Targeting Staphylococcus aureus dominated skin dysbiosis in actinic keratosis to prevent the onset of cutaneous squamous cell carcinoma: Outlook for future therapies?

Gut microbiota in melanoma: Effects and pathogeneses

The gut microbiota exhibits intricate connections with the body's immune system and holds significant implications for various diseases and cancers. Currently, accumulating evidence suggests a correlation between the composition of the gut microbiota and the development, treatment, and prognosis of melanoma. However, the underlying pathogenesis remains incompletely elucidated. In this comprehensive review, we present an in-depth review of the role played by gut microbiota in melanoma tumorigenesis, growth, metastasis, treatment response, and prognosis. Furthermore, we discuss the potential utility of gut microbiota as a promising prognostic marker. Lastly, we summarize three routes through which gut microbiota influences melanoma: immunity, aging, and the endocrine system. By modulating innate and adaptive immunity in patients with melanoma across different age groups and genders, the gut microbiota plays a crucial role in anti-tumor immune regulation from tumorigenesis to prognosis management, thereby impacting tumor growth and metastasis. This review also addresses current study limitations while highlighting future research prospects.

Skin microbiome influences the progression of cutaneous squamous cell carcinoma through the immune system

Cutaneous squamous cell carcinoma (cSCC) is a type of skin tumor that develops in the epithelial cells. This disease has the second highest incidence of human skin cancers, with a high metastatic rate. While ultraviolet radiation significantly contributes to the genomic changes that support cSCC development, the dysbiosis of the skin microbiome and influence of the immune system also play important roles in this process. In this review, we discuss the effects of skin microbes and their metabolites on the immune system, including innate immune cells, T cells, and cytokines. We also discuss how Staphylococcus aureus and human papillomavirus can affect cSCC by impacting the immune system. Furthermore, we explore the antagonism of symbiotic microorganisms with cSCC-associated pathogens and their potential as novel therapeutic modalities.

Skin Microbiome, Inflammation, and Skin Toxicities in Women With Breast Cancer Receiving Moderately Hypofractionated Radiation Therapy

PURPOSE

Up to 95% of women during and after radiation therapy (RT) for breast cancer have reported cutaneous toxicity. However, the biologic link between skin microbiome and skin toxicities from RT remains largely unknown. This study aimed to assess the associations of skin microbiome with clinician- and patient-reported skin toxicities and inflammatory markers in women with breast cancer receiving RT.

METHODS AND MATERIALS

A prospective, longitudinal study was conducted at a single institution. Thirty-two women with breast cancer undergoing moderately hypofractionated RT for 3 to 4 weeks after breast conserving surgery were enrolled and 30 of them were analyzed. A total of 240 swabs for skin microbiome and 120 plasma samples were collected pre-RT baseline (T1), week-1 of RT (T2), week-3 of RT (T3), and 3 months post-RT (T4), from the cancer-affected and contralateral healthy breasts. Skin microbiome specimens were processed using 16S V1-V3 sequencing.

RESULTS

Differences in skin microbiome of the treated breasts during RT (T2 and T3) were observed compared with the skin microbiome of pre-RT baseline breasts (T1) and contralateral, healthy breasts, with the affected breasts having an increased abundance of pathogenetic Finegoldia (P = .001), Dermacoccus (P = .01), and Variovorax (P = .003) during RT. Longitudinal analysis showed that decreased Variovorax but increased Staphylococcus were associated with increased clinician-reported grade 2 pruritus (P = .002) and dermatitis (P = .012), and increased patient-reported moderate or severe darkened skin (P = .002) and itchy skin (P = .012). Additionally, the plasma interferon gamma was associated with changes in skin microbiome in women with breast cancer undergoing RT.

CONCLUSIONS

This study shows changes in the skin microbiome during well-tolerated moderately hypofractionated breast RT. The skin microbiome return toward baseline appears to associate with improvement of clinician- and patient-reported skin toxicities post-treatment. Although there were few high-grade toxicities observed among frequently prescribed courses of hypofractionated whole breast RT, changes in skin microbiome may be of interest as further targets of symptomatic relief or intervention as ultrahypofractionated courses become more common.

