Ionizing radiation improves skin bacterial dysbiosis in cutaneous T-cell lymphoma.

Introduction: Cutaneous T-cell lymphoma (CTCL) is closely associated with the host microbiome. While recent evidence suggests that shifts in specific bacterial taxa are associated with response to UV-B, a form of non-ionizing radiation, the impact of ionizing radiation (IR) has not been investigated. Methods: 16S rRNA and Results: Radiation exposure increased CTCL skin α-diversity to levels approximating HC. TSEBT appeared to carry the greatest effect compared to local IR. Both α and β-diversity differed significantly post versus pre-IR for TSEBT, but not for local IR. IR was associated with decreases in known pathogenic bacteria such as Discussion: IR not only eliminates CTCL lesions via induction of apoptosis, but also facilitates skin barrier restoration and recolonization of bacterial taxa associated with a healthy skin microbiome. Local IR does not have as strong an effect on the skin microbiome as TSEBT. As skin microbiota act as immunomodulators with local and potentially systemic influence, TSEBT may also improve CTCL lesions via global effects on the skin microbiome. Future larger-scale studies are required to fully elucidate the relationship between cutaneous microbes and IR treatment in CTCL.