Chia, M., Naim, A. N. M., Tay, A. S. L., Lim, K., Chew, K. L., Yow, S. J., Chen, J., Common, J. E. A., Nagarajan, N., & Tham, E. H. (2022). Shared signatures and divergence in skin microbiomes of children with atopic dermatitis and their caregivers. Journal of Allergy and Clinical Immunology, 150(4), 894–908. https://doi.org/10.1016/j.jaci.2022.01.031
Abstract:
Background: Atopic dermatitis (AD) is a common chronic skin condition in children (15-20%) that can significantly impair their quality of life. As a result of its relapsing nature and enrichment of Staphylococcus aureus during flares, clinical management can include eradicating S aureus from the skin of children; however, this does not extend to their healthy caregivers, who are potential reservoirs.
Objective: Our aim was to understand skin microbiome sharing and microbial features in children with AD and their healthy adult caregivers.
Methods: We utilized whole-metagenome profiling at 4 body sites (volar forearm, antecubital fossae, cheeks, and lesions) in combination with sequencing of S aureus isolates to characterize a cohort of children with AD and their healthy caregivers (n = 30 families) compared to matched pairs from control households (n = 30 families).
Results: Metagenomic analysis revealed distinct microbiome configurations in the nonlesional skin of AD children and their healthy caregivers versus controls, which were sufficient to accurately predict case-control status (area under the receiver operating characteristic curve > 0.8). These differences were accompanied by significant microbiome similarity between children and their caregivers, indicating that microbiome sharing may play a role in recurrent disease flares. Whole-genome comparisons with high-quality S aureus isolate genomes (n = 55) confirmed significant strain sharing between AD children and their caregivers and AD-specific enrichment of strains expressing enterotoxins Q and K/K2.
Conclusion: Our results highlight the distinctive skin microbiome features of healthy caregivers for children with AD and support their inclusion in strategies for the treatment of recurrent pediatric AD.
License type:
Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Funding Info:
This research / project is supported by the National Medical Research Council (NMRC) - Research Training fellowship
Grant Reference no. : MH 095:003\008-225
This research / project is supported by the National Medical Research Council (NMRC) - transition award
Grant Reference no. : MOH-000269
This research / project is supported by the A*STAR BMRC EDB - IAF-PP - Asian Skin Microbiome Program
Grant Reference no. : H18/01/a0/016
This research is supported by core funding from: A*STAR Graduate Academy
Grant Reference no. : NA
This research / project is supported by the Institute for Health Innovation and Technology, National University of Singapore - Global Health Research and Technology (BIGHEART) Joint Research Grant 2018
Grant Reference no. : NA
This research was supported by grant funding from the National University Health System Leadership in Academic Medicine program (PFFR September 2016); Master of Clinical Investigation.