Analysis of Matched Skin and Gut Microbiome of Vitiligo Patients Reveals Deep skin Dysbiosis: Link with Mitochondrial and Immune Changes.

Vitiligo is an autoimmune disease characterized by patchy, white skin due to melanocyte loss. Commensal cutaneous or gut dysbiosis have been linked to various dermatological disorders. Here, we studied skin and gut microbiota of vitiligo patients compared to healthy controls. We obtained swabs and biopsies from both lesional (L) and non-lesional (NL) skin, as well as stool and blood samples from each individual. We detected reduced richness and diversity of microbiota in stool of vitiligo subjects compared to controls (P<0.01). Skin swabs had greater α-diversity than biopsies (P<0.001); swabs from L sites were primarily depleted of Staphylococcus compared to NL sites (P<0.02). Sampling deeper layers from the same patients showed differences in both α- and β-diversity between samples with decreased richness and distribution of species (P<0.01) in L sites. Biopsy microbiota from the L skin had distinct microbiota composition which was depleted of protective Bifidobacterium and Bacteroides but enriched in Proteobacteria, Streptococcus, Mycoplasma and mitochondrial DNA (P<0.001); the latter increased in the same patients with heightened innate immunity and stress markers in their blood (P<0.05). These data describe vitiligo-specific cutaneous and gut microbiota and a link between skin dysbiosis, mitochondrial damage and immunity in vitiligo patients.