The Role of the Skin and Gut Microbiome in Psoriatic Disease
Purpose of Review
To understand the changes in the microbiome in psoriatic disease, we conducted a systematic review of studies comparing the skin and gut microbiota in psoriatic individuals and healthy controls.
Our review of studies pertaining to the cutaneous microbiome showed a trend towards an increased relative abundance of Streptococcus and a decreased level of Propionibacterium in psoriasis patients compared to controls. In the gut microbiome, the ratio of Firmicutes and Bacteroidetes was perturbed in psoriatic individuals compared to healthy controls. Actinobacteria was also relatively underrepresented in psoriasis patients relative to healthy individuals.
Although the field of the psoriatic microbiome is relatively new, these first studies reveal interesting differences in microbiome composition that may be associated with the development of psoriatic comorbidities and serve as novel therapeutic targets.
KeywordsMicrobiome Skin microbiota Gut bacteria Mycobiome Psoriasis Psoriatic arthritis
This study was supported in part by grants to Wilson Liao (NIH R01 AR065174, NIH U01 AI119125, National Psoriasis Foundation Translational Research Award). Dr. Liao is also grateful for charitable support from the Dinsmore family. Di Yan acknowledges support from a National Psoriasis Foundation Fellowship.
Compliance with Ethical Standards
Conflict of Interest
Authors Wilson Liao, Di Yan, Ladan Afifi, Caleb Jeon, and Hsin-Win Chang report no conflicts of interest in this work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of Particular Interest, Published Recently, Have Been Highlighted as: • of Importance
- 12.Aagaard K, Petrosino J, Keitel W, et al. The Human Microbiome Project strategy for comprehensive sampling of the human microbiome and why it matters. FASEB journal: official publication of the Federation of American Societies for Experimental Biology. 2013;27(3):1012–22. doi:10.1096/fj.12-220806.CrossRefGoogle Scholar
- 21.• Alekseyenko AV, Perez-Perez GI, De Souza A, et al. Community differentiation of the cutaneous microbiota in psoriasis. Microbiome. 2013;1(1):31. doi:10.1186/2049-2618-1-31. Here Alekseyenko et al. report the results of the largest study profiling the cutaneous microbiome in psoriasis to date. This study is also the only one to profile changes in the cutaneous microbiome after treatment for psoriasis.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Jagielski T, Rup E, Ziolkowska A, et al. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods. BMC Dermatol. 2014;14:3. doi:10.1186/1471-5945-14-3.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Bellaud G, Gheit T, Pugin A, et al. Prevalence of human papillomavirus DNA in eyebrow hairs plucked from patients with psoriasis treated with TNF inhibitors. Journal of the European Academy of Dermatology and Venereology : JEADV. 2014;28(12):1816–20. doi:10.1111/jdv.12308.CrossRefPubMedGoogle Scholar
- 32.Prignano G, Ferraro C, Mussi A, et al. Prevalence of human papilloma virus type 5 DNA in lesional and non-lesional skin scales of Italian plaque-type psoriatic patients: association with disease severity. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2005;11(1):47–51. doi:10.1111/j.1469-0691.2004.01040.x.CrossRefGoogle Scholar
- 34.• Scher JU, Ubeda C, Artacho A, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis & rheumatology (Hoboken, NJ). 2015;67(1):128–39. doi:10.1002/art.38892. The study by Scher et al., is the only comprehensive, genus-level, profiling study of the gut microbiome in psoriatic disease to date. This study is also significant in that it correlates fecal metabolites with shifts in gut microbiome composition, providing the foundation for a mechanistic understanding of how bacteria can influence the host.CrossRefGoogle Scholar
- 36.Struijk L, Bouwes Bavinck JN, Wanningen P, et al. Presence of human papillomavirus DNA in plucked eyebrow hairs is associated with a history of cutaneous squamous cell carcinoma. The Journal of investigative dermatology. 2003;121(6):1531–5. doi:10.1046/j.1523-1747.2003.12632.x.CrossRefPubMedGoogle Scholar
- 65.Structure, function and diversity of the healthy human microbiome. Nature. 2012;486(7402):207–14. doi:10.1038/nature11234.