.1016/j.jaad.2016.04.066

Kennedy EA, Connolly J, Hourihane JO, Fallon PG, McLean WI, Murray D, Jo J, Segre JA, Kong HH, Irvine AD. Skin microbiome before development of atopic dermatitis: Early colonization with commensal staphylococci at 2 months is associated with a lower risk of atopic dermatitis at 1 year. Journal of Allergy and Clinical Immunology. 2017 01;139(1):166-172. https://doi.org/10.1016/j.jaci.2016.07.029

Kobayashi T, Glatz M, Horiuchi K, Kawasaki H, Akiyama H, Kaplan D et al. Dysbiosis and Staphylococcus aureus Colonization Drives Inflammation in Atopic Dermatitis. Immunity. 2015;42(4):756-766.

https://doi.org/10.1016/j.immuni.2015.03.014

Myles I, Williams K, Reckhow J, Jammeh M, Pincus N, Sastalla I et al. Transplantation of human skin microbiota in models of atopic dermatitis. JCI Insight. 2016;1(10):e86955. https://doi.org/10.1172/jci.insight.86955

Myles I, Earland N, Anderson E, Moore I, Kieh M, Williams K et al. First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis. JCI Insight. 2018;3(9):e120608.

https://doi.org/10.1172/jci.insight.120608

Kwon S, Choi J, Shin J, Huh C, Park K, Du M, Yoon S, Na J. Changes in Lesional and Non-lesional Skin Microbiome During Treatment of Atopic Dermatitis. Acta Dermato Venereologica. 2019;99(3):284-290. https://doi.org/10.2340/00015555-3089

Publicado
2020-02-01
Cómo citar
1.
Ruiz Guzmán D, Barquero Orias DE. Microbioma cutáneo, disbiosis y su rol en dermatitis atópica. Rev.méd.sinerg. [Internet]. 1 de febrero de 2020 [citado 28 de febrero de 2020];5(2):e320. Disponible en: https://revistamedicasinergia.com/index.php/rms/article/view/320
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