AUTHOR=Storz Lukas , Schmid Bettina , Bosshard Philipp Peter , Schmid-Grendelmeier Peter , Brüggen Marie-Charlotte , Lang Claudia 

TITLE=Decreased skin colonization with Malassezia spp. and increased skin colonization with Candida spp. in patients with severe atopic dermatitis

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1353784

DOI=10.3389/fmed.2024.1353784

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease in which patients are sensitized towards a plethora of allergens. The hosts fungal microbiota, the mycobiota, that is believed to be altered in patients suffering from AD acts as such an allergen. The correlation context of specific sensitization, changes in mycobiota and its impact on disease severity however remains poorly understood.</p></sec><sec id="sec2"><title>Objectives</title><p>We aim to enhance the understanding of the specific sensitization towards the mycobiota in AD patients in relation to their fungal skin colonization.</p></sec><sec id="sec3"><title>Methods</title><p>Sensitization pattern towards the <italic>Malassezia</italic> spp. and <italic>Candida albicans</italic> of 16 AD patients and 14 healthy controls (HC) were analyzed with the newly developed multiplex-assay ALEX<sup>2®</sup> and the established singleplex-assay ImmunoCAP<sup>®</sup>. We compared these findings with the fungal skin colonization analyzed by DNA sequencing of the internal transcribed spacer region 1 (ITS1).</p></sec><sec id="sec4"><title>Results</title><p>Sensitization in general and towards <italic>Malassezia</italic> spp. and <italic>C. albicans</italic> is increased in AD patients compared to HC with a quantitative difference in severe AD when compared to mild to moderate AD. Further we saw an association between sensitization towards and skin colonization with <italic>Candida</italic> spp. yet a negative correlation between sensitization towards and skin colonization with <italic>Malassezia</italic> spp.</p></sec><sec id="sec5"><title>Conclusion</title><p>We conclude that AD in general and severe AD in particular is associated with increased sensitization towards the hosts own mycobiota. There is positive correlation in <italic>Candida</italic> spp. skin colonization and negative in <italic>Malassezia</italic> spp. skin colonization when compared to AD, AD severity as well as to specific sensitization patterns.</p></sec>