人体皮肤微生态及其与皮肤病的关系

作为人体最大的器官,皮肤是机体和环境接触的主要保护屏障。人体皮肤本身也是一个复杂的生态系统,皮肤表面定殖着多种微生物并保持动态平衡,我们将之称为皮肤微生态或者人体皮肤微生物群。人体皮肤微生物群伴随人的一生,从婴儿期初始免疫系统的形成,个体发育,疾病发生,直到衰老等息息相关。人体皮肤微生物群的分布随所在部位不同存在差异,同时与人种、年龄和健康状况不同而有差异。人体皮肤微生态与人体呈共发育,共代谢,互调控的关系。皮肤微生物群落组成和动态分布与皮肤表面组织细胞乃至宿主健康免疫状态之间存在着整体平衡,这种动态平衡一旦被打破,可能会对人体健康产生影响。随着分子生物学的发展尤其是高通量测序技术相关宏基因组学、培养组学和各类新型鉴定技术的不断发展,为从生态系统角度去理解和认识皮肤微生物组提供了支持。本文针对皮肤微生物组的最新研究现状、研究方法、皮肤微生物组与人体皮肤疾病的关联研究及其前瞻性应用等方面作一个全面综述。     

微生物群落与皮肤黏膜健康及相关疾病

通常认为皮肤黏膜表面的微生物是潜在致病菌且种类有限.近年,各种围绕16S rRNA基因序列不依赖培养的分子生物学技术已用于微生物群落的研究.研究发现,皮肤黏膜表面细菌及真菌等微生物群落表现出极大的多样性和个体差异性.微生物群落参与皮肤屏障及天然免疫形成,在皮肤黏膜相关疾病的病因学中,具有不容忽视的影响.因此,对微生物群落的组成和变化特征的准确把握有助于我们更好地理解疾病的发病过程.     

皮肤微生态的研究进展

皮肤微生态学是研究皮肤微生物群的结构、功能及其与人体相互关系的一门生态学科,即皮肤的细胞水平和分子水平的生态学,它是微生态学的一个分支［１］。皮肤是人体内外环境交界的一个生物活性界面,皮肤的生态环境为微生物群的定居和繁衍提供了一个很好的场所。30年前已有相关研究显示［2］,皮肤表面栖居着大量的微生物群,包括细菌、真菌、病毒、衣原体和某些原虫等,它们与人类在共同的历史进化过程中形成了独特的生态结构,称之为皮肤正常微生物群。以往曾认为它们是“无用的”,甚至是“致病的”,近年来随着研究手段和方法的不断进展更新,尤其是微生物分子生态学的发展,宏基因组学技术的应用,使得人们改变了传统的认识,对皮肤的正常微生物群与宿主、环境之间的生态体系即皮肤微生态有了深入的了解……     

皮肤微生物多样性与相关疾病研究进展

皮肤表面定植着复杂多样的微生物,包括细菌、古生菌、真菌、病毒及螨虫类。现代测序技术增加了我们对皮肤微生物多样性的认识,本文对健康人皮肤微生物及特应性皮炎、银屑病、痤疮、酒渣鼻相关微生物的研究进展进行综述。     

痤疮丙酸杆菌的新命名及其与寻常痤疮的相关性

【摘要】 近来,有研究者建议将痤疮丙酸杆菌命名为Cutibacterium acnes（C. acnes）,以更好研究其分型并与其他丙酸杆菌区分。C. acnes是人类皮肤重要的定植菌,参与维持皮肤健康,但也可能转变成为寻常痤疮的机会性病原菌。最新的研究显示,C. acnes不同型别间的平衡和与其他微生物的相互作用在寻常痤疮发生发展中发挥关键作用。本文综述C. acnes分型及其与寻常痤疮的相关性、药物敏感性和与其他微生物的相互作用。     

皮肤共生菌调节机体免疫应答的研究进展

皮肤是人体最大的器官,也是机体防御外部环境有害物质入侵的第一道防线.皮肤除了由角质形成细胞形成的物理屏障外,还能分泌抗菌肽、活性氧和游离脂肪酸等,对入侵皮肤表皮的病原微生物起直接杀伤作用,是人体先天免疫的重要组成部分.在皮肤表面生存着大量的微生物,包括细菌、真菌、病毒、衣原体和某些原虫,这些微生物对人体的免疫应答至关重要,调节这一免疫应答的程度和持续时间对人体健康必不可少.最近的研究认为,皮肤表面微生物可能是通过我们意料之外的方式来动态平衡宿主的免疫应答,从而有益于为它们提供生存环境的宿主.因此,有必要重新认识这些被认为是“无用”甚至是“有害”的皮肤微生物的功能.     

