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Patients with Atopic Dermatitis Colonized with Staphylococcus aureus Have a Distinct Phenotype and Endotype.


ABSTRACT: Patients with atopic dermatitis (AD) are commonly colonized with Staphylococcus aureus (AD S. aureus+), but what differentiates this group from noncolonized AD patients (AD S. aureus-) has not been well studied. To evaluate whether these two groups have unique phenotypic or endotypic features, we performed a multicenter, cross-sectional study enrolling AD S. aureus+ (n = 51) and AD S. aureus- (n = 45) participants defined by the presence or absence of S. aureus by routine culture techniques and nonatopic, noncolonized control individuals (NA S. aureus-) (n = 46). Filaggrin (FLG) genotypes were determined, and disease severity (Eczema Area and Severity Index, Rajka-Langeland Severity Score, Investigator's Global Assessment score, Numerical Rating Scale, and Dermatology Life Quality Index) was captured. Skin physiology was assessed (transepidermal water loss [TEWL], stratum corneum integrity, hydration, and pH), and serum biomarkers were also measured. We found that AD S. aureus+ patients had more severe disease based on all scoring systems except itch (Numerical Rating Scale), and they had higher levels of type 2 biomarkers (eosinophil count, tIgE, CCL17, and periostin). Additionally, AD S. aureus+ patients had significantly greater allergen sensitization (Phadiatop and tIgE), barrier dysfunction (TEWL and stratum corneum integrity), and serum lactate dehydrogenase (LDH) than both the AD S. aureus- and NA S. aureus- groups. FLG mutations did not associate with S. aureus+ colonization. In conclusion, adult patients with AD who are colonized on their skin with S. aureus have more severe disease, greater type 2 immune deviation, allergen sensitization, barrier disruption, and LDH level elevation than noncolonized patients with AD.

SUBMITTER: Simpson EL 

PROVIDER: S-EPMC6153055 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Patients with Atopic Dermatitis Colonized with Staphylococcus aureus Have a Distinct Phenotype and Endotype.

Simpson Eric L EL   Villarreal Miguel M   Jepson Brett B   Rafaels Nick N   David Gloria G   Hanifin Jon J   Taylor Patricia P   Boguniewicz Mark M   Yoshida Takeshi T   De Benedetto Anna A   Barnes Kathleen C KC   Leung Donald Y M DYM   Beck Lisa A LA  

The Journal of investigative dermatology 20180328 10


Patients with atopic dermatitis (AD) are commonly colonized with Staphylococcus aureus (AD S. aureus<sup>+</sup>), but what differentiates this group from noncolonized AD patients (AD S. aureus<sup>-</sup>) has not been well studied. To evaluate whether these two groups have unique phenotypic or endotypic features, we performed a multicenter, cross-sectional study enrolling AD S. aureus<sup>+</sup> (n = 51) and AD S. aureus<sup>-</sup> (n = 45) participants defined by the presence or absence of  ...[more]

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