Key Research Questions Future Research Directions
Changes in skin microbiota composition Changes in skin microbiota composition
Do shifts in skin microbiota composition impact disease pathogenesis or do they merely reflect underlying disease processes? Mechanistic studies designed to assess the effect of changing skin microbe abundances on disease pathogenesis Intervention studies to understand role of microbes in disease pathogenesis
How do skin microbiota interact with one another, and with the host to influence disease pathogenesis? Functional analysis of the contribution of microbes e.g. bacteria, viruses, fungi and mites colonizing skin to skin disease Use of deep sequencing methods integrated with culture methods and measures of skin barrier function to determine the role of microbes in disease pathogenesis Standardization of protocols across skin phenotyping studies to allow for comparison of data Murine models investigating combinations of microbes, and deep endophenotyping of host responses
Do skin microbiota alterations in early life impact AD and FA onset in later childhood If so, what are the mechanisms through which this might occur? Larger longitudinal studies with long-term follow up, robust early life skin barrier measures, and objective allergic outcomes Mechanistic studies to validate the impact of changes in microbe composition on disease onset
Skin microbe-based therapeutic approaches Skin microbe-based therapeutic approaches
Does therapeutic manipulation of skin microbiota prevent AD or FA or reduce disease severity? If so, what is the window of opportunity for such interventions? Randomized controlled trials of early life skin microbiota manipulation with long-term follow up for allergic disease onset Detailed collection of skin barrier markers at serial time-points in early life
Which patient groups would benefit from biotherapeutic interventions? Intervention studies to include different disease phenotypes e.g. infected AD, positive colonization with target microbe, etc
Would disruption of pathogenic skin microbiota transmission between close contacts improve outcomes? Randomized controlled trials of microbe eradication techniques involving close contacts of index patients