激光捕获显微切割技术在皮肤科的应用

激光捕获显微切割是一项在显微镜下结合不同的染色技术从复杂样品中分离、纯化单一类型细胞群或特异目的细胞的技术,解决了组织中的细胞异质性问题。该技术在所需研究的细胞占样本中细胞数较少时显得尤为重要。该技术结合下游各种分子生物学研究方法应用于生命科学的各种领域。在皮肤病学领域,该技术已用于皮肤的年龄,皮肤微生物感染,紫外线照射作用,皮肤黑素瘤,皮肤淋巴瘤,银屑病,毛发生物学等方面的研究。     

特应性皮炎与皮肤微生态的研究进展

特应性皮炎是一种慢性、复发性、炎症性皮肤病.其发病机制复杂,在遗传基础上,表皮屏障功能异常、环境过敏原暴露、金黄色葡萄球菌定植等诱发的免疫炎症反应均参与其发病.皮肤微生态是皮肤表面微生物构成的复杂生态系统,近年研究提示,微生态异常在特应性皮炎的发病过程中起重要作用,特应性皮炎患者的皮肤除了存在金黄色葡萄球菌定植增多外,还存在表皮葡萄球菌等其他微生物数量和功能的改变.因此,进一步揭示各种微生物群落与特应性皮炎发病的关系,有助于特应性皮炎的防治.     

皮肤科学基础

990621 数值分类学在临床微生物流行病学研究中的应用（综述）/秦振宇（西安医大二附院皮肤科）//中国皮肤性病学杂志.-1998,12（4）.-238 数值分类是借助数值方法,根据微生物性状和状态将分类单位归类成类元。作者从数值分类学的原理、数值分类学在临床微生物流行病学研究中的应用举例及数值分类学在临床微生物流行病学研究中的应用展望三个部分进行了阐述。参17 （张孝友）     

光疗对人体皮肤微生态影响的研究进展

人体皮肤定植大量微生物,包括细菌、真菌、病毒等,与人体相互依存和影响共同构成了皮肤微生态.皮肤微生态可作为外部物理屏障,防止外来病原体入侵,对人体皮肤起到保护作用.光疗法是皮肤科常用的物理治疗方法之一,常用于治疗炎症性皮肤病、感染性皮肤病和皮肤肿瘤.该文主要就紫外线治疗、光动力治疗、激光治疗对人体皮肤微生态影响的研究进...     

Prä- und probiotische Kosmetik

The human skin provides a habitat for a variety of microorganisms, the skin microflora. There is a complex network of interactions between the microbes and cells of the epidermis. Modern analytical methods in molecular biology have revealed new insights into this complex diversity of partially unculturable microbial organisms. Most of the resident microbes on healthy skin can be regarded as being harmless or even beneficial to skin. In the case of diseases with some imbalance in microorganisms, such as impure skin/mild acne or dry skin/mild atopic dermatitis, pre- and probiotic concepts represent an effective alternative to strictly antibacterial products. Prebiotic actives rebalance the skin microflora while probiotic approaches predominantly consist of applying an inactivated microbial biomass of beneficial bacteria. Several examples of successful in vivo studies illustrate this new principle for gentle cosmetics derived from the food sector.     

Immunoglobulins coat microorganisms of skin surface: a comparative immunohistochemical and ultrastructural study of cutaneous and oral microbial symbionts

Only recently have human sweat glands been demonstrated to secrete immunoglobulins (Ig), paralleling Ig secretion in mucosal epithelia. It is well established that Ig protect mucosal membranes against infections by binding to surface structures of microorganisms. In view of these findings immunohistochemical studies were performed to determine if microbes on the skin surface are coated by Ig as proposed for mucosal bacteria and fungi. Smear preparations from the skin and oral cavity rich in micro-organisms were subjected to immunoperoxidase staining using anti-secretory component (SC), -IgA, -IgM, -IgG antibodies. An immunogold labeling technique of microbial suspensions of sweat and saliva was adapted to correlate the results on an ultrastructural level. Negative controls included unsuccessful staining for IgA in preparations obtained from an IgA-deficient patient as well as nonreactivity of subcultured microorganisms for all Ig classes or SC. Smear preparations from both the oral cavity and skin surface exhibited labeling of bacterial or fungal elements with anti-IgA, -IgM, -IgG, and -SC antibodies. Skin bacteria revealed a lower number of reactive microbes as compared to saliva. Staining intensity for the different Ig classes exhibited intra- and interindividual variations. Immunoelectronmicroscopically, Ig and SC could be detected either directly along the cell wall of coccal, coryneform, and fungal elements or on floccular and fimbrial material adhering to the bacterial surface. It is concluded that secretory Ig of the skin cover surface structures of microorganisms and thus modify their adhesional and/or infectious properties, resembling humoral surface immunity on mucous membranes.     

