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Staphylococcus epidermidis protease EcpA can be a deleterious component of the skin microbiome in atopic dermatitis - 04/03/21

Doi : 10.1016/j.jaci.2020.06.024 
Laura Cau, PhD a, b, , Michael R. Williams, PhD a, , Anna M. Butcher, BS a, Teruaki Nakatsuji, PhD a, Jeffrey S. Kavanaugh, PhD c, Joyce Y. Cheng, MD a, Faiza Shafiq, MD a, Kyle Higbee, BS a, Tissa R. Hata, MD a, Alexander R. Horswill, PhD c, d, Richard L. Gallo, MD, PhD a, e,
a Department of Dermatology, University of California San Diego, San Diego, Calif 
b R&D Department, SILAB, Brive, France 
c Department of Immunology and Microbiology, University of Colorado Anschutz, Medical Campus, Aurora, Colo 
d Department of Veterans Affairs Eastern Colorado Health Care System, Aurora, Colo 
e Center for Microbiome Innovation, University of California San Diego, San Diego, Calif 

Corresponding author: Richard L. Gallo, MD, PhD, Department of Dermatology, University of California, San Diego, 9500 Gilman Dr, #0869, La Jolla, CA 92093-0869.Department of DermatologyUniversity of CaliforniaSan Diego9500 Gilman Dr#0869La JollaCA92093-0869

Abstract

Background

Staphylococcus aureus and Staphylococcus epidermidis are the most abundant bacteria found on the skin of patients with atopic dermatitis (AD). S aureus is known to exacerbate AD, whereas S epidermidis has been considered a beneficial commensal organism.

Objective

In this study, we hypothesized that S epidermidis could promote skin damage in AD by the production of a protease that damages the epidermal barrier.

Methods

The protease activity of S epidermidis isolates was compared with that of other staphylococcal species. The capacity of S epidermidis to degrade the barrier and induce inflammation was examined by using human keratinocyte tissue culture and mouse models. Skin swabs from atopic and healthy adult subjects were analyzed for the presence of S epidermidis genomic DNA and mRNA.

Results

S epidermidis strains were observed to produce strong cysteine protease activity when grown at high density. The enzyme responsible for this activity was identified as EcpA, a cysteine protease under quorum sensing control. EcpA was shown to degrade desmoglein-1 and LL-37 in vitro, disrupt the physical barrier, and induce skin inflammation in mice. The abundance of S epidermidis and expression of ecpA mRNA were increased on the skin of some patients with AD, and this correlated with disease severity. Another commensal skin bacterial species, Staphylococcus hominis, can inhibit EcpA production by S epidermidis.

Conclusion

S epidermidis has commonly been regarded as a beneficial skin microbe, whereas S aureus has been considered deleterious. This study suggests that the overabundance of S epidermidis found on some atopic patients can act similarly to S aureus and damage the skin by expression of a cysteine protease.

Il testo completo di questo articolo è disponibile in PDF.

Graphical abstract




Il testo completo di questo articolo è disponibile in PDF.

Key words : Atopic dermatitis, microbiome, dysbiosis, Staphylococcus epidermidis, protease, skin, epidermal barrier, inflammation, cytokine

Abbreviations used : AD, agr, AIP, AMP, CFU, CoNS, DSG-1, EcpA, IVL, HEK, PSM, qPCR, TEWL, TSB, WT


Mappa


 This work was funded by National Institutes of Health grants R01 AR076082, R37 AI052453, and U19 AI117673. Postdoctoral fellowship support for L. Cau was provided by SILAB. A. R. Horswill was supported by a Merit Award (BX002711) from the US Department of Veteran Affairs.
 Disclosure of potential conflict of interest: R. L. Gallo is a cofounder, scientific advisor, and consultant of MatriSys Biosciences and has equity in the company; in addition, he receives income from and has equity in Sente. The rest of the authors declare that they have no relevant conflicts of interest.


© 2020  Pubblicato da Elsevier Masson SAS.
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