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The Skin Microbiome Acne and Eczema

For decades researchers have argued that some of the skin’s microscopic residents are partly to blame for certain disorders, such as acne and eczema. Now, it seems, bacteria may be part of the treatment, too.  This NY Times article by Ferris Jabr is an introduction to this emerging field of research.

An article by Richard Gallo on Antimicrobials and Skin Disorders describes early research into this area.  Practical applications are still a ways off, but this may prove to be an effective approach for patients with acne and atopic dermatitis.

Abstract of Gallo article:
The microbiome can promote or disrupt human health by influencing both adaptive and innate immune functions. We tested whether bacteria that normally reside on human skin participate in host defense by killing Staphylococcus aureus, a pathogen commonly found in patients with atopic dermatitis (AD) and an important factor that exacerbates this disease. High-throughput screening for antimicrobial activity against S. aureus was performed on isolates of coagulase-negative Staphylococcus (CoNS) collected from the skin of healthy and AD subjects. CoNS strains with antimicrobial activity were common on the normal population but rare on AD subjects. A low frequency of strains with antimicrobial activity correlated with colonization by S. aureus The antimicrobial activity was identified as previously unknown antimicrobial peptides (AMPs) produced by CoNS species including Staphylococcus epidermidis and Staphylococcus hominis These AMPs were strain-specific, highly potent, selectively killed S. aureus, and synergized with the human AMP LL-37. Application of these CoNS strains to mice confirmed their defense function in vivo relative to application of nonactive strains. Strikingly, reintroduction of antimicrobial CoNS strains to human subjects with AD decreased colonization by S. aureus These findings show how commensal skin bacteria protect against pathogens and demonstrate how dysbiosis of the skin microbiome can lead to disease.

Educate Your Immune System

Our bodies are confused by this 21st-century world.
by Moises Velasquez-Manoffjunem,

Op-Ed Piece in Sunday Review, NY Times, June 5, 2016

"The world today is very different from the one our immune system evolved to anticipate — not just in what we encounter, but in when we first encounter it. Preventing autoimmune disorders may require emulating aspects of that “dirtier” world: safely bottling the kinds of microbes that protect the kids, so we can give them to everyone and guide the “postmodern” immune system along a healthier path of development."

This essay argues that changes in our microbiome wrought by a "higher standard of living" in more developed countries  has led to an  increase the incidence of autoimmune diseases such as Type I diabetes and multiple sclerosis.  Other changes have also increased life-span, but some individuals have a higher burden of some diseases.  It's a complex relationship, and the arguments are presented well.

Image from Times article

 

Rethinking Clean

Forgoing a shower, even for a day, makes some people want to hide from society and double up on the deodorant. For Dave Whitlock, this is simply life as usual.

The chemical engineer and MIT grad decided back in 2003 to stop showering after discovering that animals harness bacteria in mud to stay odor-free. Called Nitrosomonas, these bacteria break down ammonia, producing nitrite (a powerful antibacterial) and nitric oxide (a beneficial gas). Speaking with LiveScience, Whitlock said he theorized that colonies of Nitrosomonas on the skin could potentially reduce body odor and keep other nasty bacteria in check.

The biggest problem with these ammonia oxidizing bacteria (or AOB) is that they take a long time to colonize on the skin and are extremely susceptible to many modern soaps and shampoos. Whitlock also discovered that modern humans are the only animal that does not harbor this particular bacteria — a likely result of our clean-obsessed lifestyles.

Consequently, he decided to isolate the bacteria into a spray and stop showering completely. Twice a day, he would apply the odorless spray to his body in an effort to build up a concentration of the bacteria on his skin. To his surprise, he discovered that not only did he not smell as time passed, but that his lack of showering had no ill effect on his health. Now 12 years later, he's still continuing the regimen –– but with a focus on only those parts he's recently washed.

"I only wash my hands," he told Motherboard. "In terms of the rest of my body, it’s basically already in a steady state. The bacteria on my skin are in a very stable, long-term state. I only need the spray on the parts of my body that I wash with water, because there the good bacteria gets washed away. If I took a normal shower, I’d have to use the spray all over my body after."

Armed with more than a dozen years of evidence that his spray harbors benefits for human skin, Whitlock recently helped launch a skin microbiome company called AOBiome. The startup's first products under the brand name Mother Dirt include not only the AO+ Mist (containing the live, beneficial Nitrosomonas bacteria), but also a biome-friendly face and body wash and shampoo.

"AOB were once a crucial part of the skin's ecosystem, but they've been lost due to modern chemistry in today's products and our lifestyles," Jasmina Aganovic, president of AOBiome, said in a statement. "With Mother Dirt, we're creating products that enhance and protect the skin biome."

According to Aganovic, users who incorporated the daily spray into their cleansing routines reported less dependence on deodorants, moisturizers and other personal care products. "They also found their skin was calmer, more hydrated, less oily, and generally more balanced," she added.

As for Whitlock, he says he's experienced another big benefit in the form of a better outlook; something he says may have something to do with the Nitrosomonas bacteria's production of nitric oxide.

"Well this is a bit speculative, but, according to science journals, nitric oxide is a very important psychological parameter," he told Motherboard. "It controls a lot of brain functions, for example. Stress is the result of low levels of nitric oxide. So if you have higher levels of nitric oxide, then it acts as an anti-stress mechanism."

The company is quick to add that you don't need to eschew showering to enjoy the benefits of a healthy skin biome.

"It’s not necessary that people stop showering or give up their soaps and shampoos," they state. "Our research shows that daily application along with normal showering in regular tap water produces a sustained level of AOB on skin. We recommend applying AO+ Mist daily as part of your usual personal hygiene routine."

Check out Aganovic speaking about AOBiome's breakthrough products at a recent IDEAS Boston conference below. (See YouTube of backstory.)

Human Microbiome Project

Image from sciencedaily.com

"A microbiome is the totality of microbes, their genetic elements (genomes), and environmental interactions in a particular environment. The term "microbiome" was coined by the Nobel Prize laureate Joshua Lederberg, who argued that microorganisms inhabiting the human body should be included as part of the human genome, because of their influence on human physiology. The human body contains over 10 times more microbial cells than human cells.

Microbiomes are being characterized in many other environments as well, including soil, seawater and freshwater systems.

A recent article in the NY Times, “In Good Health? Thank Your 100 Trillion Bacteria” by Gina Kolata, is a great introduction to the Human Microbiome Project and the recently reported initial findings.  This important field will impact on all interested in health and disease.

Here is an informative YouTube site about The NIH Human Microbiome Project (< 3 minutes).

On June 19, the NY Times had another article onthis subject:  "Tending the Body's Microbial Garden."  which is also worth reading.  These concepts have important implications for healthand disease.