افراد مبتلا به درماتیت آتوپیک با استافیلوکوکوس اورئوس مستعمره دارای فنوتیپ مشخص و اندوتایپ هستند

Atopic dermatitis (AD) patients are commonly colonized with Staphylococcus aureus (ADS.aureus+) but what differentiates this group from noncolonized AD subjects (ADS.aureus-) has not been well-studied. To evaluate whether these two groups have unique phenotypic or endotypic features we performed a multi-center, cross-sectional study enrolling ADS.aureus+ (N=51) and ADS.aureus- (N=45) subjects defined by the presence or absence of S. aureus by routine culture techniques and nonatopic, noncolonized controls NAS.aureus- (N=46). Filaggrin (FLG) genotypes were determined and disease severity (EASI, RJL, IGA, NRS and DLQI) was captured. Skin physiology was assessed (transepidermal water loss [TEWL], stratum corneum integrity, hydration and pH) and serum biomarkers were also measured. We found that ADS.aureus+ had more severe disease based on all scoring systems except itch (NRS). They had higher levels of type 2 biomarkers (eosinophil count, tIgE, CCL17, and periostin). Additionally, ADS.aureus+ had significantly greater allergen sensitization (Phadiatop and tIgE), barrier dysfunction (TEWL and SC integrity) and serum LDH than both ADS.aureus- and NAS.aureus- groups. FLG mutations did not associate with S.aureus+ colonization. In conclusion, adult AD participants who are colonized on their skin with S. aureus have more severe disease, greater type 2 immune deviation, allergen sensitization, barrier disruption, and LDH elevation than noncolonized AD subjects.