The human skin ecobiome constitutes a highly dynamic and symbiotic environment where microbial communities and host cells interact continuously to preserve epidermal integrity and immune balance. The discovery of the skin microbiome’s regulatory functions has redefined the pathophysiology of atopic dermatitis (AD), emphasizing that chronic inflammation results not only from immune dysregulation and genetic predisposition but also from microbiota imbalance. The modern concept of the “ecobiome” integrates ecological and biological perspectives, viewing the skin as a self-regulating habitat whose microbial inhabitants influence inflammation, barrier repair, and neuroimmune signaling. This review aims to summarize current evidence on the role of the skin ecobiome in the pathogenesis and management of atopic dermatitis and to outline how modulation of the cutaneous microbiota can complement conventional anti-inflammatory and barrier-repair approaches. It analyzes how microbial composition shifts in AD patients, characterized by reduced diversity, predominance of Staphylococcus aureus, and depletion of beneficial commensals such as Cutibacterium and Corynebacterium species. This dysbiosis enhances epidermal permeability, amplifies cytokine cascades, and sustains pruritus and xerosis. Restoring microbial homeostasis has therefore become a crucial therapeutic goal. Emerging interventions include topical and oral probiotics, prebiotic complexes, bacteriophage therapies, postbiotics, and microbiome-supporting emollients. These formulations modulate innate immunity, stimulate production of antimicrobial peptides, and reestablish lipid barrier synthesis. Clinical studies demonstrate that ecobiome-targeted treatments reduce colonization by S. aureus, normalize pH, and attenuate Th2-mediated inflammation, resulting in prolonged remission and fewer corticosteroid requirements. Novel bioengineering technologies now enable encapsulation of live probiotic strains in stable topical vehicles, improving their survival and activity on the skin surface. Growing evidence suggests that modulation of the skin ecobiome may influence disease onset, severity, and recurrence in atopic dermatitis. This highlights the potential role of barrier-supportive and microbiome-friendly interventions in comprehensive patient care. The ecobiome paradigm also underlines the significance of personalized care. Understanding individual microbial signatures allows clinicians to tailor therapies according to the patient’s unique microbial and immune profiles. Integration of microbiome diagnostics with conventional dermatologic evaluation opens the path to combined regimens involving anti-inflammatory, barrier-restoring, and microbiome-modulating agents. Such a multifactorial approach provides synergistic effects, improving clinical outcomes and patient quality of life. In conclusion, the ecobiome-based concept marks a transformative shift in dermatology. It bridges fundamental microbiological science with clinical innovation and positions the skin not merely as a protective shell but as a living, adaptive ecosystem. By supporting its microbial diversity and symbiosis, the next generation of therapeutic strategies may achieve not only symptom control but also restoration of physiological equilibrium and durable remission in atopic dermatitis.
更多
原文链接
分享
引用
