Medizinische Universität Graz - Research portal
Selected Publication:
Zarfl, M.
The significance of skin microbiome in the pathophysiology of polymorphic light eruption
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 77
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- Authors Med Uni Graz:
- Advisor:
- Bordag Natalie
- Wolf Peter
- Altmetrics:
- Abstract:
- Background: Polymorphic light eruption (PLE) is the most common photodermatosis, causing episodes of skin abnormalities in spring/early summer, which are associated with seasonal changes in susceptibility to UV-induced immunosuppression. Although the pathogenesis is not fully understood, there is evidence that the skin microbiome could play a crucial role. Preclinical data have shown that the skin microbiome can regulate UV-induced cytokine expression and modulate the subsequent immune response. Aim: The aim of the study was to investigate the effect of skin disinfection in patients with polymorphic light eruption (PLE), to explore whether the skin microbiome influences the expression of cytokines and thus plays a role in the pathophysiology of the disease after sunlight-simulated UV exposure. Methods: A randomized, placebo-controlled, double-blind pilot study was conducted involving 6 patients with PLE and 15 healthy individuals as a control group. A test to determine the minimal erythematous dose (MED) and photoprovocations, both on disinfected and non-disinfected skin, were performed. Moreover, cytokines from suction blister fluid (analyzed by OLINK 96 Target Inflammation Panel), skin swabs and adhesive strips for microbiome analysis, and cis-urocanic acid (cis-UCA) analysis were collected. Additionally, skin biopsies were taken to enable intra- and interindividual comparisons of UV-exposed, disinfected, and non-disinfected skin. Results: Overall, there were no significant differences in the clinical endpoints (erythema and pigmentation) between patients with PLE and control subjects (nor between disinfected and non-disinfected skin). Patients with PLE demonstrated impaired cytokine production in non-exposed, untreated skin, and UV-exposed, non-disinfected skin at MED. The ability of patients with PLE to produce cytokines was restored by disinfection after multiple UV exposures. Discussion: A regular pattern of cytokine expression was observed after multiple UV exposures and disinfection of the skin in patients with PLE. However, due to the small number of patients enrolled in the study, the results of the clinical study endpoints do not allow for definitive conclusions regarding the biological-clinical relevance of skin disinfection in PLE. Conclusion: Patients with PLE demonstrate impaired expression of numerous cytokines and chemokines, regardless of whether they are exposed to UV radiation or not. This could be partially responsible for UV-induced immunosuppression. Skin disinfection has the potential to restore cytokine production in patients with PLE and to correct the imbalance.