Malignant Fungating Wounds in Locally Aggressive Cutaneous Squamous Cell Carcinoma: A Case Series

Despite surgical removal being considered the first-line treatment, managing high-risk squamous cell carcinoma (SCC) cases remains challenging and lacks uniformity as associated complications of less common secondary bacterial infections are underreported. The skin, as well as its appendages, constitute the first line of defense against infectious pathogens. In patients with locally aggressive skin cancers, susceptibility to infectious microorganisms is elevated due to skin lesions and immunosuppression resulting from chemotherapy, surgery, immunotherapy, and stem cell transplantation. Furthermore, immunosuppressed patient populations, when infected, often have extended disease duration and heightened disease burden. Malignant fungating wounds (MFWs), cancerous lesions that typically occur during the terminal stages of a patient's illness when tumors infiltrate the skin and surrounding tissue, may further complicate cases as they often can be misdiagnosed as abscesses or infections. Due to this, we sought to thoroughly characterize the disease progression, treatment efficacy, and risk factors of two patients with locally aggressive SCCs afflicted with MFWs and secondary Pseudomonas aeruginosa (P. aeruginosa)infections. We report two cases of cutaneous SCC (cSCC) in immunocompromised patients, one with HIV and the other a lung transplant recipient on chronic immunosuppression. Both cases were complicated by extensive tumor invasion, chronic infection, and multidrug-resistant P. aeruginosa. These cases highlight the aggressive nature of cSCC in immunocompromised individuals and the complexities of balancing oncologic treatment, palliative care, and infectious disease management.

Global Trends and Scientific Impact of Topical Probiotics in Dermatological Treatment and Skincare

The skin plays a crucial role in maintaining homeostasis and protecting against external aggressors. Recent research has highlighted the potential of probiotics and postbiotics in dermatological treatments and skincare. These beneficial microorganisms interact with the skin microbiota, modulate the immune response, and enhance the skin barrier, offering a promising therapeutic avenue for various skin conditions, such as acne, dermatitis, eczema, and psoriasis. This bibliometric study aims to analyze the global trends and scientific impact of topical probiotics in dermatology. By reviewing 106 articles published between 2013 and 2023, the study categorizes the applications of probiotics in wound healing, inflammatory skin diseases, and general skincare. The findings indicate a significant increase in publications from 2021 onwards, attributed to the heightened focus on medical research during the COVID-19 pandemic. This study also identifies the most productive countries, institutions, and authors in this field, highlighting the importance of international collaborations. The results underscore the efficacy of probiotic-based topical formulations in improving skin health, reducing inflammation, and enhancing wound healing. This comprehensive analysis supports the development of new therapeutic strategies based on topical probiotics and encourages high-quality research in this promising area.

Characterization of the skin microbiome in normal and cutaneous squamous cell carcinoma affected cats and dogs

Human cutaneous squamous cell carcinomas (SCCs) and actinic keratoses (AK) display microbial dysbiosis with an enrichment of staphylococcal species, which have been implicated in AK and SCC progression. SCCs are common in both felines and canines and are often diagnosed at late stages leading to high disease morbidity and mortality rates. Although recent studies support the involvement of the skin microbiome in AK and SCC progression in humans, there is no knowledge of this in companion animals. Here, we provide microbiome data for SCC in cats and dogs using culture-independent molecular profiling and show a significant decrease in microbial alpha diversity on SCC lesions compared to normal skin (P ≤ 0.05). Similar to human skin cancer, SCC samples had an elevated abundance of staphylococci relative to normal skin-50% (6/12) had >50% staphylococci, as did 16% (4/25) of perilesional samples. Analysis of Staphylococcus at the species level revealed an enrichment of the pathogenic species Staphylococcus felis in cat SCC samples, a higher prevalence of Staphylococcus pseudintermedius in dogs, and a higher abundance of Staphylococcus aureus compared to normal skin in both companion animals. Additionally, a comparison of previously published human SCC and perilesional samples against the present pet samples revealed that Staphylococcus was the most prevalent genera across human and companion animals for both sample types. Similarities between the microbial profile of human and cat/dog SCC lesions should facilitate future skin cancer research.

