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Published in: Current Allergy and Asthma Reports 11/2015

01-11-2015 | Allergens (RK Bush and JA Woodfolk, Section Editors)

The Role of the Skin Microbiome in Atopic Dermatitis

Authors: Michael R. Williams, Richard L. Gallo

Published in: Current Allergy and Asthma Reports | Issue 11/2015

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Abstract

Atopic dermatitis (AD) is a common skin disease that affects a large proportion of the population worldwide. The incidence of AD has increased over the last several decades along with AD’s burden on the physical and psychological health of the patient and family. However, current advances in understanding the mechanisms behind the pathophysiology of AD are leading to a hopeful outlook for the future. Staphylococcus aureus (S. aureus) colonization on AD skin has been directly correlated to disease severity but the functions of other members of the skin bacterial community may be equally important. Applying knowledge gained from understanding the role of the skin microbiome in maintaining normal skin immune function, and addressing the detrimental consequences of microbial dysbiosis in driving inflammation, is a promising direction for development of new treatments. This review discusses current preclinical and clinical research focused on determining how the skin microbiome may influence the development of AD.
Literature
1.
2.
go back to reference Carroll CL, Balkrishnan R, Feldman SR, Fleischer AB, Manuel JC. The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol. 2005;22:8.CrossRef Carroll CL, Balkrishnan R, Feldman SR, Fleischer AB, Manuel JC. The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol. 2005;22:8.CrossRef
3.
go back to reference Beikert FC, Langenbruch AK, Radtke MA, Kornek T, Purwins S, Augustin M. Willingness to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res. 2014;306:279–86.CrossRefPubMed Beikert FC, Langenbruch AK, Radtke MA, Kornek T, Purwins S, Augustin M. Willingness to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res. 2014;306:279–86.CrossRefPubMed
4.
go back to reference Su JC, Kemp AS, Varigos GA, Nolan TM. Atopic eczema: its impact on the family and financial cost. Arch Dis Child. 1997;76:4.CrossRef Su JC, Kemp AS, Varigos GA, Nolan TM. Atopic eczema: its impact on the family and financial cost. Arch Dis Child. 1997;76:4.CrossRef
5.
go back to reference Kapoor R, Menon C, Hoffstad O, Bilker W, Leclerc P, Margolis DJ. The prevalence of atopic triad in children with physician-confirmed atopic dermatitis. J Am Acad Dermatol. 2008;58:68–73.CrossRefPubMed Kapoor R, Menon C, Hoffstad O, Bilker W, Leclerc P, Margolis DJ. The prevalence of atopic triad in children with physician-confirmed atopic dermatitis. J Am Acad Dermatol. 2008;58:68–73.CrossRefPubMed
6.
go back to reference Ring J, Kramer U, Schafer T, Behrendt H. Why are allergies increasing? Curr Opin Immunol. 2001;13:8. Ring J, Kramer U, Schafer T, Behrendt H. Why are allergies increasing? Curr Opin Immunol. 2001;13:8.
7.
go back to reference Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR, International Study of, A., Allergies in Childhood Phase, O., and Three Study, G. Is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008;121:947–54. e915.CrossRefPubMed Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR, International Study of, A., Allergies in Childhood Phase, O., and Three Study, G. Is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008;121:947–54. e915.CrossRefPubMed
8.
go back to reference Kato A, Fukai K, Oiso N, Hosomi N, Murakami T, Ishii M. Association of SPINK5 gene polymorphisms with atopic dermatitis in the Japanese population. Br J Dermatol. 2003;148:665.CrossRefPubMed Kato A, Fukai K, Oiso N, Hosomi N, Murakami T, Ishii M. Association of SPINK5 gene polymorphisms with atopic dermatitis in the Japanese population. Br J Dermatol. 2003;148:665.CrossRefPubMed
9.
go back to reference Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38:441–6.CrossRefPubMed Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38:441–6.CrossRefPubMed
10.
go back to reference Weidinger S, Illig T, Baurecht H, Irvine AD, Rodriguez E, Diaz-Lacava A, et al. Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol. 2006;118:214–9.CrossRefPubMed Weidinger S, Illig T, Baurecht H, Irvine AD, Rodriguez E, Diaz-Lacava A, et al. Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol. 2006;118:214–9.CrossRefPubMed
11.
go back to reference Zhao LP, Di Z, Zhang L, Wang L, Ma L, Lv Y, et al. Association of SPINK5 gene polymorphisms with atopic dermatitis in Northeast China. J Eur Acad Dermatol Venereol. 2012;26:572–7.CrossRefPubMed Zhao LP, Di Z, Zhang L, Wang L, Ma L, Lv Y, et al. Association of SPINK5 gene polymorphisms with atopic dermatitis in Northeast China. J Eur Acad Dermatol Venereol. 2012;26:572–7.CrossRefPubMed
12.
go back to reference De Benedetto A, Rafaels NM, McGirt LY, Ivanov AI, Georas SN, Cheadle C, et al. Tight junction defects in patients with atopic dermatitis. J Allergy Clin Immunol. 2011;127(773–786):e771–7. De Benedetto A, Rafaels NM, McGirt LY, Ivanov AI, Georas SN, Cheadle C, et al. Tight junction defects in patients with atopic dermatitis. J Allergy Clin Immunol. 2011;127(773–786):e771–7.
