Dermatológia pre prax 3/2024

The role of intestinal microbiome and intestinal bacterial overgrowth syndrome in the patogenesis of inflammatory immune-mediated dermatoses

The microbiome is a key regulator of the immune system, as it aims to maintain homeostasis by communicating with tissues and organs in both directions. The microbiome plays an important role in a wide range of dermatoses, in which not only the cutaneous but surprisingly also the gut microbiome is altered. According to literature data, intestinal dysbiosis promotes the production of pro-inflammatory cytokines and is associated with an altered immune response, which promotes the development of diseases such as atopic dermatitis, psoriasis, or hidradenitis suppurativa. Bacterial overgrowth in the small intestine (SIBO) is a condition that is characterized by an increased concentration of colon bacteria in the small intestine. Eradication of SIBO was able to improve skin manifestations in terms of severity index, e.g. in psoriasis. In this context, it is hypothesized that the eradication of SIBO may have a beneficial effect on the severity of the manifestations of inflammatory immune-mediated skin diseases, including HS. The role of the gut microbiome in dermatology is subject to further investigation for a better understanding of the interconnections, as well as the development of new therapeutic approaches.

Keywords: gut-brain-skin axis, immune-mediated inflammation, gut microbiome, hidradenitis suppurativa, psoriasis vulgaris, alopecia areata, atopic dermatitis, diet, environmental factors, SIBO