IMPORTANCE

The progression of precancerous actinic keratosis lesions (AK) to cutaneous squamous cell carcinoma (SCC) is poorly understood in humans and companion animals, despite causing a significant burden of disease. Recent studies have revealed that the microbiota may play a significant role in disease progression. Staphylococcus aureus has been found in high abundance on AK and SCC lesions, where it secretes DNA-damaging toxins, which could potentiate tumorigenesis. Currently, a suitable animal model to investigate this relationship is lacking. Thus, we examined the microbiome of cutaneous SCC in pets, revealing similarities to humans, with increased staphylococci and reduced commensals on SCC lesions and peri-lesional skin compared to normal skin. Two genera that were in abundance in SCC samples have also been found in human oral SCC lesions. These findings suggest the potential suitability of pets as a model for studying microbiome-related skin cancer progression.

Mechanistic insight of Staphylococcus aureus associated skin cancer in humans by Santalum album derived phytochemicals: an extensive computational and experimental approaches

An excessive amount of multidrug-resistant Staphylococcus aureus is commonly associated with actinic keratosis (AK) and squamous cell carcinoma (SCC) by secreted virulence products that induced the chronic inflammation leading to skin cancer which is regulated by staphylococcal accessory regulator (SarA). It is worth noting that there is currently no existing published study that reports on the inhibitory activity of phytochemicals derived from Santalum album on the SarA protein through in silico approach. Therefore, our study has been designed to find the potential inhibitors of S. aureus SarA protein from S. album-derived phytochemicals. The molecular docking study was performed targeting the SarA protein of S. aureus, and CID:5280441, CID:162350, and CID: 5281675 compounds showed the highest binding energy with -9.4 kcal/mol, -9.0 kcal/mol, and -8.6 kcal/mol respectively. Further, molecular dynamics simulation revealed that the docked complexes were relatively stable during the 100 ns simulation period whereas the MMPBSA binding free energy proposed that the ligands were sustained with their binding site. All three complexes were found to be similar in distribution with the apoprotein through PCA analysis indicating conformational stability throughout the MD simulation. Moreover, all three compounds' ADMET profiles revealed positive results, and the AMES test did not show any toxicity whereas the pharmacophore study also indicates a closer match between the pharmacophore model and the compounds. After comprehensive in silico studies we evolved three best compounds, namely, Vitexin, Isovitexin, and Orientin, which were conducted in vitro assay for further confirmation of their inhibitory activity and results exhibited all of these compounds showed strong inhibitory activity against S. aureus. The overall result suggests that these compounds could be used as a natural lead to inhibit the pathogenesis of S. aureus and antibiotic therapy for S. aureus-associated skin cancer in humans as well.

Role of the Microbiota in Skin Neoplasms: New Therapeutic Horizons

The skin and the gut are regularly colonized by a variety of microorganisms capable of interacting with the immune system through their metabolites and influencing the balance between immune tolerance and inflammation. Alterations in the composition and diversity of the skin microbiota have been described in various cutaneous diseases, including skin cancer, and the actual function of the human microbiota in skin carcinogenesis, such as in progression and metastasis, is currently an active area of research. The role of Human Papilloma Virus (HPV) in the pathogenesis of squamous cell carcinoma is well consolidated, especially in chronically immunosuppressed patients. Furthermore, an imbalance between Staphylococcus spp., such as Staphylococcus epidermidis and aureus, has been found to be strongly related to the progression from actinic keratosis to squamous cell carcinoma and differently associated with various stages of the diseases in cutaneous T-cell lymphoma patients. Also, in melanoma patients, differences in microbiota have been related to dissimilar disease course and prognosis and may affect the effectiveness and tolerability of immune checkpoint inhibitors, which currently represent one of the best chances of a cure. From this point of view, acting on microbiota can be considered a possible therapeutic option for patients with advanced skin cancers, even if several issues are still open.