13.
go back to reference Kawashima T, Noguchi E, Arinami T, Yamakawa-Kobayashi K, Nakagawa H, Otsuka F, et al. Linkage and association of an interleukin 4 gene polymorphism with atopic dermatitis in Japanese families. J Med Genet. 1998;35:502–4.PubMedCentralCrossRefPubMed Kawashima T, Noguchi E, Arinami T, Yamakawa-Kobayashi K, Nakagawa H, Otsuka F, et al. Linkage and association of an interleukin 4 gene polymorphism with atopic dermatitis in Japanese families. J Med Genet. 1998;35:502–4.PubMedCentralCrossRefPubMed
14.
go back to reference Tsunemi Y, Saeki H, Nakamura K, Sekiya T, Hirai K, Kakinuma T, et al. Interleukin-13 gene polymorphism G4257A is associated with atopic dermatitis in Japanese patients. J Dermatol Sci. 2002;30:100–7.CrossRefPubMed Tsunemi Y, Saeki H, Nakamura K, Sekiya T, Hirai K, Kakinuma T, et al. Interleukin-13 gene polymorphism G4257A is associated with atopic dermatitis in Japanese patients. J Dermatol Sci. 2002;30:100–7.CrossRefPubMed
15.
go back to reference Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA, Sampson HA. Prevelance of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998;101:6.CrossRef Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA, Sampson HA. Prevelance of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998;101:6.CrossRef
16.
go back to reference Fuiano N, Fusilli S, Incorvaia C. House dust mite-related allergic diseases: role of skin prick test, atopy patch test, and RAST in the diagnosis of different manifestations of allergy. Eur J Pediatr. 2010;169:819–24.CrossRefPubMed Fuiano N, Fusilli S, Incorvaia C. House dust mite-related allergic diseases: role of skin prick test, atopy patch test, and RAST in the diagnosis of different manifestations of allergy. Eur J Pediatr. 2010;169:819–24.CrossRefPubMed
19.
go back to reference Oyoshi MK, He R, Kumar L, Yoon J, Geha RS. Chapter 3 cellular and molecular mechanisms in atopic. Dermatitis. 2009;102:135–226. Oyoshi MK, He R, Kumar L, Yoon J, Geha RS. Chapter 3 cellular and molecular mechanisms in atopic. Dermatitis. 2009;102:135–226.
20.
go back to reference Grice EA, Kong HH, Conlan S, Deming CB, Davis J, Young AC, et al. Topographical and temporal diversity of the human skin microbiome. Science. 2009;324:1190–2.PubMedCentralCrossRefPubMed Grice EA, Kong HH, Conlan S, Deming CB, Davis J, Young AC, et al. Topographical and temporal diversity of the human skin microbiome. Science. 2009;324:1190–2.PubMedCentralCrossRefPubMed
22.
go back to reference Leyden JJ, Marples RR, Kligman AM. Staphylococcus aureus in the lesions of atopic dermatitis. Br J Dermatol. 1974;90:525–30.CrossRefPubMed Leyden JJ, Marples RR, Kligman AM. Staphylococcus aureus in the lesions of atopic dermatitis. Br J Dermatol. 1974;90:525–30.CrossRefPubMed
23.•
go back to reference Kong HH, Oh J, Deming C, Conlan S, Grice EA, Beatson MA, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22:850–9. First study to use 16S rRNA sequencing to analyze the skin microbiome of normal versus atopic dermatitis patients.PubMedCentralCrossRefPubMed Kong HH, Oh J, Deming C, Conlan S, Grice EA, Beatson MA, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22:850–9. First study to use 16S rRNA sequencing to analyze the skin microbiome of normal versus atopic dermatitis patients.PubMedCentralCrossRefPubMed
24.
go back to reference Fitz-Gibbon S, Tomida S, Chiu BH, Nguyen L, Du C, Liu M, et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2013;133:2152–60.PubMedCentralCrossRefPubMed Fitz-Gibbon S, Tomida S, Chiu BH, Nguyen L, Du C, Liu M, et al. Propionibacterium acnes strain populations in the human skin microbiome associated with acne. J Invest Dermatol. 2013;133:2152–60.PubMedCentralCrossRefPubMed
25.
go back to reference Tomida S, Nguyen L, Chiu BH, Liu J, Sodergren E, Weinstock GM, et al. Pan-genome and comparative genome analyses of propionibacterium acnes reveal its genomic diversity in the healthy and diseased human skin microbiome. mBio. 2013;4:e00003–13.PubMedCentralCrossRefPubMed Tomida S, Nguyen L, Chiu BH, Liu J, Sodergren E, Weinstock GM, et al. Pan-genome and comparative genome analyses of propionibacterium acnes reveal its genomic diversity in the healthy and diseased human skin microbiome. mBio. 2013;4:e00003–13.PubMedCentralCrossRefPubMed
26.
go back to reference Wang Y, Kuo S, Shu M, Yu J, Huang S, Dai A, et al. Staphylococcus epidermidis in the human skin microbiome mediates fermentation to inhibit the growth of Propionibacterium acnes: implications of probiotics in acne vulgaris. Appl Microbiol Biotechnol. 2014;98:411–24.PubMedCentralCrossRefPubMed Wang Y, Kuo S, Shu M, Yu J, Huang S, Dai A, et al. Staphylococcus epidermidis in the human skin microbiome mediates fermentation to inhibit the growth of Propionibacterium acnes: implications of probiotics in acne vulgaris. Appl Microbiol Biotechnol. 2014;98:411–24.PubMedCentralCrossRefPubMed
27.
go back to reference Kloos WE, Musselwhite MS. Distribution and persistence of Staphylococcus and Micrococcus species and other aerobic bacteria on human skin. Appl Microbiol. 1975;30:381–5.PubMedCentralPubMed Kloos WE, Musselwhite MS. Distribution and persistence of Staphylococcus and Micrococcus species and other aerobic bacteria on human skin. Appl Microbiol. 1975;30:381–5.PubMedCentralPubMed
28.••
go back to reference Oh J, Byrd AL, Deming C, Conlan S, Program NCS, Kong HH, et al. Biogeography and individuality shape function in the human skin metagenome. Nature. 2014;514:59–64. Major study involving the use of metagenomics to define the skin microbiome.PubMedCentralCrossRefPubMed Oh J, Byrd AL, Deming C, Conlan S, Program NCS, Kong HH, et al. Biogeography and individuality shape function in the human skin metagenome. Nature. 2014;514:59–64. Major study involving the use of metagenomics to define the skin microbiome.PubMedCentralCrossRefPubMed
29.
go back to reference Belkaid Y, Segre JA. Dialogue between skin microbiota and immunity. Science. 2014;346:7.CrossRef Belkaid Y, Segre JA. Dialogue between skin microbiota and immunity. Science. 2014;346:7.CrossRef
30.
