Forum for Nordic Dermato-Venereology Nr2,2017 | Page 26

Hanna Brauner – Karolinska Dermatology Symposium, 2017 “The Microbiome in Health and Disease – Focus on SKIN”
and does not require further screening for possible infections
or gastro-intestinal diseases among the donor etc. Since the
original fecal donation to generate the ACHIM is from the
1990 when antibiotic resistance was less wide-spread, fewer
resistance genes are also transferred to the patient.
The ongoing studies by Norin and colleagues focus on treat-
ing patients with Clostridium difficile diarrhea and irritable
bowel syndrome (IBS) with ACHIM. In both these diseases the
commensal ecology is unbalanced and available treatment
options often insufficient.
patients with psoriasis and also in AD non-lesional vs lesional
skin. Compared to AD, psoriasis displayed a more complex
pattern, involving more different types of bacteria.
Finally the potential role of polyoma viruses in skin disease
was discussed, as an increased shedding of polyoma virus is
observed in several dermatological conditions. It may however
be too early to firmly establish a causative role for polyoma
virus and an alternative explanation may be that there is an
increased shedding of virus particles generally in diseased skin.
Gene environment interplay in health and disease
Methods for studying microbiota
Björn Andersson, Professor, Karolinska Institutet, Solna
Harri Alenius, professor
Karolinska Institutet and Helsinki University
Professor Alenius started by explaining how the immune sys-
tem has developed during evolution and how environmental
biodiversity, human microbiota and allergy are interrelated.
Some immune responses remain against pathogens no longer
present in modern civilization and may be involved in causing
pathology instead.
Professor Alenius reviewed his research on the relationship
between skin microbes and expression levels of immune
genes in peripheral blood, showing that dermal exposure to
Acinetobacter protects from allergic inflammation.
In the EU consortium “microbes in allergy and autoimmunity
related to the skin”, MAARS, skin from patients with psoriasis
and AD is compared in search for differences in the microbi-
ome. The sampling and methods included in this ambitious
project include 16s rRNA PCR + sequencing, swab + biopsy,
microbiome sequencing and virus screening.
Professor Andersson is one of the responsible scientists for the
MAARS project, and he reviewed the experimental approaches
of the project. One novel technique is for example “shotgun
sequencing”, where everything in the sample undergoes deep
sequencing without selection. This approach has helped
identifying additional organisms but the data analysis is
challenging. The recent review in J Invest Dermatol regarding
standardization of methods to perform studies of skin micro-
biome is recommended for anyone with a particular interest
in the methodology (J Invest Dermatol, Research Techniques
Made Simple, 2015–2016).
Some yet unpublished interesting findings of the MAARS study
were also reviewed, where differences were found in skin from
patients with AD compared to skin from healthy subjects and
56
M eeting R eport
In another interesting study Finnish and Russian school
children in Karelia were compared with respect to nasal mi-
crobiota and gene expression. Approximately 100 genes were
differently expressed between the groups, many of which are
related to innate immunity. This led to the conclusion that
microorganisms somehow affect genes and pathways, possibly
through expansion of effector cells during an infection.
In light of recent findings discussed throughout the Karolin-
ska Dermatology Symposia Professor Alenius philosophically
asked: “Are we more microbe than man?”
Cutaneous microbiome and atopic dermatitis
Thomas Volz, Senior Dermatologist and Researcher, Munich Tech-
nical University, Munich
Dr Volz described the pathophysiologic vicious circle in atopic
dermatitis (AD), with dry skin, impaired cutaneous barrier,
reduced resistance to environmental influences and the micro-
biome lead to disease. Immune alterations associated with AD
are skewing towards a Th2 immune response, with increased
levels of the cytokine IL-4, and colonization with S. aureus.
The effects of IL-4 include reduction of barrier functions and
suppression of the cytokines IL-17 and IFNg.
Forum for Nord Derm Ven 2017, Vol. 22, No. 2