Gut Microbiota Influence on Inflammatory Skin Diseases

The human gut microbiota constitutes a complex community of bacteria, archaea, viruses and fungi that interact intimately with host immunity and metabolism. Growing evidence indicates that alterations in this ecosystem—termed dysbiosis—can contribute to the onset and severity of inflammatory skin disorders such as psoriasis, atopic dermatitis and hidradenitis suppurativa. Dysbiosis may impair the intestinal barrier, promote translocation of microbial antigens, modulate systemic cytokine networks and sculpt the differentiation of T helper 17 cells, thereby fuelling cutaneous inflammation. Conversely, skin perturbations can feed back upon the gut through release of dermal factors that reshape microbial composition and host defence programmes in the intestine. Insights into this bidirectional skin–gut axis have uncovered novel metabolic mediators, including fatty acids and host defence peptides, and offer potential targets for therapeutic modulation via probiotics, antibiotics or faecal microbial transplantation. The global burden of chronic inflammatory dermatoses underscores the translational importance of delineating gut–skin interactions and devising microbiome-based interventions to restore immunological balance and improve patient outcomes.

Research from Nature Portfolio

Recent studies have demonstrated that injury to the skin not only triggers local inflammation but also alters gut microbial communities, leading to increased intestinal permeability and heightened susceptibility to colitis in experimental models. These findings reveal that hyaluronan released from wounded skin induces expression of mucins and antimicrobial peptides in the colon, facilitating translocation of gut bacteria and exacerbating systemic inflammation. In clinical cohorts, analyses of faecal samples from patients with plaque psoriasis have identified a distinct psoriatic core microbiome, characterised by reduced abundance of beneficial commensals such as Bifidobacterium and elevated proportions of pro-inflammatory taxa. Earlier foundational work showed that neonatal exposure to broad-spectrum antibiotics disrupts the maturation of gut flora and primes immune cells for exaggerated IL-22 and IL-17 responses in adult mice, resulting in worsened psoriasiform dermatitis. Together, these studies underscore the reciprocal dialogue between skin and gut and establish microbial composition as both biomarker and modulator of cutaneous inflammation.

Gut Microbiota Influence on Inflammatory Skin Diseases publication trend

The graph below shows the total number of articles in gut microbiota influence on inflammatory skin diseases across all publications each year (not limited to Nature Index journals).

Technical terms

Gut microbiota: The collective microorganisms residing in the intestinal tract that interact with host physiological processes.

Dysbiosis: A perturbation in the composition or function of the microbiota associated with disease states.

Gut–skin axis: The bidirectional communication network linking intestinal microbes and skin health through immune and metabolic pathways.

Th17 cells: A subset of CD4+ T lymphocytes that produce interleukin-17 and are central to barrier immunity and inflammatory disorders.

Fecal microbial transplantation: The process of transferring stool from a healthy donor to a recipient to restore microbial balance.

References

1. Intestinal dysbiosis exacerbates the pathogenesis of psoriasis-like phenotype through changes in fatty acid metabolism. Signal Transduction and Targeted Therapy (2023).
2. Dermal injury drives a skin to gut axis that disrupts the intestinal microbiome and intestinal immune homeostasis in mice. Nature Communications (2024).
3. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes (2022).
4. Antibiotics in neonatal life increase murine susceptibility to experimental psoriasis. Nature Communications (2015).
5. Gut microbial composition in patients with psoriasis. Scientific Reports (2018).
6. Acne vulgaris, probiotics and the gut-brain-skin axis - back to the future?. Gut Pathogens (2011).
7. Alterations of the Skin and Gut Microbiome in Psoriasis and Psoriatic Arthritis. International Journal of Molecular Sciences (2021).