31.
go back to reference Lai Y, Di Nardo A, Nakatsuji T, Leichtle A, Yang Y, Cogen AL, et al. Commensal bacteria regulate Toll-like receptor 3-dependent inflammation after skin injury. Nat Med. 2009;15:1377–82.PubMedCentralCrossRefPubMed Lai Y, Di Nardo A, Nakatsuji T, Leichtle A, Yang Y, Cogen AL, et al. Commensal bacteria regulate Toll-like receptor 3-dependent inflammation after skin injury. Nat Med. 2009;15:1377–82.PubMedCentralCrossRefPubMed
32.•
go back to reference Naik S, Bouladoux N, Wilhelm C, Molloy MJ, Salcedo R, Kastenmuller W, et al. Compartmentalized control of skin immunity by resident commensals. Science. 2012;337:1115–9. Demonstrated direct communication between skin commensal bacteria and host immune response in murine models.PubMedCentralCrossRefPubMed Naik S, Bouladoux N, Wilhelm C, Molloy MJ, Salcedo R, Kastenmuller W, et al. Compartmentalized control of skin immunity by resident commensals. Science. 2012;337:1115–9. Demonstrated direct communication between skin commensal bacteria and host immune response in murine models.PubMedCentralCrossRefPubMed
33.
go back to reference Lai Y, Cogen AL, Radek KA, Park HJ, Macleod DT, Leichtle A, et al. Activation of TLR2 by a small molecule produced by Staphylococcus epidermidis increases antimicrobial defense against bacterial skin infections. J Invest Dermatol. 2010;130:2211–21.PubMedCentralCrossRefPubMed Lai Y, Cogen AL, Radek KA, Park HJ, Macleod DT, Leichtle A, et al. Activation of TLR2 by a small molecule produced by Staphylococcus epidermidis increases antimicrobial defense against bacterial skin infections. J Invest Dermatol. 2010;130:2211–21.PubMedCentralCrossRefPubMed
34.
go back to reference Wang Z, MacLeod DT, Di Nardo A. Commensal bacteria lipoteichoic acid increases skin mast cell antimicrobial activity against vaccinia viruses. J Immunol. 2012;189:1551–8.PubMedCentralCrossRefPubMed Wang Z, MacLeod DT, Di Nardo A. Commensal bacteria lipoteichoic acid increases skin mast cell antimicrobial activity against vaccinia viruses. J Immunol. 2012;189:1551–8.PubMedCentralCrossRefPubMed
35.
go back to reference Yuki T, Yoshida H, Akazawa Y, Komiya A, Sugiyama Y, Inoue S. Activation of TLR2 enhances tight junction barrier in epidermal keratinocytes. J Immunol. 2011;187:3230–7.CrossRefPubMed Yuki T, Yoshida H, Akazawa Y, Komiya A, Sugiyama Y, Inoue S. Activation of TLR2 enhances tight junction barrier in epidermal keratinocytes. J Immunol. 2011;187:3230–7.CrossRefPubMed
36.••
go back to reference Nakatsuji T, Chiang HI, Jiang SB, Nagarajan H, Zengler K, Gallo RL. The microbiome extends to subepidermal compartments of normal skin. Nat Commun. 2013;4:1431. Revolutionary study indentifying that microbial communities can penetrate and reside in deeper layers of the skin.PubMedCentralCrossRefPubMed Nakatsuji T, Chiang HI, Jiang SB, Nagarajan H, Zengler K, Gallo RL. The microbiome extends to subepidermal compartments of normal skin. Nat Commun. 2013;4:1431. Revolutionary study indentifying that microbial communities can penetrate and reside in deeper layers of the skin.PubMedCentralCrossRefPubMed
38.
go back to reference Sugimoto S, Iwamoto T, Takada K, Okuda K, Tajima A, Iwase T, et al. Staphylococcus epidermidis Esp degrades specific proteins associated with Staphylococcus aureus biofilm formation and host-pathogen interaction. J Bacteriol. 2013;195:1645–55.PubMedCentralCrossRefPubMed Sugimoto S, Iwamoto T, Takada K, Okuda K, Tajima A, Iwase T, et al. Staphylococcus epidermidis Esp degrades specific proteins associated with Staphylococcus aureus biofilm formation and host-pathogen interaction. J Bacteriol. 2013;195:1645–55.PubMedCentralCrossRefPubMed
39.
go back to reference Cogen AL, Yamasaki K, Sanchez KM, Dorschner RA, Lai Y, MacLeod DT, et al. Selective antimicrobial action is provided by phenol-soluble modulins derived from Staphylococcus epidermidis, a normal resident of the skin. J Invest Dermatol. 2010;130:192–200.PubMedCentralCrossRefPubMed Cogen AL, Yamasaki K, Sanchez KM, Dorschner RA, Lai Y, MacLeod DT, et al. Selective antimicrobial action is provided by phenol-soluble modulins derived from Staphylococcus epidermidis, a normal resident of the skin. J Invest Dermatol. 2010;130:192–200.PubMedCentralCrossRefPubMed
40.
go back to reference Shu M, Wang Y, Yu J, Kuo S, Coda A, Jiang Y, et al. Fermentation of Propionibacterium acnes, a commensal bacterium in the human skin microbiome, as skin probiotics against methicillin-resistant Staphylococcus aureus. PLoS One. 2013;8, e55380.PubMedCentralCrossRefPubMed Shu M, Wang Y, Yu J, Kuo S, Coda A, Jiang Y, et al. Fermentation of Propionibacterium acnes, a commensal bacterium in the human skin microbiome, as skin probiotics against methicillin-resistant Staphylococcus aureus. PLoS One. 2013;8, e55380.PubMedCentralCrossRefPubMed
41.
