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Sánchez-Pellicer P, Eguren-Michelena C, García-Gavín J, Llamas-Velasco M, Navarro-Moratalla L, Núñez-Delegido E, Agüera-Santos J, Navarro-López V. Rosacea, microbiome and probiotics: the gut-skin axis. Front Microbiol 2024; 14:1323644. [PMID: 38260914 PMCID: PMC10800857 DOI: 10.3389/fmicb.2023.1323644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Rosacea is an inflammatory skin disease involving diverse symptoms with a variable clinical progress which can severely impact the patient's quality of life as well as their mental health. The pathophysiological model of rosacea involves an unbalanced immune system predisposed to excessive inflammation, in addition to vascular and nervous alterations, being certain cutaneous microorganisms' triggers of the symptoms onset. The gut-skin axis explains a bidirectional interaction between skin and gut microbiota in some inflammatory skin diseases such as atopic dermatitis, psoriasis, or rosacea. The introduction and consolidation of the next-generation sequencing in recent years has provided unprecedented information about the microbiome. However, the characterization of the gut and skin microbiota and the impact of the gut-skin axis in patients with rosacea has been little explored, in contrast to other inflammatory skin diseases such as atopic dermatitis or psoriasis. Furthermore, the clinical evolution of patients with rosacea is not always adequate and it is common for them to present a sustained symptomatology with frequent flare-ups. In this context, probiotic supplementation could improve the clinical evolution of these patients as happens in other pathologies. Through this review we aim to establish and compile the basics and directions of current knowledge to understand the mechanisms by which the microbiome influences the pathogenesis of rosacea, and how modulation of the skin and gut microbiota could benefit these patients.
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Affiliation(s)
- Pedro Sánchez-Pellicer
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | | | | | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Laura Navarro-Moratalla
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Eva Núñez-Delegido
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Juan Agüera-Santos
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Vicente Navarro-López
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital of Vinalopó-Fisabio, Elche, Spain
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Sánchez-Pellicer P, Navarro-Moratalla L, Núñez-Delegido E, Agüera-Santos J, Navarro-López V. How Our Microbiome Influences the Pathogenesis of Alopecia Areata. Genes (Basel) 2022; 13:genes13101860. [PMID: 36292745 PMCID: PMC9601531 DOI: 10.3390/genes13101860] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/04/2022] Open
Abstract
Alopecia areata is a multifactorial autoimmune-based disease with a complex pathogenesis. As in all autoimmune diseases, genetic predisposition is key. The collapse of the immune privilege of the hair follicle leading to scalp loss is a major pathogenic event in alopecia areata. The microbiota considered a bacterial ecosystem located in a specific area of the human body could somehow influence the pathogenesis of alopecia areata, as it occurs in other autoimmune diseases. Moreover, the Next Generation Sequencing of the 16S rRNA bacterial gene and the metagenomic methodology have provided an excellent characterization of the microbiota. The aim of this narrative review is to examine the published literature on the cutaneous and intestinal microbiota in alopecia areata to be able to establish a pathogenic link. In this review, we summarize the influence of the microbiota on the development of alopecia areata. We first introduce the general pathogenic mechanisms that cause alopecia areata to understand the influence that the microbiota may exert and then we summarize the studies that have been carried out on what type of gut and skin microbiota is found in patients with this disease.
