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Interactions between the immune system and skin bacteria are of major importance in the pathophysiology of atopic dermatitis (AD), yet our understanding of them is limited. From a cohort of very young AD children (1 to 3 years old), sensitized to  Dermatophagoides pteronyssinus  allergens (Der p), we conducted culturomic analysis of skin microbiota, cutaneous transcript profiling and quantification of anti-Der p CD4 +  T cells. This showed that the presence of  S .  aureus  in inflamed skin of AD patients was associated with a high IgE response, increased expression of inflammatory and Th2/Th22 transcripts and the prevalence of a peripheral Th2 anti-Der p response. Monocyte-derived dendritic cells (moDC) exposed to the  S .  aureus  and  S .  epidermidis  secretomes were found to release pro-inflammatory IFN-γ and anti-inflammatory IL-10, respectively. Allogeneic moDC exposed to the  S .  aureus  secretome also induced the proliferation of CD4 +  T cells and this effect was counteracted by concurrent exposure to the  S .  epidermidis  secretome. In addition, whereas the  S .  epidermidis  secretome promoted the activity of regulatory T cells (Treg) in suppressing the proliferation of conventional CD4 +  T cells, the Treg lost this ability in the presence of the  S .  aureus  secretome. We therefore conclude that  S .  aureus  may cause and promote inflammation in the skin of AD children through concomitant Th2 activation and the silencing of resident Treg cells. Commensals such as  S .  epidermidis  may counteract these effects by inducing the release of IL-10 by skin dendritic cells.

plos one

Effects of the Staphylococcus aureus and Staphylococcus epidermidis Secretomes Isolated from the Skin Microbiota of Atopic Children on CD4+ T Cell Activation