go back to reference Gong JQ, Lin L, Lin T, Hao F, Zeng FQ, Bi ZG, et al. Skin colonization by Staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial. Br J Dermatol. 2006;155:680–7.CrossRefPubMed Gong JQ, Lin L, Lin T, Hao F, Zeng FQ, Bi ZG, et al. Skin colonization by Staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial. Br J Dermatol. 2006;155:680–7.CrossRefPubMed
42.
go back to reference Pascolini C, Sinagra J, Pecetta S, Bordignon V, De Santis A, Cilli L, et al. Molecular and immunological characterization of Staphylococcus aureus in pediatric atopic dermatitis: implications for prophylaxis and clinical management. Clin Dev Immunol. 2011;2011:718708.PubMedCentralCrossRefPubMed Pascolini C, Sinagra J, Pecetta S, Bordignon V, De Santis A, Cilli L, et al. Molecular and immunological characterization of Staphylococcus aureus in pediatric atopic dermatitis: implications for prophylaxis and clinical management. Clin Dev Immunol. 2011;2011:718708.PubMedCentralCrossRefPubMed
43.
go back to reference Chavanas S, Bodemer C, Rochat A, Hamel-Teillac D, Ali M, Irvine AD, et al. Mutations in SPINK5, encoding a serine protease inhibitor, cause Netherton syndrome. Nat Genet. 2000;25:2. Chavanas S, Bodemer C, Rochat A, Hamel-Teillac D, Ali M, Irvine AD, et al. Mutations in SPINK5, encoding a serine protease inhibitor, cause Netherton syndrome. Nat Genet. 2000;25:2.
44.
go back to reference Hannula-Jouppi K, Laasanen SL, Heikkila H, Tuomiranta M, Tuomi ML, Hilvo S, et al. IgE allergen component-based profiling and atopic manifestations in patients with Netherton syndrome. J Allergy Clin Immunol. 2014;134:985–8.CrossRefPubMed Hannula-Jouppi K, Laasanen SL, Heikkila H, Tuomiranta M, Tuomi ML, Hilvo S, et al. IgE allergen component-based profiling and atopic manifestations in patients with Netherton syndrome. J Allergy Clin Immunol. 2014;134:985–8.CrossRefPubMed
45.
go back to reference Renner ED, Hartl D, Rylaarsdam S, Young ML, Monaco-Shawver L, Kleiner G, et al. Comel-Netherton syndrome defined as primary immunodeficiency. J Allergy Clin Immunol. 2009;124:536–43.PubMedCentralCrossRefPubMed Renner ED, Hartl D, Rylaarsdam S, Young ML, Monaco-Shawver L, Kleiner G, et al. Comel-Netherton syndrome defined as primary immunodeficiency. J Allergy Clin Immunol. 2009;124:536–43.PubMedCentralCrossRefPubMed
46.•
go back to reference Oh J, Freeman AF, Program NCS, Park M, Sokolic R, Candotti F, et al. The altered landscape of the human skin microbiome in patients with primary immunodeficiencies. Genome Res. 2013;23:2103–14. Second major study analyzing how the skin microbiome composition is effected during disease states by 16S rRNA sequencing.PubMedCentralCrossRefPubMed Oh J, Freeman AF, Program NCS, Park M, Sokolic R, Candotti F, et al. The altered landscape of the human skin microbiome in patients with primary immunodeficiencies. Genome Res. 2013;23:2103–14. Second major study analyzing how the skin microbiome composition is effected during disease states by 16S rRNA sequencing.PubMedCentralCrossRefPubMed
47.
go back to reference Knor T, Meholjic-Fetahovic A, Mehmedagic A. Stratum corneum hydration and skin surface pH in patients with atopic dermatitis. Acta Dermatovenerol Croat ADC. 2011;19:242–7.PubMed Knor T, Meholjic-Fetahovic A, Mehmedagic A. Stratum corneum hydration and skin surface pH in patients with atopic dermatitis. Acta Dermatovenerol Croat ADC. 2011;19:242–7.PubMed
48.
go back to reference Rippke F, Schreiner V, Doering T, Maibach HI. Stratum corneum pH in atopic dermatitis: impact on skin barrier function and colonization with Staphylococcus Aureus. Am J Clin Dermatol. 2004;5:217–23.CrossRefPubMed Rippke F, Schreiner V, Doering T, Maibach HI. Stratum corneum pH in atopic dermatitis: impact on skin barrier function and colonization with Staphylococcus Aureus. Am J Clin Dermatol. 2004;5:217–23.CrossRefPubMed
49.
go back to reference Bhanu S, Francois PP, NuBe O, Foti M, Hartford OM, Vaudaux P, et al. Fibronectin-binding protein acts as Staphylococcus aureus invasin via fibronectin bridging to integrin α5β1. Cell Microbiol. 1999;1:17. Bhanu S, Francois PP, NuBe O, Foti M, Hartford OM, Vaudaux P, et al. Fibronectin-binding protein acts as Staphylococcus aureus invasin via fibronectin bridging to integrin α5β1. Cell Microbiol. 1999;1:17.
50.
go back to reference Cho SH, Strickland I, Boguniewicz M, Leung DY. Fibronectin and fibrinogen contribute to the enhanced binding of Staphylococcus aureus to atopic skin. J Allergy Clin Immunol. 2001;108:269–74.CrossRefPubMed Cho SH, Strickland I, Boguniewicz M, Leung DY. Fibronectin and fibrinogen contribute to the enhanced binding of Staphylococcus aureus to atopic skin. J Allergy Clin Immunol. 2001;108:269–74.CrossRefPubMed
51.
go back to reference Dean SN, Bishop BM, van Hoek ML. Natural and synthetic cathelicidin peptides with anti-microbial and anti-biofilm activity against Staphylococcus aureus. BMC Microbiol. 2011;11:114.PubMedCentralCrossRefPubMed Dean SN, Bishop BM, van Hoek ML. Natural and synthetic cathelicidin peptides with anti-microbial and anti-biofilm activity against Staphylococcus aureus. BMC Microbiol. 2011;11:114.PubMedCentralCrossRefPubMed
52.
