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PubMed RSS Feed - -Microbiome: Role in Inflammatory Skin Diseases


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J Inflamm Res. 2024 Feb 15;17:1057-1082. doi: 10.2147/JIR.S441100. eCollection 2024.


As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies.

PMID:38375021 | PMC:PMC10876011 | DOI:10.2147/JIR.S441100

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This article is some good research since rosacea is an ISD (Inflammatory Skin Diseases). I have always known that the human microbiome is important to understanding rosacea. Since the skin comprises the largest organ it makes sense that the different microbes existing in this organ would interact and be important to understanding why an inflammatory response is indicated in rosacea. Could rosacea actually be the result of various microbes interplaying or could it actually be just one microbe that is triggering it? In normal skin without rosacea, these various microbes seem to live together without an inflammatory response or initiating an immune system response. There may be other factors that would contribute to upsetting the skin microbiome, i.e., age, diet and exercise, lifestyle, stress, cormobidities, co-existing conditions, medications, etc., which complicates the issue, but nevertheless, rosacea is a skin disease and microbes may play a part in triggering it. The classic example proving this point is that antibiotics have been used to treat rosacea for decades and more recently treatment for the eradication of demodex mites are just two microbes worth considering, bacteria and demodex, which the vast majority of rosacea research has focused on. There is little, if any, research done on rosacea involving other microbes, i.e., virus, archaea, fungi, protozoa, helminths, parasites, etc., and the list of microbes on the skin microbiome could include other microbes not yet considered since the bias in rosacea research has mainly focused on bacteria as the culprit. since antibiotic treatment does indeed clears rosacea, but overtime complicates the issue with side effects worse than the actual disease. 

If you note, the research in this article is Chinese and apparently no conflict of interest is involved, for example, the skin industry in western medicine probably didn't give these researchers a dime. Bravo for such research. If only the RRDi could engage in such novel research. The following reveals who funded this research: 

"This work was supported by the Chengdu University of Traditional Chinese Medicine “Xinglin Scholars” Discipline Talent Research Improvement Program, Project Number: QJJJ2021001; Chengdu University of Traditional Chinese Medicine “Foundation Thickening” Action Plan (2023-42); Chengdu University of Traditional Chinese Medicine Hospital’s “Hundred Person Plan” (21-L03 and 22-B09). “Young Qihuang” Scholars of the State Administration of Traditional Chinese Medicine (2022-256)"

Read the full article.

Furthermore, we also know that Gut Rosacea is related to this subject. For example, this research paper states, "Accumulating evidence shows that dysregulation of intestinal flora is associated with inflammatory skin diseases, specifically atopic dermatitis (AD), psoriasis (PSO), and rosacea (ROS). However, the causality is still unclear." [1] This same article notes that "A total of 24 specific gut microbiota species related to AD, PSO, and ROS were identified by 2SMR analysis." [1] 

Can you see we need more research and that rosaceans could be involved with such novel research rather than letting the skin industry in western medicine sponsor the vast amount of rosacea research? Could rosaceans actually be united into sponsoring their own rosacea research?

End Notes

[1] PubMed RSS Feed - -The associations between gut microbiota and inflammatory skin diseases: a bi-directional two-sample Mendelian randomization study  

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