Abstract
Background: Epithelial linings in the human body are constantly populated by different microbes, an active process where innate immunity plays a pivotal role. We have previously reported that there is an upregulation of innate immunity in the skin of the healthy newborn infant. This event may be seen as a rash, known as Erythema Toxicum and is most probably a response to commensal skin colonization at birth. Now we postulated that the hair follicle immune system constitutes the physiologic room where microbes are presented to immune competent cells.
Design: Microbial cultures were collected from 70 healthy 1-day infants, skin punch-biopsies were analysed with transmission electron microscopy (TEM) and with immunohistochemistry by staining for Toll-like receptor (TLR) 2 and 4.
Results: We found that 84% of all of healthy 1-day old infants were colonized with coagulase-negative Staphylococci, remaining were positive for Staphylococcus aureus, Alfa-streptococcus, group B streptococcus and Enterococcus species.We also found that TLR 2 and TLR4 were expressed in the epidermis and in the epithelial layer of the hair follicle. In the lesions of Erythema Toxicum, TEM revealed microbe-like material into phagosomes of epithelial cells and into immune cell located in proximity to the hair follicles.
Conclusion: At birth, there is a penetration/presentation of commensal microbes at the epithelial linings. This exposure provides signals, possibly mediated by the TLRs, that alert the immune system and promotes a protective immune response.
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Nelson, A., Edner, J., Yektaei-Karin, E. et al. 233 Microbial Presentation at the Epithelial Linings: A Strategic Way to Promote the Generation of Immunity at Birth.. Pediatr Res 58, 394 (2005). https://doi.org/10.1203/00006450-200508000-00262
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DOI: https://doi.org/10.1203/00006450-200508000-00262