Staphylococcus aureus in atopic dermatitis: How a common bacterium exploits and drives disease.

Abstract

The role of Staphylococcus aureus in atopic dermatitis (AD) has been extensively studied. Although its role in the pathophysiology of AD was previously controversial, current evidence now shows that it is a major factor promoting the disease and is responsible for significant morbidity. Its influence in AD stems from widespread exposure because S aureus is common on healthy skin and is frequently part of the normal human skin microbiome. In AD, S aureus and the closely related Staphylococcus epidermidis gain a selective growth advantage over most other members of the skin microbiome due to a complex relationship involving the skin's innate immune system, other members of the microbiome, and skin barrier properties. Disruption in the functioning of these components or changes in their interactions lead to dysbiosis, skin barrier damage, and the progression of skin disease. This review summarizes research findings on these relationships and highlights the interactions and factors that promote S aureus survival on skin and its participation in the pathogenesis of AD.