Findings presented at today’s EADV Spring Symposium 2021 suggest that an imbalance in the gut microbiota (dysbiosis) could play an important role in the progression of the inflammatory skin disease, Hidradenitis suppurativa (HS).
HS is a long-term painful skin condition, chronic and relapsing in nature that significantly affects the quality of life of patients.
Researchers from Hacettepe University collected fecal samples from 15 HS patients and 15 age- and sex-matched healthy individuals and analyzed regions of the bacterial 16S rRNA gene to investigate differences in their gut microbiota. The researchers found that the relative abundance of three genera of bacteria (collectively known as Firmicutes), unclassified Clostridiales, unclassified Firmicutes and Fusicatenibacter in patients with HS was significantly lower than in controls (p = 0.005, p = 0.029 and p = 0.046 , respectively). ).
Reduced amounts of these bacteria are known to alter the regulatory balance within the intestine and stimulate an inflammatory response.
The human gastrointestinal tract is inhabited by a wide variety of bacterial organisms, collectively known as the gut microbiome.1 Studies have increasingly shown that the gut microbiome and skin are intrinsically connected, offering defense against pathogens in the environment.
This relationship is known as the "gut-skin axis" and has been linked to many inflammatory and autoimmune skin disorders, such as acne and psoriasis. This connection inspired researchers to characterize the gut microbiome composition of HS patients, hypothesizing that the imbalance may play a role in the high inflammatory burden of this condition.
HS is a multifactorial disease caused by genetic and environmental factors. Obesity and smoking can significantly exacerbate symptoms, and both have an impact on the gut microbiome.
Dr Neslihan Demirel Ogut, Usak University Research and Training Hospital explains: "Our research provides evidence that the gut-skin axis is involved in the progression of this chronic inflammatory skin disorder. While more is required "Our research suggests that dietary alteration and personalized probiotic supplementation could also be beneficial for patients with HS, especially since treatment options are limited for these people."
The intestinal microbiota plays a fundamental role in human health through the development of the immune response, controlled by specific pathways and the products of metabolism, known as short chain fatty acids (SCFA).
Bacteria in the gut (such as Firmicutes) produce these SCFAs which ensure that the balance is maintained between immune cells that stimulate or suppress an inflammatory response. Any disturbance of this balance, as evidenced by the reduced abundance of these organisms in the gut microbiome of HS patients, may induce an unwanted inflammatory response.
Additional research is required to better understand and explain the connections between gut microbiota and excessive inflammatory status in patients with HS. "As one of the preliminary studies investigating HS, this pioneering research lays the foundation for future research into the management of this debilitating condition. It is an exciting development in a topic that is currently at the forefront of scientific research," says Marie -Aleth Richard, EADV Council Member and professor at La Timone University Hospital, Marseille.
References:
1. Silva YP, Bernardi A, Frozza RL. The role of short-chain fatty acids from fut microbiota in gut-brain communication. Front. Endocrinol. 2020 Available from: https://www.frontiersin.org/articles/10.3389/fendo.2020.00025/fullAccessed April 2021
2. Bukin, Y., Galachyants, Y., Morozov, I. et al. The effect of 16S rRNA region choice on bacterial community metabarcoding results. Nature Sci Data. 2019. Available from: https://www.nature.com/articles/sdata20197. Accessed April 2021
3. Dufour DN, Emtestam L, Jemec GB. Hidradenitis suppurativa: a common and burdensome, yet under-recognized, inflammatory skin disease. Postgrad. Med. J. 2014;90:216-221.
4. Kurzen H et al What causes hidradenitis suppurativa? Exp Dermatol. 2008 May;17(5):455-6 Accessed April 2021
