Microbial and transcriptional differences elucidate atopic dermatitis heterogeneity across skin sites

Noora Ottman, Mauricio Barrientos-Somarribas, Nanna Fyhrquist, Helen Alexander, Lukas Wisgrill, Peter Olah, Sophia Tsoka, Dario Greco, Francesca Levi-Schaffer, Vassili Soumelis, Jens M. Schröder, Juha Kere, Frank O. Nestle, Jonathan Barker, Annamari Ranki, Antti Lauerma, Bernhard Homey, Björn Andersson, Harri Alenius*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


It is well established that different sites in healthy human skin are colonized by distinct microbial communities due to different physiological conditions. However, few studies have explored microbial heterogeneity between skin sites in diseased skin, such as atopic dermatitis (AD) lesions. To address this issue, we carried out deep analysis of the microbiome and transcriptome in the skin of a large cohort of AD patients and healthy volunteers, comparing two physiologically different sites: upper back and posterior thigh. Microbiome samples and biopsies were obtained from both lesional and nonlesional skin to identify changes related to the disease process. Transcriptome analysis revealed distinct disease-related gene expression profiles depending on anatomical location, with keratinization dominating the transcriptomic signatures in posterior thigh, and lipid metabolism in the upper back. Moreover, we show that relative abundance of Staphylococcus aureus is associated with disease severity in the posterior thigh, but not in the upper back. Our results suggest that AD may select for similar microbes in different anatomical locations—an "AD-like microbiome," but distinct microbial dynamics can still be observed when comparing posterior thigh to upper back. This study highlights the importance of considering the variability across skin sites when studying the development of skin inflammation.

Original languageAmerican English
Pages (from-to)1173-1187
Number of pages15
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number4
StatePublished - Apr 2021

Bibliographical note

Publisher Copyright:
© 2020 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd


  • atopic dermatitis
  • inflammation
  • microbiome


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