Microbiome, host response and wound healing (212.3)

It has long been appreciated that a multitude of bacteria, fungi and viruses colonise our skin (collectively termed the skin microbiome). However, only recently have technological advances allowed comprehensive profiling of the wide diversity of the skin microbiome across homeostasis and disease. A picture is emerging where resident commensal microbes may confer significant beneficial effects on skin health. Conversely pathogenic bacteria are currently being linked to numerous skin diseases. Surprisingly, in the context of wound repair it remains largely unclear how the skin microbiome influences healing outcome, both for normal and pathological healing. Indeed, chronic wound infection remains a clinical diagnosis largely based on the physical appearance of a wound. Here we address the mechanisms whereby a host senses and responds to changes in the wound microbiome. We demonstrate that experimental perturbation of specific aspects of the murine host response directly the skin bacterial profile and lead to delayed wound repair. Our data reveal specific changes to the host innate immune response, including altered antimicrobial peptide production. In fact, numerous factors that influence wound healing also alter the wound microbiome. Finally, we demonstrate clinical relevance with distinct bacterial signatures distinguishing chronic wounds that fail to heal from those that respond to treatment.