go back to reference Harder J, Bartels J, Christophers E, Schroder JM. Isolation and characterization of human beta -defensin-3, a novel human inducible peptide antibiotic. J Biol Chem. 2001;276:5707–13.CrossRefPubMed Harder J, Bartels J, Christophers E, Schroder JM. Isolation and characterization of human beta -defensin-3, a novel human inducible peptide antibiotic. J Biol Chem. 2001;276:5707–13.CrossRefPubMed
53.
go back to reference Ong PY, Ohtake T, Brandt C, Strickland I, Boguniewicz M, Ganz T, et al. Endogenous antimicrobial peptides and skin infections in atopic dermatitis. N Engl J Med. 2002;347:10.CrossRef Ong PY, Ohtake T, Brandt C, Strickland I, Boguniewicz M, Ganz T, et al. Endogenous antimicrobial peptides and skin infections in atopic dermatitis. N Engl J Med. 2002;347:10.CrossRef
54.
go back to reference Nomura I, Goleva E, Howell MD, Hamid QA, Ong PY, Hall CF, et al. Cytokine milieu of atopic dermatitis, as compared to psoriasis, skin prevents induction of innate immune response genes. J Immunol. 2003;171:3262–9.CrossRefPubMed Nomura I, Goleva E, Howell MD, Hamid QA, Ong PY, Hall CF, et al. Cytokine milieu of atopic dermatitis, as compared to psoriasis, skin prevents induction of innate immune response genes. J Immunol. 2003;171:3262–9.CrossRefPubMed
55.
go back to reference Howell MD, Novak N, Bieber T, Pastore S, Girolomoni G, Boguniewicz M, et al. Interleukin-10 downregulates anti-microbial peptide expression in atopic dermatitis. J Invest Dermatol. 2005;125:738–45.CrossRefPubMed Howell MD, Novak N, Bieber T, Pastore S, Girolomoni G, Boguniewicz M, et al. Interleukin-10 downregulates anti-microbial peptide expression in atopic dermatitis. J Invest Dermatol. 2005;125:738–45.CrossRefPubMed
56.
go back to reference McFadden JP, Noble WC, Camp RD. Superantigenic exotoxin-secreting potential of staphylococci isolated from atopic eczematous skin. Br J Dermatol. 1993;128:631–2.CrossRefPubMed McFadden JP, Noble WC, Camp RD. Superantigenic exotoxin-secreting potential of staphylococci isolated from atopic eczematous skin. Br J Dermatol. 1993;128:631–2.CrossRefPubMed
57.
go back to reference Zollner TM, Wichelhaus TA, Hartung A, Von Mallinckrodt C, Wagner TO, Brade V, et al. Colonization with superantigen-producing Staphylococcus aureus is associated with increased severity of atopic dermatitis. Clin Exp Allergy. 2000;30:7.CrossRef Zollner TM, Wichelhaus TA, Hartung A, Von Mallinckrodt C, Wagner TO, Brade V, et al. Colonization with superantigen-producing Staphylococcus aureus is associated with increased severity of atopic dermatitis. Clin Exp Allergy. 2000;30:7.CrossRef
58.
go back to reference Johnson WM, Tyler SD, Ewan EP, Ashton FE, Pollard DR, Rozee KR. Detection of genes for enterotoxins, exfoliative toxins, and toxic shock syndrome toxin 1 in Staphylococcus aureus by the polymerase chain reaction. J Clin Microbiol. 1991;29:426–30.PubMedCentralPubMed Johnson WM, Tyler SD, Ewan EP, Ashton FE, Pollard DR, Rozee KR. Detection of genes for enterotoxins, exfoliative toxins, and toxic shock syndrome toxin 1 in Staphylococcus aureus by the polymerase chain reaction. J Clin Microbiol. 1991;29:426–30.PubMedCentralPubMed
59.
go back to reference Bunikowski R, Mielke M, Skarabis H, Herz U, Bergmann RL, Wahn U, et al. Prevelance and role of serum IgE antibodies to the Staphylococcus aureus-derived superantigens SEA and SEB in children with atopic dermatitis. J Allergy Clin Immunol. 1999;103:6.CrossRef Bunikowski R, Mielke M, Skarabis H, Herz U, Bergmann RL, Wahn U, et al. Prevelance and role of serum IgE antibodies to the Staphylococcus aureus-derived superantigens SEA and SEB in children with atopic dermatitis. J Allergy Clin Immunol. 1999;103:6.CrossRef
60.
go back to reference Bantel H, Sinha B, Domschke W, Peters G, Schulze-Osthoff K, Janicke RU. alpha-Toxin is a mediator of Staphylococcus aureus-induced cell death and activates caspases via the intrinsic death pathway independently of death receptor signaling. J Cell Biol. 2001;155:637–48.PubMedCentralCrossRefPubMed Bantel H, Sinha B, Domschke W, Peters G, Schulze-Osthoff K, Janicke RU. alpha-Toxin is a mediator of Staphylococcus aureus-induced cell death and activates caspases via the intrinsic death pathway independently of death receptor signaling. J Cell Biol. 2001;155:637–48.PubMedCentralCrossRefPubMed
61.
go back to reference Walev I, Martin E, Jonas D, Mohamadzadeh M, Muller-Klieser W, Kunz L, et al. Staphylococcal alpha-toxin kills human keratinocytes by permeabilizing the plasma membrane for monovalent ions. Infect Immun. 1993;61:8. Walev I, Martin E, Jonas D, Mohamadzadeh M, Muller-Klieser W, Kunz L, et al. Staphylococcal alpha-toxin kills human keratinocytes by permeabilizing the plasma membrane for monovalent ions. Infect Immun. 1993;61:8.
