Eczema, also known as atopic dermatitis (AD) is the most common skin disease of children in developed societies. It is associated with intense itch and loss of sleep in early life and with other conditions such as food allergy and asthma in later life.
The early origins of AD are not fully completely understood but involve a complex interplay between the skin barrier, unrestrained or unregulated immune responses and the microbiome, which is the collective name for the community of organisms that live on all of our skin.
Eczema has a close relationship with the existence on skin of a bacteria calledStaphylococcus Aureus (SA) and this is known to drive flares or exacerbations of AD. It was, however, not known which came first-colonisation of the skin by staphylococcus or eczema followed by staphylococcal colonisation?
In collaborative work funded by the National Children’s Research Centre, researchers from Trinity College Dublin’s School of Medicine, University College Cork, University of Dundee and the National Institutes of Health, very carefully followed a cohort of patients during their first year of life and regularly sampled their skin microbiome. The infants were part of a longitudinal birth research cohort called the Cork BASELINE Cohort.
Led by Professor of Dermatology, Alan Irvine in Trinity, the study group were able to show that Staphylococcus colonisation did not precede development of AD and, surprisingly, several species of staphylococcus actually appeared to protect against developing AD at 1 year. This is an important new finding in the complex relationship between the microbiome and skin inflammation, suggesting that some related bacteria may be anti-inflammatory or protective against developing eczema.
Professor Irvine said: “This work is the first study that has followed babies at several time points in their first year of life and examined the bacterial communities of their skin at this early stage. Our findings suggest that while the relationship between these skin bacterial communities and development of disease is complicated, we have shown for the first time that some bacteria may help prevent skin inflammation in these very young children. Our work is an early discovery, future work will hopefully clarify how these works and determine if we can harness to prevent disease.”