{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:40:34Z","timestamp":1790671234960,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>The ocular surface microbiome is an essential factor that maintains ocular surface homeostasis. Since the ocular surface is continuously exposed to the external environment, its microbiome, tears, and local immunity are vital for maintaining normal conditions. Additionally, this microbiome helps prevent pathogen colonization, which commonly leads to opportunistic infection. The abnormal ocular surface microbiome has previously been reported in several conditions, including dry eyes, allergy, blepharitis, graft-versus-host disease (GVHD), and Stevens-Johnson syndrome (SJS). Several approaches were applied to identify the ocular microbiome, including conventional culture techniques and molecular sequencing techniques. By using 16s rRNA sequencing, alterations in the type, proportion, and composition of bacterial communities, described by alpha (\u03b1)-and beta (\u03b2)-diversity, were observed in SJS patients compared to the healthy group. Conventional culture techniques indicated a higher number of positive bacterial cultures in the SJS group, with a predominance of gram-positive cocci and gram-positive bacilli. Besides, there are increased variations and multiple detections of bacterial genera. Taken together, SJS causes structural changes in the ocular surface and significantly affects its microbiome. Further studies into the area of temporal relationship, metagenomics, proteomics, and metabolomics analysis of the microbiome will lead to a better understanding of this disease. Finally, the treatment using prebiotics and probiotics to re-establish the normal ocular ecosystem and bring back a healthy ocular surface await confirmation.<\/jats:p>","DOI":"10.3389\/fmed.2021.645053","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T14:36:09Z","timestamp":1620398169000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["The Ocular Microbiome in Stevens-Johnson Syndrome"],"prefix":"10.3389","volume":"8","author":[{"given":"Thanachaporn","family":"Kittipibul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilavun","family":"Puangsricharern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4593","DOI":"10.1167\/iovs.17-22119","article-title":"Role of microbiota in strengthening ocular mucosal barrier function through secretory IgA","volume":"58","author":"Kugadas","year":"2017","journal-title":"Invest Opthalmol Vis Sci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.advms.2017.04.005","article-title":"The human microbiome","volume":"62","author":"Blum","year":"2017","journal-title":"Adv Med Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1038\/nm.4517","article-title":"Current understanding of the human microbiome","volume":"24","author":"Gilbert","year":"2018","journal-title":"Nat Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1097\/ICO.0000000000000857","article-title":"Conjunctival Microbial Flora in Ocular Stevens-Johnson Syndrome Sequelae Patients at a Tertiary Eye Care Center","volume":"35","author":"Venugopal","year":"2016","journal-title":"Cornea."},{"key":"B5","doi-asserted-by":"publisher","first-page":"4353","DOI":"10.1038\/s41598-020-60794-w","article-title":"Comparison of the ocular microbiome between chronic Stevens-Johnson syndrome patients and healthy subjects","volume":"10","author":"Kittipibul","year":"2020","journal-title":"Sci Reports."},{"key":"B6","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/S0008-4182(05)80004-3","article-title":"Evaluation of normal ocular bacterial flora with two different culture media","volume":"40","author":"De Aguiar Moeller","year":"2005","journal-title":"Can J Ophthalmol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"5408","DOI":"10.1167\/iovs.10-6939","article-title":"Diversity of Bacteria at healthy human conjunctiva","volume":"52","author":"Dong","year":"2011","journal-title":"Invest Opthalmol Vis Sci."},{"key":"B8","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.jtos.2019.05.006","article-title":"Relationship between the microbiome and ocular health","volume":"17","author":"Cavuoto","year":"2019","journal-title":"Ocul Surf."},{"key":"B9","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s13073-014-0099-x","article-title":"The conjunctival microbiome in health and trachomatous disease: a case-control study","volume":"6","author":"Zhou","year":"2014","journal-title":"Genome Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"5116","DOI":"10.1167\/iovs.16-19803","article-title":"Paucibacterial microbiome and resident DNA virome of the healthy conjunctiva","volume":"57","author":"Doan","year":"2016","journal-title":"Invest Opthalmol Vis Sci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e00196","DOI":"10.1128\/mBio.00198-16","article-title":"Changes in the eye microbiota associated with contact lens wearing","volume":"7","author":"Shin","year":"2016","journal-title":"mBio."},{"key":"B12","doi-asserted-by":"publisher","first-page":"5616","DOI":"10.1167\/iovs.07-0588","article-title":"Ocular pathogen or commensal: a PCR-Based study of surface bacterial flora in normal and dry eyes","volume":"48","author":"Graham","year":"2007","journal-title":"Invest Opthalmol Vis Sci."},{"key":"B13","first-page":"2291","article-title":"Relation of cholesterol-stimulated Staphylococcus aureus growth to chronic blepharitis","volume":"34","author":"Shine","year":"1993","journal-title":"Invest Ophthalmol Vis Sci."},{"key":"B14","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jtos.2019.02.001","article-title":"Commensal microflora in human conjunctiva; characteristics of microflora in the patients with chronic ocular graft-versus-host disease","volume":"17","author":"Shimizu","year":"2019","journal-title":"Ocul Surf."},{"key":"B15","doi-asserted-by":"publisher","first-page":"187.e1","DOI":"10.1016\/j.jaad.2013.05.002","article-title":"Toxic epidermal necrolysis: part II. 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