{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:36:58Z","timestamp":1784288218506,"version":"3.55.0"},"reference-count":8,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec id=\"ab-cbr230023-4\"><jats:title>Importance<\/jats:title><jats:p>The interindividual differences in severity of acute radiation dermatitis are not well understood. To date, the pathomechanism and interplay of microbiome and radiodermatitis before and during treatment remain largely unknown.<\/jats:p><\/jats:sec><jats:sec id=\"ab-cbr230023-5\"><jats:title>Objective<\/jats:title><jats:p>To assess the association of skin microbiome baseline composition and dynamics with severity of radiodermatitis in patients undergoing adjuvant radiotherapy for breast cancer.<\/jats:p><\/jats:sec><jats:sec id=\"ab-cbr230023-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A longitudinal prospective pilot observational study was conducted between January 2017 and January 2019. Sequencing results were received in March 2021, and the data were analyzed from August 2021 to March 2023. This study was performed at an urban academic university cancer center. A total of 21 female patients with breast cancer after surgery were consecutively approached, of which 1 patient withdrew consent before the study started.<\/jats:p><\/jats:sec><jats:sec id=\"ab-cbr230023-7\"><jats:title>Exposure<\/jats:title><jats:p>Adjuvant radiotherapy for breast cancer for 7 weeks.<\/jats:p><\/jats:sec><jats:sec id=\"ab-cbr230023-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main outcome was the association of baseline skin microbiome composition and its dynamics with the severity of radiodermatitis. A total of 360 skin microbiome samples from patients were analyzed, taken before, during, and after radiotherapy, from both the treated and contralateral healthy sides. The skin microbiome samples were analyzed using 16S (V1-V3) amplicon sequencing and quantitative polymerase chain reaction bacterial enumeration.<\/jats:p><\/jats:sec><jats:sec id=\"ab-cbr230023-9\"><jats:title>Results<\/jats:title><jats:p>Twenty female patients with breast cancer after surgery who underwent radiotherapy enrolled in the study had a median (range) age of 61 (37-81) years. The median (range) body mass index of the patients was 24.2 (17.6-38.4). The 16S sequencing revealed that low (&amp;amp;lt;5%) relative abundance of commensal skin bacteria (<jats:italic>Staphylococcus epidermidis, Staphylococcus hominis, Cutibacterium acnes<\/jats:italic>) at baseline composition was associated with the development of severe radiodermatitis with an accuracy of 100% (sensitivity and specificity of 100%, <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). Furthermore, in patients with severe radiodermatitis, quantitative polymerase chain reaction bacterial enumeration revealed a general non\u2013species-specific overgrowth of skin bacterial load before the onset of severe symptoms. Subsequently, the abundance of commensal bacteria increased in severe radiodermatitis, coinciding with a decline in total bacterial load.<\/jats:p><\/jats:sec><jats:sec id=\"ab-cbr230023-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The findings of this observational study indicated a potential mechanism associated with the skin microbiome for the pathogenesis of severe radiodermatitis, which may be a useful biomarker for personalized prevention of radiodermatitis in patients undergoing adjuvant radiotherapy for breast cancer.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoncol.2023.6533","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T16:32:23Z","timestamp":1706805143000},"page":"516","source":"Crossref","is-referenced-by-count":33,"title":["Association of Skin Microbiome Dynamics With Radiodermatitis in Patients With Breast Cancer"],"prefix":"10.1001","volume":"10","author":[{"given":"Claudia","family":"H\u00fclp\u00fcsch","sequence":"first","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"},{"name":"Chair of Environmental Medicine, Technical University Munich, Munich, Germany"},{"name":"CK CARE, Christine K\u00fchne Center for Allergy Research and Education, Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avidan Uriel","family":"Neumann","sequence":"additional","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"},{"name":"CK CARE, Christine K\u00fchne Center for Allergy Research and Education, Davos, Switzerland"},{"name":"Institute of Environmental Medicine, Helmholtz Munich, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Reiger","sequence":"additional","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"},{"name":"Chair of Environmental Medicine, Technical University Munich, Munich, Germany"},{"name":"Institute of Environmental Medicine, Helmholtz Munich, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius Clemens","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo","family":"de Tomassi","sequence":"additional","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gertrud","family":"Hammel","sequence":"additional","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"},{"name":"Institute of Environmental Medicine, Helmholtz Munich, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"G\u00fclzow","sequence":"additional","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"},{"name":"Chair of Environmental Medicine, Technical University Munich, Munich, Germany"},{"name":"CK CARE, Christine K\u00fchne Center for Allergy Research and Education, Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Fleming","sequence":"additional","affiliation":[{"name":"Chair of Environmental Medicine, Technical University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Dapper","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mayinger","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vogel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Ertl","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Elisabeth","family":"Combs","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"},{"name":"Germany Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences, Helmholtz Munich, Oberschlei\u00dfheim, Germany"},{"name":"German Consortium for Translational Cancer Research (DKTK), Partner Site Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Traidl-Hoffmann","sequence":"additional","affiliation":[{"name":"Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany"},{"name":"Chair of Environmental Medicine, Technical University Munich, Munich, Germany"},{"name":"CK CARE, Christine K\u00fchne Center for Allergy Research and Education, Davos, Switzerland"},{"name":"Institute of Environmental Medicine, Helmholtz Munich, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai Joachim","family":"Borm","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"1","key":"cbr230023r1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.jpainsymman.2019.03.017","article-title":"The impact of radiodermatitis on breast cancer patients\u2019 quality of life during radiotherapy: a prospective cohort study.","volume":"58","author":"Fuzissaki","year":"2019","journal-title":"J Pain Symptom Manage"},{"issue":"1","key":"cbr230023r2","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1186\/s13014-018-1160-5","article-title":"Acute radiodermatitis in modern adjuvant 3D conformal radiotherapy for breast cancer\u2014the impact of dose distribution and patient related factors.","volume":"13","author":"Borm","year":"2018","journal-title":"Radiat 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