Staphylococcus Agr virulence is critical for epidermal colonization and associates with atopic dermatitis development

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Science Translational Medicine  08 Jul 2020:
Vol. 12, Issue 551, eaay4068
DOI: 10.1126/scitranslmed.aay4068

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Staph aureus sees the onset of childhood atopic dermatitis

Inhibition of Staphylococcus aureus Agr–mediated quorum sensing is known to protect against atopic dermatitis (AD). Now, Matsuoka et al. show that infants who developed AD early in life were more likely to have cheek skin colonized by S. aureus. However, infants harboring S. aureus with acquired spontaneous mutations in Agr were more likely to remain healthy, despite the presence of this bacterium on their skin. This work suggests that S. aureus and associated functional quorum sensing may play a role in the onset of AD in children.


Atopic dermatitis (AD) is commonly associated with colonization by Staphylococcus aureus in the affected skin. To understand the role of S. aureus in the development of AD, we performed whole-genome sequencing of S. aureus strains isolated from the cheek skin of 268 Japanese infants 1 and 6 months after birth. About 45% of infants were colonized with S. aureus at 1 month regardless of AD outcome. In contrast, skin colonization by S. aureus at 6 months of age increased the risk of developing AD. Acquisition of dysfunctional mutations in the S. aureus Agr quorum-sensing (QS) system was primarily observed in strains from 6-month-old infants who did not develop AD. Expression of a functional Agr system in S. aureus was required for epidermal colonization and the induction of AD-like inflammation in mice. Thus, retention of functional S. aureus agr virulence during infancy is associated with pathogen skin colonization and the development of AD.

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