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Annales de Dermatologie et de Vénéréologie
Volume 142, n° S1
pages 18-22 (janvier 2015)
Doi : 10.1016/S0151-9638(15)30003-X
Microbiote cutané et dermatite atopique : vers une nouvelle prise en charge thérapeutique ?
Skin microbiota and atopic dermatitis: toward new therapeutic options?
 

J.-Ph. Lacour
 Service de dermatologie, hôpital Archet 2 - CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, CS 23079, 06202 Nice Cedex 3, France 

Résumé

La peau chez les patients atteints de dermatite atopique (DA) est constamment colonisée par S. aureus , situation favorisée par un déficit en peptides antimicrobiens épidermiques. S. aureus peut occasionner des surinfections mais est également impliqué dans la survenue et la sévérité des poussées inflammatoires. La diversité du microbiote cutané est ainsi anormale dans la DA et des études dynamiques du microbiote montrent que la prédominance des staphylocoques est encore accrue au cours des poussées de DA. Cet état de dysbiose conduit à une majoration des réactions inflammatoires dans lesquels certaines toxines staphylococciques jouent un rôle important. Des modifications du microbiote intestinal jouent également un rôle dans la maturation précoce du système immunitaire et la survenue de manifestations allergiques.

Des tentatives de modulation du microbiote cutané ont récemment été faites montrant qu’une crème contenant un lysat de V. filiformis est capable d’améliorer les manifestations de la DA. Ces effets pourraient passer par une régulation de l’immunité innée cutanée par le biais des Toll like receptors (TLR-2), la sécrétion d’IL-10 et l’induction de lymphocytes T régulateurs.

The full text of this article is available in PDF format.
Summary

The skin in patients with atopic dermatitis (AD) is constantly colonized by S. aureus , in part due to a deficit in epidermal antimicrobial peptides. S. aureus can cause secondary infections but is also involved in the occurrence and severity of the inflammatory flares of AD. Thus, the diversity of skin microbiota is abnormal in AD. Dynamic studies of the microbiota showed that the prevalence of staphylococcae sp. is further increased during flares of AD. This dysbiosis leads to an increase in inflammatory reactions in which staphylococcal toxins play an important role. Changes in the gut microbiota also play a role in the early maturation of the immune system and the occurrence of allergic reactions. Attempts in the modulation of skin microbiota have recently been made showing that a cream containing a lysate of a non pathogenic Gram negative bacteria, V. filiformis , is capable of improving the manifestations of AD. These effects may be driven by a regulation of skin innate immunity through Toll like receptors (TLR-2), the secretion of IL-10 and the induction of regulatory T cells.

The full text of this article is available in PDF format.

Mots-clés : Dermatite atopique, Eczéma atopique, Microbiote, Microbiome, S. aureus , V. filiformis

Keywords : Atopic dermatitis, Atopic eczema, Microbiota, Microbiome, S. aureus , V. filiformis




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