The skin microbiome’s role in atopic dermatitis, with Dr. Maria Teresa García-Romero, MD MPH

This episode features Dr. Maria Teresa García-Romero, MD MPH from the National Institute of Pediatrics in Mexico City, talking about the skin microbiome and how it relates to atopic dermatitis. The skin microbiome varies widely at different sites on the body, but in general, increased diversity is associated with healthy skin. In atopic dermatitis, Staphylococcus aureus becomes abundant and skin microbiome diversity decreases, correlating with inflammatory responses. Treatments have the effect of reducing Staphylococcus aureus. These bacteria are now established to have a role in the pathophysiology of the disease. The caution with antibiotic treatment is that a systematic review and meta-analysis from Dr. García-Romero’s group found Staphylococcus aureus isolates from people with atopic dermatitis had suboptimal susceptibility to commonly used antimicrobials, especially in lower middle-income and upper middle-income countries. Mechanistically, Staphylococcus aureus decrease natural antimicrobial molecules in the skin, stimulate the innate immune response, and likely reduce beneficial bacteria. New treatments are urgently needed because atopic dermatitis is very prevalent (affecting 20-30% of the population), with far-reaching effects in children’s and families’ lives. Two ingested probiotics are commercially available for atopic dermatitis, backed by clinical data, whereas topical probiotic treatments require further research. Episode abbreviations and links: Paper showing how treatments for atopic dermatitis help the skin microbiome more closely resemble healthy controls: The Skin Microbiome of Patients With Atopic Dermatitis Normalizes Gradually During Treatment Systematic Review and Meta-Analysis looking at susceptibility of atopic-dermatis associated Staphylococcus aureus to antibiotics in different regions of the world: Global Antimicrobial Susceptibility Patterns of Staphylococcus aureus in Atopic Dermatitis About Dr. Maria Teresa García-Romero: Dr. Maria Teresa García-Romero is a medical doctor graduated from Tec de Monterrey School of Medicine, magna cum laude. She has a Specialty in Dermatology and Diploma in Medical Mycology from UNAM, Mexico City. Dr. García-Romero completed a Fellowship in Pediatric Dermatology at the University of Toronto, and a Master’s degree in Public Health and Quantitative methods of research at Harvard University Chan School of Public Health.  She has received meritorious awards including the Mexican Foundation for Health (FUNSALUD), Harvard University Presidential Award, Society for Pediatric Dermatology Fellow Award, among others; and funding for research projects by prestigious international organizations such as MIT (Massachusetts Institute for Technology) seed funds and EB Research Partnership.  She is currently an attending physician in the Dermatology Department of the National Institute of Pediatrics in Mexico City and a member of the National System of Researchers level II. She has more than 150 articles published in national and international magazines, supervised multiple postgraduate theses and has presented in multiple forums worldwide. Dr. García-Romero is a member of the Editorial Committee of JAMA Dermatology, Pediatric Dermatology and other high impact journals. Her research interests include the skin microbiome, atopic dermatitis, vascular anomalies and autoimmune disease.