Lactobacillus reuteri Protects Epidermal Keratinocytes from Staphylococcus aureus-Induced Cell Death by Competitive Exclusion
ABSTRACTRecent studies have suggested that the topical application of probiotic bacteria can improve skin health or combat disease. We have utilized a primary human keratinocyte culture model to investigate whether probiotic bacteria can inhibitStaphylococcus aureusinfection. Evaluation of the candidate probioticsLactobacillus reuteriATCC 55730,Lactobacillus rhamnosusAC413, andLactobacillus salivariusUCC118 demonstrated that bothL. reuteriandL. rhamnosus, but notL. salivarius, reducedS. aureus-induced keratinocyte cell death in both undifferentiated and differentiated keratinocytes. Keratinocyte survival was significantly higher if the probiotic was applied prior to (P< 0.01) or simultaneously with (P< 0.01) infection withS. aureusbut not when added after infection had commenced (P> 0.05). The protective effect ofL. reuteriwas not dependent on the elaboration of inhibitory substances such as lactic acid.L. reuteriinhibited adherence ofS. aureusto keratinocytes by competitive exclusion (P= 0.026).L. salivariusUCC118, however, did not inhibitS. aureusfrom adhering to keratinocytes (P> 0.05) and did not protect keratinocyte viability.S. aureusutilizes the α5β1 integrin to adhere to keratinocytes, and blocking of this integrin resulted in a protective effect similar to that observed with probiotics (P= 0.03). This suggests that the protective mechanism forL. reuteri-mediated protection of keratinocytes was by competitive exclusion of the pathogen from its binding sites on the cells. Our results suggest that use of a topical probiotic prophylactically could inhibit the colonization of skin byS. aureusand thus aid in the prevention of infection.