35例儿童特应性皮炎患者的皮肤菌群特征与润肤剂治疗研究  

Study on the characteristics of skin microflora and emollient therapy in pediatric patients with atopic dermatitis

作　　者：万朋杰 李梅云 韦艳霞 陈戟[1] WAN Pengjie;LI Meiyun;WEI Yanxia;CHEN Ji(Department of Dermatology,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Department of Pathogenic Biology and Immunology/School of Stomatology,Xuzhou Medical University,Xuzhou 221004,Jiangsu Province,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心皮肤科,上海200127 [2]徐州医科大学病原生物学与免疫学教研室,江苏徐州221004

出　　处：《世界临床药物》2023年第10期1068-1074,共7页World Clinical Drug

基　　金：国家自然科学基金青年项目(82203910);上海交通大学医工交叉研究课题(YG2021QN112);上海儿童医学中心院级临床研究课题(LYSCMC2020-05)。

摘　　要：目的比较婴儿期和儿童期特应性皮炎(atopic dermatitis,AD)患儿肘窝处皮损与非皮损的菌群差异,并分析润肤剂治疗对轻度儿童期AD患儿皮肤菌群的影响。方法采用自身对照研究方法,使用Illumina MiSeq测序平台对AD患儿皮损与非皮损处、润肤剂治疗前后同一皮损处皮肤表面菌群16S核糖体DNA基因V3~V4区进行高通量测序,比较皮损处与非皮损处以及润肤剂治疗前后的菌群差异。结果共35例AD患儿纳入研究。与邻近非皮损处的正常皮肤相比,AD患儿肘窝部皮损葡萄球菌属丰度明显升高,菌群α多样性明显下降,两者差异具有统计学意义(P<0.05);婴儿期及儿童期AD患儿菌群多样性未见明显差异;润肤剂治疗后1个月金黄色葡萄球菌由优势菌转变为非优势菌。结论婴儿期及儿童期AD患儿皮损处均以葡萄球菌属定植为主,未见随年龄改变而出现的菌群构成差异改变;单纯润肤剂治疗可使轻度AD患儿皮损处的金黄色葡萄球菌由优势菌转变为非优势菌。Objective To compare the difference of microbiota between lesions and non-lesions of elbow fossa in children with infantile atopic dermatitis(AD)and childhood AD,and to analyze the effect of emollient therapy on skin microbiota in mild pediatric AD patients.Methods By using self-control study,Illumina MiSeq sequencing platform was used to sequence the V3—V4 region of 16S ribosome DNA gene on the skin surface of AD children with and without skin lesions,and on the same skin lesion before and after treatment with emollient.The differences of microbiota between skin lesions and non-skin lesions and before and after treatment with emollient were compared.Results A total of 35 children with AD were included in the study.Compared with the normal skin without skin lesions,the abundance of staphylococci in AD elbow lesions was significantly increased and theαdiversity of microbiota decreased significantly(P<0.05),and there was no significant difference between infantile AD and childhood AD.One month after treatment,Staphylococcus aureus changed from dominant microbiota to non-dominant microbiota.Conclusion Staphylococci colonization is the dominant bacteria in the skin lesions of infants with AD and childhood AD,and there is no difference in the composition of microbiota with age,and emollient treatment can change Staphylococcus aureus in skin lesions of mild childhood AD patients from dominant microbiota to non-dominant microbiota.

关 键 词：特应性皮炎 儿童 菌群失调 润肤剂 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]