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Affiliation(s)
- Pedro Sánchez-Pellicer
- MiBioPath Research Group, Department of Clinical Medicine, Health Sciences Faculty, Catholic University of Murcia, Campus de los Jerónimos 135, 30107 Murcia, Spain
| | - Laura Navarro-Moratalla
- MiBioPath Research Group, Department of Clinical Medicine, Health Sciences Faculty, Catholic University of Murcia, Campus de los Jerónimos 135, 30107 Murcia, Spain
| | - Eva Núñez-Delegido
- MiBioPath Research Group, Department of Clinical Medicine, Health Sciences Faculty, Catholic University of Murcia, Campus de los Jerónimos 135, 30107 Murcia, Spain
| | - Juan Agüera-Santos
- MiBioPath Research Group, Department of Clinical Medicine, Health Sciences Faculty, Catholic University of Murcia, Campus de los Jerónimos 135, 30107 Murcia, Spain
| | - Vicente Navarro-López
- MiBioPath Research Group, Department of Clinical Medicine, Health Sciences Faculty, Catholic University of Murcia, Campus de los Jerónimos 135, 30107 Murcia, Spain
- Infectious Diseases Unit, University Hospital of Vinalopó-Fisabio, Carrer Tonico Sansano Mora 14, 03293 Elche, Spain
- Correspondence:
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Navarro-López V, Méndez-Miralles MÁ, Vela-Yebra R, Fríes-Ramos A, Sánchez-Pellicer P, Ruzafa-Costas B, Núñez-Delegido E, Gómez-Gómez H, Chumillas-Lidón S, Picó-Monllor JA, Navarro-Moratalla L. Gut Microbiota as a Potential Predictive Biomarker in Relapsing-Remitting Multiple Sclerosis. Genes (Basel) 2022; 13:genes13050930. [PMID: 35627315 PMCID: PMC9140870 DOI: 10.3390/genes13050930] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The influence of the microbiome on neurological diseases has been studied for years. Recent findings have shown a different composition of gut microbiota detected in patients with multiple sclerosis (MS). The role of this dysbiosis is still unknown. OBJECTIVE We analyzed the gut microbiota of 15 patients with active relapsing-remitting multiple sclerosis (RRMS), comparing with diet-matched healthy controls. METHOD To determine the composition of the gut microbiota, we performed high-throughput sequencing of the 16S ribosomal RNA gene. The specific amplified sequences were in the V3 and V4 regions of the 16S ribosomal RNA gene. RESULTS The gut microbiota of RRMS patients differed from healthy controls in the levels of the Lachnospiraceae, Ezakiella, Ruminococcaceae, Hungatella, Roseburia, Clostridium, Shuttleworthia, Poephyromonas, and Bilophila genera. All these genera were included in a logistic regression analysis to determine the sensitivity and the specificity of the test. Finally, the ROC (receiver operating characteristic) and AUC with a 95% CI were calculated and best-matched for Ezakiella (AUC of 75.0 and CI from 60.6 to 89.4) and Bilophila (AUC of 70.2 and CI from 50.1 to 90.4). CONCLUSIONS There is a dysbiosis in the gut microbiota of RRMS patients. An analysis of the components of the microbiota suggests the role of some genera as a predictive factor of RRMS prognosis and diagnosis.
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Affiliation(s)
- Vicente Navarro-López
- Ph.D. Program in Health Sciences, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
- Infectious Disease Unit, University Hospital Vinalopó, Carrer Tonico Sansano Mora 14, 03293 Elche, Spain
- Correspondence: (V.N.-L.); (M.Á.M.-M.)
| | - María Ángeles Méndez-Miralles
- Ph.D. Program in Health Sciences, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
- Department of Neurology, University Hospital of Torrevieja, Carretera CV95, s/n, 03186 Alicante, Spain;
- Correspondence: (V.N.-L.); (M.Á.M.-M.)
| | - Rosa Vela-Yebra
- Department of Neurology, University Hospital of Torrevieja, Carretera CV95, s/n, 03186 Alicante, Spain;
| | - Ana Fríes-Ramos
- Department of Neurology, University Hospital of Vinalopó, Carrer Tonico Sansano Mora 14, 03293 Elche, Spain;
| | - Pedro Sánchez-Pellicer
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
| | - Beatriz Ruzafa-Costas
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
| | - Eva Núñez-Delegido
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
| | - Humberto Gómez-Gómez
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
| | - Sara Chumillas-Lidón
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
| | - Jose A. Picó-Monllor
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
- Department of Pharmacology, Pediatrics and Organic Chemistry, Faculty of Pharmacy, Universidad Miguel Hernández de Elche, 03202 Elche, Spain
| | - Laura Navarro-Moratalla
- MiBioPath Research Group, Department of Clinical Medicine, Campus de los Jerónimos 135, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.S.-P.); (B.R.-C.); (E.N.-D.); (H.G.-G.); (S.C.-L.); (J.A.P.-M.); (L.N.-M.)
