Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis.
Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis.
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儿童特应性皮炎的氟替卡松乳膏和辅助漂白浴的皮肤微生物组作用。
DOI：
10.1016/j.jaad.2016.04.066
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发表时间：
2016-09
影响因子：
13.8
通讯作者：
Blaser MJ
中科院分区：
文献类型：
--
作者：
Gonzalez ME;Schaffer JV;Orlow SJ;Gao Z;Li H;Alekseyenko AV;Blaser MJ
特应性皮炎（AD）患者容易发生皮肤感染，金黄色葡萄球菌等微生物可能是致病原因。漂白浴可能通过减少皮肤微生物负担来改善AD。描述AD和对照幼儿皮损和非皮损皮肤的微生物群特征，并比较局部皮质类固醇（TCS）单独治疗或TCS +稀释漂白浴（BB）治疗后的变化。在一项针对21名AD儿童和14名健康儿童的随机、安慰剂对照、单盲临床试验中，在基线时和单独使用TCS或TCS加BB治疗4周后检查了病变和非病变AD皮肤。提取微生物DNA用于优势属的qPCR和16 S rRNA测序。在基线时，总细菌和葡萄球菌，包括S。金黄色葡萄球菌在最差AD病变部位的细菌群落显著高于非病变（p=0.001）或对照（p<0.001）皮肤;病变和非病变AD皮肤上的细菌群落彼此显著不同（p=0.04）并且与对照（p<0.001）显著不同。TCS + BB或单独TCS后，病变皮肤上的细菌组成正常化（p<0.0001），类似于非病变皮肤，微生物多样性恢复到对照皮肤水平。4周的时间和/或每周两次的沐浴可能不足以对皮肤微生物组产生额外的影响。更详细的测序可以更好地表征BB处理的区别类群。局部皮质类固醇乳膏治疗足以使病灶AD上的皮肤微生物群正常化;治疗后，病灶皮肤上的细菌群落类似于非病灶皮肤，但与对照组保持不同。
Patients with atopic dermatitis (AD) are prone to skin infections, with microbes like Staphylococcus aureus suspected of contributing to pathogenesis. Bleach baths might improve AD by reducing skin microbial burden. To characterize the microbiota of lesional and nonlesional skin in young children with AD and controls and compare changes after treatment with a topical corticosteroid (TCS) alone or TCS + dilute bleach baths (BB). In a randomized, placebo-controlled, single-blinded clinical trial in 21 children with AD and 14 healthy children, lesional and nonlesional AD skin was examined at baseline and after 4-week treatment with TCS alone or TCS plus BB. Microbial DNA was extracted for qPCR of predominant genera and 16S rRNA sequencing. At baseline, densities of total bacteria and Staphylococcus, including S. aureus, were significantly higher at the worst AD lesional site than nonlesional (p=0.001) or control (p<0.001) skin; bacterial communities on lesional and nonlesional AD skin significantly differed from each other (p=0.04) and from control (p<0.001). After TCS + BB or TCS alone, bacterial compositions on lesional skin normalized (p<0.0001), resembling nonlesional skin, with microbial diversity restored to control skin levels. The 4-week time period and/or the twice-weekly baths may not have been sufficient for additional impact on the cutaneous microbiome. More detailed sequencing may allow better characterization of the distinguishing taxa with BB-treatment. Treatment with a topical corticosteroid cream suffices to normalize the cutaneous microbiota on lesional AD; after treatment, bacterial communities on lesional skin resemble nonlesional skin but remain distinct from control.