62.
go back to reference Brauweiler AM, Goleva E, Leung DY. Th2 cytokines increase Staphylococcus aureus alpha toxin-induced keratinocyte death through the signal transducer and activator of transcription 6 (STAT6). J Invest Dermatol. 2014;134:2114–21.PubMedCentralCrossRefPubMed Brauweiler AM, Goleva E, Leung DY. Th2 cytokines increase Staphylococcus aureus alpha toxin-induced keratinocyte death through the signal transducer and activator of transcription 6 (STAT6). J Invest Dermatol. 2014;134:2114–21.PubMedCentralCrossRefPubMed
63.
go back to reference Hong SW, Choi EB, Min TK, Kim JH, Kim MH, Jeon SG, et al. An important role of alpha-hemolysin in extracellular vesicles on the development of atopic dermatitis induced by Staphylococcus aureus. PLoS One. 2014;9, e100499.PubMedCentralCrossRefPubMed Hong SW, Choi EB, Min TK, Kim JH, Kim MH, Jeon SG, et al. An important role of alpha-hemolysin in extracellular vesicles on the development of atopic dermatitis induced by Staphylococcus aureus. PLoS One. 2014;9, e100499.PubMedCentralCrossRefPubMed
64.
go back to reference Ezepchuk YV, Leung DY, Middleton MH, Bina P, Reiser R, Norris DA. Staphylococcal toxins and protein A differentially induce cytotoxicity and release of tumor necrosis factor-alpha from human keratinocytes. J Invest Dermatol. 1996;107:603–9.CrossRefPubMed Ezepchuk YV, Leung DY, Middleton MH, Bina P, Reiser R, Norris DA. Staphylococcal toxins and protein A differentially induce cytotoxicity and release of tumor necrosis factor-alpha from human keratinocytes. J Invest Dermatol. 1996;107:603–9.CrossRefPubMed
65.
go back to reference Nakamura Y, Oscherwitz J, Cease KB, Chan SM, Munoz-Planillo R, Hasegawa M, et al. Staphylococcus delta-toxin induces allergic skin disease by activating mast cells. Nature. 2013;503:397–401.PubMedCentralCrossRefPubMed Nakamura Y, Oscherwitz J, Cease KB, Chan SM, Munoz-Planillo R, Hasegawa M, et al. Staphylococcus delta-toxin induces allergic skin disease by activating mast cells. Nature. 2013;503:397–401.PubMedCentralCrossRefPubMed
66.
go back to reference Hanakawa Y, Selwood T, Woo D, Lin C, Schechter NM, Stanley JR. Calcium-dependent conformation of desmoglein 1 is required for its cleavage by exfoliative toxin. J Invest Dermatol. 2003;121:383–9.CrossRefPubMed Hanakawa Y, Selwood T, Woo D, Lin C, Schechter NM, Stanley JR. Calcium-dependent conformation of desmoglein 1 is required for its cleavage by exfoliative toxin. J Invest Dermatol. 2003;121:383–9.CrossRefPubMed
67.
go back to reference Hirasawa Y, Takai T, Nakamura T, Mitsuishi K, Gunawan H, Suto H, et al. Staphylococcus aureus extracellular protease causes epidermal barrier dysfunction. J Invest Dermatol. 2010;130:614–7.CrossRefPubMed Hirasawa Y, Takai T, Nakamura T, Mitsuishi K, Gunawan H, Suto H, et al. Staphylococcus aureus extracellular protease causes epidermal barrier dysfunction. J Invest Dermatol. 2010;130:614–7.CrossRefPubMed
68.
go back to reference Ladhani S. Understanding the mechanism of action of the exfoliative toxins ofStaphylococcus aureus. FEMS Immunol Med Microbiol. 2003;39:181–9.CrossRefPubMed Ladhani S. Understanding the mechanism of action of the exfoliative toxins ofStaphylococcus aureus. FEMS Immunol Med Microbiol. 2003;39:181–9.CrossRefPubMed
69.
go back to reference Syed AK, Reed TJ, Clark KL, Boles BR, Kahlenberg JM. Staphylococcus aureus phenol soluble modulins stimulate the release of pro-inflammatory cytokines from keratinocytes and are required for induction of skin inflammation. Infect Immun. 2015. Syed AK, Reed TJ, Clark KL, Boles BR, Kahlenberg JM. Staphylococcus aureus phenol soluble modulins stimulate the release of pro-inflammatory cytokines from keratinocytes and are required for induction of skin inflammation. Infect Immun. 2015.
70.
71.
go back to reference Hirose A, Ikejima T, Gill DM. Established macrophagelike cell lines synthesize interleukin-1 in response to toxic shock syndrome toxin. Infect Immun. 1985;50:6. Hirose A, Ikejima T, Gill DM. Established macrophagelike cell lines synthesize interleukin-1 in response to toxic shock syndrome toxin. Infect Immun. 1985;50:6.
72.
go back to reference Kim KH, Han JH, CHung JH, Cho KH, Eun HC. Role of staphylococcal superantigen in atopic dermatitis: influence on keratinocytes. J Korean Med Sci. 2006;21:9. Kim KH, Han JH, CHung JH, Cho KH, Eun HC. Role of staphylococcal superantigen in atopic dermatitis: influence on keratinocytes. J Korean Med Sci. 2006;21:9.
73.
go back to reference Bhardwaj N, Friedman SM, Cole BC, Nisanian AJ. Dendritic cells are potent antigen-presenting cells for microbial superantigens. J Exp Med. 1992;175:7.CrossRef Bhardwaj N, Friedman SM, Cole BC, Nisanian AJ. Dendritic cells are potent antigen-presenting cells for microbial superantigens. J Exp Med. 1992;175:7.CrossRef
74.
go back to reference Komatsu N, Saijoh K, Kuk C, Liu AC, Khan S, Shirasaki F, et al. Human tissue kallikrein expression in the stratum corneum and serum of atopic dermatitis patients. Exp Dermatol. 2007;16:513–9.CrossRefPubMed Komatsu N, Saijoh K, Kuk C, Liu AC, Khan S, Shirasaki F, et al. Human tissue kallikrein expression in the stratum corneum and serum of atopic dermatitis patients. Exp Dermatol. 2007;16:513–9.CrossRefPubMed
75.
