Topical probiotics as novel treatments for skin in health and Disease

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Ami Fletcher
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6/21/214 Topical probiotics as novel treatments for skin in health and Disease Cath O Neill Dermatological Sciences Research Group Faculty of Human and Medical Sciences The University of

1 6/21/214 Topical probiotics as novel treatments for skin in health and Disease Cath O Neill Dermatological Sciences Research Group Faculty of Human and Medical Sciences The University of Manchester, UK ISAPP 214 Skin Barrier Function is Critical to Health Epidermis The epidermis is a barrier that protects from: Dermis subcutis dehydration UVR invasion by pathogens Chemical pollutants etc 1

Epidermolysis Bullosa Psoriasis Diabetic foot ulcer

2 6/21/214 Aberant Barrier function is evident in a number of skin diseases Atopic dermatitis Epidermolysis Bullosa Psoriasis Diabetic foot ulcer Can probiotic extracts help to repair/enhance/maintain the skin barrier? 2

3 6/21/214 Lysates of Specific Species increase the Rate of Re epithelialisation Con h 6h 12h 18h 24h LGG LR LF LP Lysates from L. rhamnosus GG stimulate keratinocyte migration and proliferation migrated cells (%) rate of proliferation (% control) h 4h 6h 8h 6h control treated 3

4 6/21/214 Testing the lysate in human skin Excision wound LGG lysate promotes reepithelialisation in human skin D D1 D3 D7 C 25 LGG length of tongue (um) D D1 D3 D7 CON LGG 4

Apoptosis 163 viability 37 Cell Signalling 17 Chemotaxis 16 Differentiation 65 Protein expression 16 Response to

5 6/21/214 LGG increases keratinocyte migration and proliferation cortactin Ki67 CON (D7) LGG (D7) CON (D7) LGG (D7) Microarray Analysis of the Effects of LGG on the Wound Healing Response Function Number of genes Cell adhesion 25 Apoptosis 163 viability 37 Cell Signalling 17 Chemotaxis 16 Differentiation 65 Protein expression 16 Response to infection 11 Inflammatory response 14 Cell migration 1 Cell proliferation 244 Cytostasis 1 Activation of Antigen 11 presenting cells P=<.5 5

6 6/21/214 Candidate genes were validated using qpcr Gene Fold change CXCL 54 CXCLR2 52 KGF 5 KGFR 43 LGG increases the protein levels of KGFR and CXCLR2 β actin CXCLR2 KGFR Con LGG fold change CXCLR2 KGFR 6

7 6/21/214 LGG increases the production of KGF and CXCL CXCL2 (ug/ml) KGF (ug/ml) day 3 day 7 Time day 3 day 7 Time CON LGG Conclusions Lysates from probiotic bacteria increase reepithelialisation of model wounds Species dependent effects Mechanisms include induction of chemokinereceptor pairs leading to increased keratinocyte proliferation and migration Bacterial lysates have a huge capacity to alter skin cell physiology!! 7

aureus infection Foot ulcer commonly associated with S.

8 6/21/214 Infection and Barrier Dysfunction Atopic dermatitis (Eczema) increased susceptibility to S. aureus infection Foot ulcer commonly associated with S. aureus infection Can probiotic extracts protect against pathogens? 8

9 6/21/214 Probiotics protect Keratinocytes from S. aureus induced toxicity in a strain dependent manner 1 8 % viability Prince et al, 212 Con SA LRE LRH LS LRE LRH LS +SA +SA +SA L. reuteri protects keratinocytes only if added prior to infection with S. aureus % viability (%) 4 % viability Con SA SA+LR 1h 2h 4h PRE Con SA 1h 2h 4h post Prince et al,

10 6/21/214 L. rhamnosus GG can rescue keratinocytes from S. aureus induced toxicity % viability 6 4 % viability Con SA 2h 4h Con SA 2h 4h 6h 8h 1h 12h Pre Post Mechanism? Hypothesis inhibition of pathogen adhesion Integrin receptor blockade reduces S. aureus adhesion to keratinocytes SA SA+ α5β1 1

11 6/21/214 Factors that reduce adhesion of S. aureus to keratinocytes also reduce its toxicity 1 8 % viability Prince et al, 212 Con SA SA +α5β1 LGG inhibits binding of S. aureus to keratinocytes 8 con treated no. of adherent S. aureus (log CFU/ml) PRE POST 11

12 6/21/214 L. Reuteri inhibits adhesion of S. aureus to keratinocytes 6 no. of adherent bacteria (log 1 cfu/ml) no. of adherent bacteria (log 1 cfu/ml) Co pre post SA L. salivarius + SA con treated Lactobacilli protect keratinocytes from S. aureus induced toxicity in species dependent ways: Competitive exclusion Competitive displacement LGG and others! L. Reuteri works only by exclusion of S. aureus 12

13 6/21/214 What are the molecules in LGG mediating its effects? Re epithelialisation Inhibition of pathogen adhesion Tight junction function (Sultanna et al, 213) Identifying efficacious molecules in the LGG Lysate B1 4 aceto LGG RC 1:1_UV1_28nm B1 4 aceto LGG RC 1:1_UV2_215nm B1 4 aceto LGG RC 1:1_Cond B1 4 aceto LGG RC 1:1_Conc B1 4 aceto LGG RC 1:1_Fractions B1 4 aceto LGG RC 1:1_Inject B1 4 aceto LGG RC 1:1_Logbook mau MS/MS analysis F2 A4A7 A11 B1B4B7 B11 C2 C7 C13 D4 D9 D15 E6 E12 F3F7F12 G3 G8 G14 H5 H11 I1I4I7I11 J1 J5J9 J14K4 K9 K15L5L9L14 M min reepithelialisation TJ function Waste Inhibition of pathogen adhesion Two molecules identified so far inhibition of pathogen adhesion 13

6/21/214 Summary Probiotic bacteria offer great potential for use on skin Species

efficacious molecules Possible applications in: Wound care Barrier related conditions

Acknowledgements: Collaborators: Staff and students: Dr Andrew McBain (Manchester)

14 6/21/214 Summary Probiotic bacteria offer great potential for use on skin Species dependent effects and mechanisms Two pronged approach to identify mechanisms and efficacious molecules Possible applications in: Wound care Barrier related conditions e.g. AD Cosmetic preparations Anti infectives Etc. Acknowledgements: Collaborators: Staff and students: Dr Andrew McBain (Manchester) Prof Ralf Paus (Lubech) Dr Tessa Prince Mrs Walaa Saeed Dr Rawshan Choudray Miss Reshma Sultanna Miss Maryam Moradi Mrs Carol Ward 14

The gut-skin axis in health and disease. Cath O Neill Centre for Dermatology University of Manchester

The gut-skin axis in health and disease Cath O Neill Centre for Dermatology University of Manchester Skin Structure Dermis Der epidermis mis subcutis Can skin structure/function be modified via the gut?