New perspectives on dandruff and seborrheic dermatitis: lessons we learned from bacterial and fungal skin microbiota

The human body is inhabited by complex microbial communities, which positively impact different aspects of our health, and might also be related to the development of diseases. Progress in technologies, particularly sequencing methods and bioinformatics tools, has been crucial for the advances in this field. Microbial communities from skin can modulate immune response and protect the host against pathogens, and there are also data supporting their association with several skin conditions; including dandruff and seborrheic dermatitis. For decades, they have been thought to be related to Malassezia yeasts; however, the microbial role has not been elucidated, and their etiology remains poorly understood. This review discusses the recent findings in dandruff and seborrheic dermatitis and their relation to the skin microbiota. Data provided new perceptions to aid in the understanding of these skin disorders, broadening our view of their etiology and the possible roles of microbial communities in symptom development.     

Mechanisms of microbial pathogenesis and the role of the skin microbiome in psoriasis: A review

The pathogenesis of psoriasis may involve a breakdown of immune tolerance to cutaneous microorganisms. Psoriasis is associated with a higher incidence of Crohn disease and periodontitis, two diseases involving impaired tolerance and abnormal immune activation in response to intestinal and oral microbiota, respectively. In addition, guttate and chronic plaque psoriasis are associated with Streptococcus pyogenes colonization. The aim of this review is to characterize the microorganisms implicated in psoriasis by examining results of major association studies and possible mechanisms of pathogenesis. Although studies show relative increases in Streptococcus and Staphylococcus and decreases in Malassezia and Cutibacterium, they differ in methods of sampling and methods of microbial analysis. As such, no definitive associations between microbes and psoriasis have been found to date. It also remains unclear if changes in the microbiomal composition have a causal association with psoriasis or are simply a consequence of the inflammatory microenvironment. Techniques enabling strain-level analysis rather than species-level analysis of the skin microbiome are likely necessary to determine microbiomal signatures of psoriasis. Future investigations may lead to new diagnostic tests and novel treatments, such as probiotics or bacterial transplantation.     

The mechanism of skin lipids influencing skin status

Skin lipids, compose of sebocyte-, keratinocyte-, and microbe- derived lipids, dramatically influence skin status by different mechanisms. (I) Physical chemistry function: They are “mortar” to establish the physico-chemical barrier function of skin; (II) Biochemistry function: They function as signals in the complex signaling network originating at the epidermal level; (III) Microecology function: Sebocyte- and keratinocyte-derived lipids vary the composition of microbial skin flora, and microorganisms metabolize them to produce lipids as signal starting signaling transduction. Importantly, further research needs lipidiomics, more powerful analytical ability and high-throughput manner, to identify skin lipid components into individual species. The validation of lipid structure and function to research the process that lipid species involved in. Additional, the integration of lipidomics data with other omics strategies can develop the power to study the mechanism of skin lipids influencing skin status.     

The potential role of microorganisms in the development of rosacea

Rosacea is a chronic cutaneous disorder characterized by centrofacial persisting erythema, telangiectases, papules, pustules, edema, phymas and ocular involvement. Despite being one of the most common skin disorders, its pathogenesis remains unclear and controversial. Although the disease triggering factors are well recognized, the underlying causes of rosacea have not yet been identified. Several different postulates about its pathogenesis can be found in the medical literature. Abnormalities of the pilosebaceous unit, as well as genetic, vascular, inflammatory, environmental and microbial factors have been described. The microorganisms that have been associated include Helicobacter pylori, Demodex folliculorum, Staphylococcus epidermidis, and Chlamydia pneumonia; all the studies have been inconclusive. We review currently available scientific data on the potential pathogenetic role of microorganisms in the development of rosacea.     

The role of dendritic cells during infection

The skin and the mucosa of the respiratory and gastrointestinal tracts are continuously exposed to microorganisms, but only a limited number of these enter the body and cause disease. To resist microbial infection, the host has developed a multitude of defense mechanisms involving the innate and adaptive immune systems. Dendritic cells (DCs) provide the link between these arms of the immune system. The initiation of an immune response is critically dependent on the activation of DCs, which can discriminate between different classes of microorganisms and elicit tailored antimicrobial immune responses. They have an extraordinary capacity to stimulate naive T cells and initiate primary immune responses. In turn, some pathogens interfere with DC function to block or delay their elimination by the host. Progress in understanding the role of DCs in the host response to microbes is reviewed.     

The skin microbiome: Associations between altered microbial communities and disease

A single square centimetre of the human skin can contain up to one billion microorganisms. These diverse communities of bacteria, fungi, mites and viruses can provide protection against disease, but can also exacerbate skin lesions, promote disease and delay wound healing. This review addresses the current knowledge surrounding the healthy skin microbiome and examines how different alterations to the skin microbial communities can contribute to disease. Current methodologies are considered, changes in microbial diversity and colonisation by specific microorganisms are discussed in the context of atopic dermatitis, psoriasis, acne vulgaris and chronic wounds. The recent impact of modern Westernised lifestyles on the human skin microbiome is also examined, as well as the potential benefits and pitfalls of novel therapeutic strategies. Further analysis of the human skin microbiome, and its interactions with the host immune system and other commensal microorganisms, will undoubtedly elucidate molecular mechanisms for disease and reveal gateways for novel therapeutic treatment strategies.