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Sánchez-Pellicer P, Navarro-López V, González-Tamayo R, Llopis-Ruiz C, Núñez-Delegido E, Ruzafa-Costas B, Navarro-Moratalla L, Agüera-Santos J. Descriptive Study of Gut Microbiota in Infected and Colonized Subjects by Clostridiodes difficile. Microorganisms 2021; 9:microorganisms9081727. [PMID: 34442805 PMCID: PMC8401824 DOI: 10.3390/microorganisms9081727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
Clostridiodes difficile can lead to a range of situations from the absence of symptoms (colonization) to severe diarrhea (infection). Disruption of gut microbiota provides an ideal environment for infection to occur. Comparison of gut microbiota of infected and colonized subjects could provide relevant information on susceptible groups or protectors to the development of infection, since the presence of certain genera could be related to the inhibition of transition from a state of colonization to infection. Through high-throughput sequencing of 16S rDNA gene, we performed alpha and beta diversity and composition studies on 15 infected patients (Group CDI), 15 colonized subjects (Group P), and 15 healthy controls (Group CTLR). A loss of alpha diversity and richness and a different structure have been evidenced in the CDI and P groups with respect to the CTRL group, but without significant differences between the first two. In CDI and P groups, there was a strong decrease in phylum Firmicutes and an expansion of potential pathogens. Likewise, there was a loss of inhibitory genus of C. difficile germination in infected patients that were partially conserved in colonized subjects. Therefore, infected and colonized subjects presented a gut microbiota that was completely different from that of healthy controls, although similar to each other. It is in composition where we found that colonized subjects, especially in minority genera, presented differences with respect to those infected.
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Affiliation(s)
- Pedro Sánchez-Pellicer
- MiBioPath Group, Health and Science Faculty, Catholic University of Murcia, Campus de los Jerónimos, 135, 30107 Murcia, Spain; (E.N.-D.); (B.R.-C.); (L.N.-M.); (J.A.-S.)
- Correspondence: (P.S.-P.); (V.N.-L.)
| | - Vicente Navarro-López
- MiBioPath Group, Health and Science Faculty, Catholic University of Murcia, Campus de los Jerónimos, 135, 30107 Murcia, Spain; (E.N.-D.); (B.R.-C.); (L.N.-M.); (J.A.-S.)
- Infectious Diseases Unit, University Hospital of Vinalopó, Carrer Tonico Sansano Mora, 14, 03293 Elche, Spain
- Correspondence: (P.S.-P.); (V.N.-L.)
| | - Ruth González-Tamayo
- Biochemistry Laboratory, Vega Baja Hospital, Carretera Orihuela-Almoradí s/n, 03314 San Bartolomé, Spain;
| | - Coral Llopis-Ruiz
- Microbiology Laboratory, University Hospital of Vinalopó, Carrer Tonico Sansano Mora, 14, 03293 Elche, Spain;
| | - Eva Núñez-Delegido
- MiBioPath Group, Health and Science Faculty, Catholic University of Murcia, Campus de los Jerónimos, 135, 30107 Murcia, Spain; (E.N.-D.); (B.R.-C.); (L.N.-M.); (J.A.-S.)
| | - Beatriz Ruzafa-Costas
- MiBioPath Group, Health and Science Faculty, Catholic University of Murcia, Campus de los Jerónimos, 135, 30107 Murcia, Spain; (E.N.-D.); (B.R.-C.); (L.N.-M.); (J.A.-S.)
| | - Laura Navarro-Moratalla
- MiBioPath Group, Health and Science Faculty, Catholic University of Murcia, Campus de los Jerónimos, 135, 30107 Murcia, Spain; (E.N.-D.); (B.R.-C.); (L.N.-M.); (J.A.-S.)
| | - Juan Agüera-Santos
- MiBioPath Group, Health and Science Faculty, Catholic University of Murcia, Campus de los Jerónimos, 135, 30107 Murcia, Spain; (E.N.-D.); (B.R.-C.); (L.N.-M.); (J.A.-S.)
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