Non-invasive detection of pediatric atopic dermatitis based on fecal microbiota and metabolite profiles: a diagnostic approach

BackgroundAtopic dermatitis (AD) is a common chronic skin inflammation, which affects 15-20% of children worldwide. Gut microbiota and its metabolites are crucial modulators of the “gut-skin axis” in atopic dermatogenesis.

However, systematic investigations integrating microbiome and metabolome profiling in mild-to-moderate pediatric AD remain limited.ObjectivesTo characterize gut microbiota and metabolic profiles in children with mild-to-moderate AD versus healthy controls, and to identify potential biomarkers and mechanistic pathways involved in disease pathogenesis.MethodsThis single-center case-control study investigated 53 children diagnosed with AD and 16 healthy participants, and collected their fecal samples for microbial and metabonomic analysis.ResultsMild-moderate pediatric AD patients exhibited significantly increased gut microbial richness and distinct β-diversity compared to controls (PERMANOVA, R²=0.025, P = 0.017). Bacteroidota was enriched while Actinomycetota was depleted in AD patients (P < 0.05).

At genus level, Parabacteroides and Klebsiella increased, whereas Bifidobacterium decreased in AD. Species-level analysis revealed enrichment of bacteroides_plebeius, bacteroides_thetaiotaomicron, bacteroides_xylanisolvens, and parabacteroides_merdae in AD.

A combined biomarker panel (Bacteroidota, Parabacteroides, and four key species) demonstrated promising exploratory diagnostic potential (AUC = 0.941, accuracy 84.6%), although these results require external validation in larger independent cohorts.