go back to reference Voegeli R, Rawlings AV, Breternitz M, Doppler S, Schreier T, Fluhr JW. Increased stratum corneum serine protease activity in acute eczematous atopic skin. Br J Dermatol. 2009;161:70–7.CrossRefPubMed Voegeli R, Rawlings AV, Breternitz M, Doppler S, Schreier T, Fluhr JW. Increased stratum corneum serine protease activity in acute eczematous atopic skin. Br J Dermatol. 2009;161:70–7.CrossRefPubMed
76.
go back to reference Borgono CA, Michael IP, Komatsu N, Jayakumar A, Kapadia R, Clayman GL, et al. A potential role for multiple tissue kallikrein serine proteases in epidermal desquamation. J Biol Chem. 2007;282:3640–52.CrossRefPubMed Borgono CA, Michael IP, Komatsu N, Jayakumar A, Kapadia R, Clayman GL, et al. A potential role for multiple tissue kallikrein serine proteases in epidermal desquamation. J Biol Chem. 2007;282:3640–52.CrossRefPubMed
77.
go back to reference Sakabe J, Yamamoto M, Hirakawa S, Motoyama A, Ohta I, Tatsuno K, et al. Kallikrein-related peptidase 5 functions in proteolytic processing of profilaggrin in cultured human keratinocytes. J Biol Chem. 2013;288:17179–89.PubMedCentralCrossRefPubMed Sakabe J, Yamamoto M, Hirakawa S, Motoyama A, Ohta I, Tatsuno K, et al. Kallikrein-related peptidase 5 functions in proteolytic processing of profilaggrin in cultured human keratinocytes. J Biol Chem. 2013;288:17179–89.PubMedCentralCrossRefPubMed
78.
go back to reference Stefansson K, Brattsand M, Roosterman D, Kempkes C, Bocheva G, Steinhoff M, et al. Activation of proteinase-activated receptor-2 by human kallikrein-related peptidases. J Invest Dermatol. 2008;128:18–25.CrossRefPubMed Stefansson K, Brattsand M, Roosterman D, Kempkes C, Bocheva G, Steinhoff M, et al. Activation of proteinase-activated receptor-2 by human kallikrein-related peptidases. J Invest Dermatol. 2008;128:18–25.CrossRefPubMed
79.
go back to reference Yamasaki K, Schauber J, Coda A, Lin H, Dorschner RA, Schechter NM, et al. Kallikrein-mediated proteolysis regulates the antimicrobial effects of cathelicidins in skin. FASEB J Off Publ Fed Am Soc Exp Biol. 2006;20:2068–80. Yamasaki K, Schauber J, Coda A, Lin H, Dorschner RA, Schechter NM, et al. Kallikrein-mediated proteolysis regulates the antimicrobial effects of cathelicidins in skin. FASEB J Off Publ Fed Am Soc Exp Biol. 2006;20:2068–80.
80.
go back to reference Cogen AL, Yamasaki K, Sanchez KM, Dorschner RA, Lai Y, Macleod DT, et al. Selective antimicrobial action is prodived by phenol-soluble modulins derived from staphylococcus epidermidis, a normal resident of the skin. J Investig Dermatol. 2010;130:9.CrossRef Cogen AL, Yamasaki K, Sanchez KM, Dorschner RA, Lai Y, Macleod DT, et al. Selective antimicrobial action is prodived by phenol-soluble modulins derived from staphylococcus epidermidis, a normal resident of the skin. J Investig Dermatol. 2010;130:9.CrossRef
81.
go back to reference Wanke I, Steffen H, Christ C, Krismer B, Gotz F, Peschel A, et al. Skin commensals amplify the innate immune response to pathogens by activation of distinct signaling pathways. J Invest Dermatol. 2011;131:382–90.CrossRefPubMed Wanke I, Steffen H, Christ C, Krismer B, Gotz F, Peschel A, et al. Skin commensals amplify the innate immune response to pathogens by activation of distinct signaling pathways. J Invest Dermatol. 2011;131:382–90.CrossRefPubMed
82.
go back to reference Iwase T, Uehara Y, Shinji H, Tajima A, Seo H, Takada K, et al. Staphylococcus epidermidis Esp inhibits Staphylococcus aureus biofilm formation and nasal colonization. Nature. 2010;465:346–9.CrossRefPubMed Iwase T, Uehara Y, Shinji H, Tajima A, Seo H, Takada K, et al. Staphylococcus epidermidis Esp inhibits Staphylococcus aureus biofilm formation and nasal colonization. Nature. 2010;465:346–9.CrossRefPubMed
83.
go back to reference Kobayashi T, Glatz M, Horiuchi K, Kawasaki H, Akiyama H, Kaplan DH, et al. Dysbiosis and Staphyloccus aureus colonization drives inflammation in atopic dermatitis. Immunity. 2015;42:756–66.CrossRefPubMed Kobayashi T, Glatz M, Horiuchi K, Kawasaki H, Akiyama H, Kaplan DH, et al. Dysbiosis and Staphyloccus aureus colonization drives inflammation in atopic dermatitis. Immunity. 2015;42:756–66.CrossRefPubMed
84.
go back to reference Ewing CI, Ashcroft C, Gibbs AC, Jones GA, Connor PJ, David TJ. Flucloxacillin in the treatment of atopic dermatitis. Br J Dermatol. 1998;138:1022–9.CrossRefPubMed Ewing CI, Ashcroft C, Gibbs AC, Jones GA, Connor PJ, David TJ. Flucloxacillin in the treatment of atopic dermatitis. Br J Dermatol. 1998;138:1022–9.CrossRefPubMed
85.
go back to reference Lever R, Hadley K, Downey D, Mackie R. Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy. Br J Dermatol. 1988;119:189–98.CrossRefPubMed Lever R, Hadley K, Downey D, Mackie R. Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy. Br J Dermatol. 1988;119:189–98.CrossRefPubMed
86.
