The Skin Microbiota and Patient-Reported Outcomes in Psoriasis: Using the Metagenomic Approach to Decipher the Role of Commensals in the Cellular and Molecular Mechanisms of Pruritus

For the majority of patients with psoriasis, the psoriasis activity severity index can predictably reflect treatment responses to the standard care, whereas patient-reported outcomes (PRO) have less frequently assessed as the primary outcome of interest in an interventional trial. For instance, pruritus was reportedly the most common symptom experienced by patients with psoriasis; evidence also suggested that the degree of pruritus was negatively correlated with patients’ reported quality of life, but only until recently did interventional trials begin to appreciate the importance of these patient-centered clinical outcomes. Prior in vivo and in vitro studies have shown that, the exposure of epidermal T cells taken from patients with atopic dermatitis to Staphylococcal enterotoxin B resulted in an increased expression of interleukin-31, supporting the notion that Staphylococcus aureus was pivotal in the pruritic symptoms. As accumulating evidence has suggested that psoriatic skin is also prone to Staphylococcal colonization, and that as many as 60-90% of patients suffered from bothering pruritus, we hypothesize that the colonizing bacteria could also take part in the underlying mechanisms of itch in patients with psoriasis.An increasing body of knowledge on the role of the skin microbiome in human health and disease showed that, skin commensals are capable to modulate host cellular recognition and responses to external or self-antigens. The current proposal aims to apply the shotgun metagenomic method to comprehensively profile the skin microbiome, including bacteria, fungus, and viruses, and its encoded gene functions before and after psoriasis patients receiving systemic treatment with a hope of better understanding the role of skin microbes in mediating important PROs. Significance of the proposed work may comprise of the development of further research into identifying microbial signature or products as novel biomarkers for patient stratification and treatment prediction, both of which are in line with the core value of the emerging personalized medicine.

Project ID:PC10708-1047
External Project ID:MOST107-2314-B182-055