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The skin microbiome in psoriatic disease: A systematic review and critical appraisal
Meital Yerushalmi1,2, Ofir Elalouf1,3, Melanie Anderson4
1Psoriatic Disease Program, Krembil Research Institute, University Health Network, Canada.
Background:
Psoriasis affects 1-3% of the Canadian population. Psoriatic arthritis (PsA), the most common comorbidity of psoriasis, affects up to 30% of psoriasis patients. The skin microbiome is hypothesized to play a role in the pathogenesis of psoriatic disease (PsD-psoriasis and PsA).
Objective:
To summarize the current state of literature on the skin microbiome in PsD.
Methods:
A systematic review was performed using searches in Ovid, Medline, Embase, Medline Epub Ahead of Print and In-Process & Other Non-Indexed Citations, and Cochrane Central Register of Controlled Trials (CENTRAL). Search was limited to humans and English language, with no limits for date or publication type.
Results:
Of 4,032 citations identified, 9 studies met inclusion criteria (7 on psoriasis only and 2 studies compared the microbiome characteristics between psoriasis and PsA). Compared to healthy controls, lesions demonstrated a decreased alpha diversity, higher relative abundances of Firmicutes, and lower relative abundances of Actinobacteria. Less conclusive were genus-level results, which nonetheless demonstrated trends towards increased Streptococcus, Staphylococcus, and Corynebacterium and decreased Propionibacterium in lesions vs. control.
Limitations:
Study designs were heterogeneous, including sampling technique and exclusion criteria.
Conclusions:
Phyla- and selected genus-level characteristic of the psoriatic microbiome are presented; further research is warranted.
Insights
The skin microbiome in psoriatic disease shows altered bacterial phyla, with lower diversity in lesions. Further research is needed to understand the role of specific bacteria in psoriasis and psoriatic arthritis.
Area of Science:
- Dermatology
- Microbiology
- Immunology
Background:
- Psoriasis affects 1-3% of Canadians, with psoriatic arthritis (PsA) impacting up to 30% of patients.
- The skin microbiome is implicated in the pathogenesis of psoriatic disease (PsD), encompassing psoriasis and PsA.
Purpose of the Study:
- To systematically review and summarize existing literature on the skin microbiome in psoriatic disease.
Main Methods:
- A comprehensive systematic review was conducted across multiple databases (Ovid, Medline, Embase, CENTRAL).
- Searches were limited to human studies published in English, with no date or publication type restrictions.
Main Results:
- Nine studies met inclusion criteria, analyzing psoriasis and/or PsA.
- Psoriatic lesions exhibited decreased alpha diversity, increased Firmicutes, and decreased Actinobacteria compared to healthy controls.
- Trends indicated increased Streptococcus, Staphylococcus, and Corynebacterium, with decreased Propionibacterium in lesions.
Conclusions:
- Significant heterogeneity exists in study designs, including sampling methods and exclusion criteria.
- Distinct phyla- and genus-level characteristics of the psoriatic microbiome were identified.
- Further research is warranted to elucidate the role of the skin microbiome in PsD.