go back to reference Parish LC, Jorizzo JL, Breton JJ, Hirman JW, Scangarella NE, Shawar RM, et al. Topical retapamulin ointment (1%, wt/wt) twice daily for 5 days versus oral cephalexin twice daily for 10 days in the treatment of secondarily infected dermatitis: results of a randomized controlled trial. J Am Acad Dermatol. 2006;55:1003–13.CrossRefPubMed Parish LC, Jorizzo JL, Breton JJ, Hirman JW, Scangarella NE, Shawar RM, et al. Topical retapamulin ointment (1%, wt/wt) twice daily for 5 days versus oral cephalexin twice daily for 10 days in the treatment of secondarily infected dermatitis: results of a randomized controlled trial. J Am Acad Dermatol. 2006;55:1003–13.CrossRefPubMed
87.
go back to reference Gilani SJ, Gonzalez M, Hussain I, Finlay AY, Patel GK. Staphylococcus aureus re-colonization in atopic dermatitis: beyond the skin. Clin Exp Dermatol. 2005;30:10–3.CrossRefPubMed Gilani SJ, Gonzalez M, Hussain I, Finlay AY, Patel GK. Staphylococcus aureus re-colonization in atopic dermatitis: beyond the skin. Clin Exp Dermatol. 2005;30:10–3.CrossRefPubMed
88.
go back to reference Breuer K, Haussler S, Kapp A, Werfel T. Clinical and Laboratory Investigations Staphylococcus aureus: colonizing features and influence of an antibacterial treatment in adults with atopic dermatitis. Br J Dermatol. 2002;147:7.CrossRef Breuer K, Haussler S, Kapp A, Werfel T. Clinical and Laboratory Investigations Staphylococcus aureus: colonizing features and influence of an antibacterial treatment in adults with atopic dermatitis. Br J Dermatol. 2002;147:7.CrossRef
89.
go back to reference Herold BC, Immergluck LC, Maranan MC, Lauderdale DS, Gaskin RE, VBoyle-Vavra S, et al. Community-acquired methicilin-resistant staphylococcus aureus in children with no identified presdisposing risk. JAMA. 1998;279:6.CrossRef Herold BC, Immergluck LC, Maranan MC, Lauderdale DS, Gaskin RE, VBoyle-Vavra S, et al. Community-acquired methicilin-resistant staphylococcus aureus in children with no identified presdisposing risk. JAMA. 1998;279:6.CrossRef
90.
go back to reference Barnes TM, Greive KA. Use of bleach baths for the treatment of infected atopic eczema. Aust J Dermatol. 2013;54:251–8.CrossRef Barnes TM, Greive KA. Use of bleach baths for the treatment of infected atopic eczema. Aust J Dermatol. 2013;54:251–8.CrossRef
91.
go back to reference Huang JT, Abrams M, Tlougan B, Rademaker A, Paller AS. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009;123:e808–14.CrossRefPubMed Huang JT, Abrams M, Tlougan B, Rademaker A, Paller AS. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009;123:e808–14.CrossRefPubMed
92.
go back to reference Wong SM, Ng TG, Baba R. Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia. J Dermatol. 2013;40:874–80.CrossRefPubMed Wong SM, Ng TG, Baba R. Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia. J Dermatol. 2013;40:874–80.CrossRefPubMed
93.
go back to reference Leung TH, Zhang LF, Wang J, Ning S, Knox SJ, Kim SK. Topical hypochlorite ameliorates NF-kappaB-mediated skin diseases in mice. J Clin Invest. 2013;123:5361–70.PubMedCentralCrossRefPubMed Leung TH, Zhang LF, Wang J, Ning S, Knox SJ, Kim SK. Topical hypochlorite ameliorates NF-kappaB-mediated skin diseases in mice. J Clin Invest. 2013;123:5361–70.PubMedCentralCrossRefPubMed
94.
go back to reference Zhang LJ, Guerrero-Juarez CF, Hata T, Bapat SP, Ramos R, Plikus MV, et al. Innate immunity. Dermal adipocytes protect against invasive Staphylococcus aureus skin infection. Science. 2015;347:67–71.PubMedCentralCrossRefPubMed Zhang LJ, Guerrero-Juarez CF, Hata T, Bapat SP, Ramos R, Plikus MV, et al. Innate immunity. Dermal adipocytes protect against invasive Staphylococcus aureus skin infection. Science. 2015;347:67–71.PubMedCentralCrossRefPubMed
95.
go back to reference Koller DY, Halmerbauer G, Bock A, Engstler G. Action of a silk fabric treated with AEGIS in children with atopic dermatitis: a 3-month trial. Pediatr Allergy Immunol Off Publ Eur Soc Pediatr Allergy Immunol. 2007;18:335–8.CrossRef Koller DY, Halmerbauer G, Bock A, Engstler G. Action of a silk fabric treated with AEGIS in children with atopic dermatitis: a 3-month trial. Pediatr Allergy Immunol Off Publ Eur Soc Pediatr Allergy Immunol. 2007;18:335–8.CrossRef
96.
go back to reference Stinco G, Piccirillo F, Valent F. A randomized double-blind study to investigate the clinical efficacy of adding a non-migrating antimicrobial to a special silk fabric in the treatment of atopic dermatitis. Dermatology. 2008;217:191–5.CrossRefPubMed Stinco G, Piccirillo F, Valent F. A randomized double-blind study to investigate the clinical efficacy of adding a non-migrating antimicrobial to a special silk fabric in the treatment of atopic dermatitis. Dermatology. 2008;217:191–5.CrossRefPubMed
97.
go back to reference Aroniadis OC, Brandt LJ. Intestinal microbiota and the efficacy of fecal microbiota transplantation in gastrointestinal disease. Gastroenterol Hepatol. 2014;10:230–7. Aroniadis OC, Brandt LJ. Intestinal microbiota and the efficacy of fecal microbiota transplantation in gastrointestinal disease. Gastroenterol Hepatol. 2014;10:230–7.
Metadata
Title
The Role of the Skin Microbiome in Atopic Dermatitis
Authors
Michael R. Williams
Richard L. Gallo
Publication date
01-11-2015
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 11/2015
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-015-0567-4

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