Symbiotic microorganisms: prospects for treating atopic dermatitis

ABSTRACT

Introduction

Atopic dermatitis (AD) is a common chronic recurrent inflammatory skin disease. The pathogenesis is unclear but may be related to genetic, immune, and environmental factors and abnormal skin barrier function. Symbiotic microorganisms in the gut and on the skin are associated with AD occurrence.

Areas covered

We discuss the metabolism and distribution of intestinal and skin flora and review their relationship with AD, summarizing the recent applications of intestinal and skin flora in AD treatment, and discussing the prospect of research on these two human microbiota systems and their influence on AD treatment. The PubMed database was searched to identify relevant publications from 1949 to 2020 for the bibliometric analysis of atopic dermatitis and symbiotic microorganisms.

Expert opinion

Many studies have suggested a potential contribution of microbes in the intestine and on the skin to AD. Bacteria living on the skin can aggravate AD by secreting numerous virulence factors. Moreover, the metabolism of intestinal flora can influence AD occurrence and development via the circulatory system. Current evidence suggests that by regulating intestinal and skin flora, AD can be treated and prevented.

KEYWORDS:

• Atopic dermatitis
• intestinal
• skin
• symbiotic microorganisms
• microbiome therapy

Article highlights

• Symbiotic microorganisms affect the occurrence and development of atopic dermatitis.

• We searched the PubMed database for articles published between 1949 and 2020 using the keywords ‘(bacteria or fungi)’ and ‘atopic dermatitis’.

• Bibliometric analysis revealed several trending topics that are gaining attention from researchers in the field.

• Regulation of the intestinal and skin flora represents a promising strategy for the treatment and prevention of atopic dermatitis.

• Further studies are warranted to develop an effective microbiome therapy with minimal adverse reactions.

This box summarizes key points contained in the article.

Acknowledgments

We would like to thank Editage (www.editage.cn) for English language editing.

Author contributions

Conceptualization: R.C. and Q.Z.; Methodology: R.C.; Software: Z.T.; Validation: Y.Z., C.C., and Z.C.; Formal analysis: Z.T.; Investigation: Z.C.; Resources: Q.Z.; Data curation: Z.T.; Writing—original draft preparation: R.C.; Writing—review & editing: Y.Z.; Visualization: Z.T.; Supervision: Z.C.; Project administration: Q.Z.; Funding acquisition: Q.Z. R.C. and Z.T. contributed equally to this work. All authors have read and approved the final version of the manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by National Natural Science Foundation of China (81803078 and 82073385), Shanghai Science and Technology Committee (20DZ2255200), the Key Discipline Construction Project and Doctoral Supervisor Candidate of Shanghai Skin Disease Hospital (2019zdxk03 and 17HBDS03). The funders had no role in the design of the study; in the collection, analysis, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.