What markers track the skin microbiome?
A research-supply overview of clinical markers used to track the skin microbiome, including serine protease activity, cathelicidin, serum inflammation, and Th2-related pathways, as studied in atopic dermatitis, rosacea,
What markers track the skin microbiome?
The skin microbiome is tracked in clinical research through a combination of direct microbial sampling and host-derived markers of barrier function, inflammation, and antimicrobial peptide expression. Direct sampling typically involves swabs or scrapes to characterize bacterial communities, while host markers include serine protease activity, cathelicidin (an antimicrobial peptide), serum inflammatory biomarkers, and Th2-related cytokines. These markers are used across conditions such as atopic dermatitis, rosacea, aging skin, and lymphedema to assess how the microbiome interacts with skin physiology and systemic inflammation.
The work centres on pathways involving skin-barrier integrity, innate immune signalling through antimicrobial peptides, and T helper 2 (Th2)-related inflammation.
Research Studies
Vernix caseosa and atopic dermatitis prevention in newborns
Vernix caseosa is a naturally occurring, white, creamy substance that covers the skin of newborns at birth and forms during the last trimester. A clinical trial is investigating the retention of vernix caseosa in newborns for the primary prevention of atopic dermatitis (AD), also known as eczema. AD is a common chronic inflammatory skin disease that usually begins in infancy and causes significant itching, discomfort, and sleep disturbance, affecting up to one in five children worldwide. Research has shown that genetic and environmental factors contribute to its development, especially those related to skin-barrier integrity and the skin microbiome during early life. Preventing AD before it starts—known as primary prevention—has become an important goal [1].
Ivermectin and rosacea-specific inflammation markers
A single-site, 16-week open-label study at the University of California, San Diego, assessed the role of topical ivermectin 1% cream and its effect on protease and antimicrobial peptide expression and on the skin microbiome in rosacea. The investigators measured serine protease activity and cathelicidin and skin microbiome of all subjects. All subjects received ivermectin topical cream and were instructed to apply it daily for 12 weeks. Participants returned for monthly visits during which their clinical symptoms of facial redness and number of facial papules were scored, and they had [4].
Skin barrier function and inflammation in aging: the BIA study
A randomized, investigator-blinded, self-controlled pilot study of the physiologic response to topical moisturizers among older adults with dry skin tested the hypothesis that skin barrier decline is an important source of chronic inflammation, and that skin barrier restoration with moisturizers can reduce serum biomarkers of inflammation. The primary objective was to determine the feasibility for a larger trial, and the secondary objectives were to determine the extent to which measures of serum inflammation, skin barrier function, and the skin microbiome change in response to moisturizers. Participants were asked to apply one of two topical moisturizers that are widely available [3].
Th2-related inflammation and lymphedema markers
An observational, cross-sectional study aims to characterize the biological profile of primary and secondary lymphedema by investigating five interconnected biological domains: T helper 2 (Th2)-related inflammation, endothelial activation, metabolic dysfunction, lymphatic biology, and tissue fibrosis. Lymphedema is traditionally considered a disorder of impaired lymphatic drainage resulting in the accumulation of interstitial fluid. However, increasing evidence suggests that its development and progression involve chronic inflammation, endothelial dysfunction, metabolic alterations, abnormal lymphatic signalling, adipose tissue accumulation, and progressive tissue fibrosis [2].
Comparison of markers across studies
| Study | Condition | Markers assessed |
|---|---|---|
| Vernix caseosa retention [1] | Atopic dermatitis prevention | Skin-barrier integrity, skin microbiome |
| Topical ivermectin [4] | Rosacea | Serine protease activity, cathelicidin, skin microbiome |
| BIA study [3] | Aging skin | Serum inflammation, skin barrier function, skin microbiome |
| Lymphedema profile [2] | Lymphedema | Th2-related inflammation, endothelial activation, metabolic dysfunction, lymphatic biology, tissue fibrosis |
Animal and in vitro evidence
The evidence block does not specify animal-only or in vitro studies for the markers listed. All cited studies are clinical trials or observational studies in human populations.
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Sources
- [1] Retention of Vernix Caseosa in Newborns for Primary Prevention of Atopic Dermatitis
- [2] Biological Profile of Primary and Secondary Lymphedema: Inflammatory, Endothelial, Metabolic, Lymphatic, and Fibrotic Markers
- [3] Skin Barrier Function and Inflammation in Aging: The BIA Study
- [4] Evaluation of the Inhibitory Effects of Topical Ivermectin on Markers of Rosacea Specific Inflammation.