Integrating Metagenomics into Personalized Medicine in Dermatology

Main Article Content

Amy Huang
Sharon Glick

Keywords

metagenomics, personalized medicine, microbiome, dysbiosis, sequencing, atopic dermatitis, melanoma

Abstract

There has been a recent focus on the association between human microbiomes and disease development, disease resistance, and therapy response. Fecal transplants for inflammatory bowel disease and resistant Clostridium difficile infection have demonstrated that manipulating the gut microbiome can be beneficial in treating disease. Microbiomes are important in dermatology, where response to immune checkpoint inhibitors for melanoma therapy can be affected by differences in gut microbial composition. Bleach baths, which alter the skin microbiome, are known to be beneficial in atopic dermatitis. Gut dysbiosis, or disturbance in the gut microbiome in early life, can influence the development of systemic sclerosis and atopic dermatitis. Metagenomic sequencing can therefore be a useful addition to personalized medicine to identify therapy responders versus non-responders, patients at risk of serious side-effects from biologics and immune checkpoint inhibitors, and prebiotic supplements that aid in improving therapy response.

References

1. Scher JU, Ubeda C, Artacho A, et al. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol 2015; 67(1):128-39.

2. Song H, Yoo Y, Hwang J, et al. Faecalibacterium prausnitzii subspecies-level dysbiosis in the human gut microbiome underlying atopic dermatitis. J Allergy Clin Immunol 2016; 137(3):852-60.

3. West CE, Ryden P, Lundin D, et al. Gut microbiome and innate immune response patterns in IgE-associated eczema. Clin Exp Allergy 2015; 45(9):1419-29.

4. Lee SY, Yu J, Ahn KM, et al. Additive effect between IL-13 polymorphism and cesarean section delivery/prenatal antibiotics use on atopic dermatitis: a birth cohort study (COCOA). PLoS One 2014; 9(5):e96603.

5. Williams MR, Gallo RL. Evidence that Human Skin Microbiome Dysbiosis Promotes Atopic Dermatitis. J Invest Dermatol 2017; 137(12):2460-1.

6. Mehta H, Goulet PO, Mashiko S, et al. Early-Life Antibiotic Exposure Causes Intestinal Dysbiosis and Exacerbates Skin and Lung Pathology in Experimental Systemic Sclerosis. J Invest Dermatol 2017; 137(11):2316-25.

7. Gopalakrishnan V, Spencer CN, Nezi L, et al. Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients. Science 2018; 359(6371):97-103.

8. Sivan A, Corrales L, Hubert N, et al. Commensal Bifidobacterium promotes antitumor immunity and facilitates anti-PD-L1 efficacy. Science 2015; 350(6264):1084-9.

9. Vetizou M, Pitt JM, Daillere R, et al. Anticancer immunotherapy by CTLA-4 blockade relies on the gut microbiota. Science 2015; 350(6264):1079-84.

10. Dubin K, Callahan MK, Ren B, et al. Intestinal microbiome analyses identify melanoma patients at risk for checkpoint-blockade-induced colitis. Nat Commun 2016; 7(10391.

11. Routy B, Le Chatelier E, Derosa L, et al. Gut microbiome influences efficacy of PD-1-based immunotherapy against epithelial tumors. Science 2018; 359(6371):91-7.

12. Botticelli A, Zizzari I, Mazzuca F, et al. Cross-talk between microbiota and immune fitness to steer and control response to anti PD-1/PDL-1 treatment. Oncotarget 2017; 8(5):8890-9.

13. Roy S, Trinchieri G. Microbiota: a key orchestrator of cancer therapy. Nat Rev Cancer 2017; 17(5):271-85.

14. Shi B, Bangayan NJ, Curd E, et al. The skin microbiome is different in pediatric versus adult atopic dermatitis. J Allergy Clin Immunol 2016; 138(4):1233-6.