Under the Microscope: Bacteria and Eczema

The National Eczema Association (NEA) is the largest private nonprofit funder of research for adult and pediatric eczema, investing more than $4 million to date. Ever wonder what exactly our research grant recipients are working on? Under the Microscope is where we provide an inside look at research from one of our latest grant recipients, including what they are studying and its potential impact on the eczema community.

Battling bacteria

Human skin hosts many types of bacteria, including Staphylococcus aureus (or staph), which are generally a neutral presence in the skin microbiome. But scientists have long known that staph is anything but benign for people with atopic dermatitis, the most common type of eczema. 

Staph is found in higher concentrations in eczema lesions than in unaffected skin, and when it becomes densely populated, it releases toxins that exacerbate itch, inflammation and the breakdown of the skin barrier. 

Dr. Cassandra Quave, associate professor of dermatology and human health at Emory University’s School of Medicine and curator of the Emory University Herbarium, explained that her research found that the staph bacteria in lesions of people with severe eczema were more prolific at producing toxins than in milder cases of eczema. 

Through her work, Dr. Quave became an expert at understanding how staph bacteria become harmful and which toxins they release in eczema outbreaks. Her goal was to figure out a way to hinder its ability to produce toxins. And now, with the help of an Eczema Champion Research Grant from the National Eczema Association, Dr. Quave is furthering her tests of several substances that have been proven in the lab to stop staph from producing toxins. 

“What is exciting about this research is that we are identifying a new way to reduce toxin load, which we know is a driver of disease severity, and that could eventually help patients,” said Dr. Quave. 

Molecules from plants may lead to a new treatment option

One thing that sets Dr. Quave apart from other medical researchers is that she searches for solutions in nature. A biologist and medical ethnobotanist, Dr. Quave has collected more than 750 plants from around the world that have been used to treat skin disease. From those plants, she has extracted more than 2,500 molecules which she has tested against staph bacteria to examine whether any can alter its ability to make toxins. 

“There are more than 400,000 species of plants on earth and between 34,000 and 35,000 plants have been used in medicine in some way,” said Dr. Quave, who wrote about her research on medicinal plants in a book entitled The Plant Hunter. 

She eventually focused her attention on a few molecules extracted from two types of trees that have been used as traditional medicines for centuries. She is determining if these molecules can reduce the toxin load on the skin and if that reduction diminishes the severity of eczema outbreaks. She also plans to evaluate whether these molecules work equally well for severe, moderate and mild cases of eczema. 

Dr. Quave’s research is ongoing, and, while it is too soon for her to reach any conclusions, she said the work in her laboratory is promising. “We have identified at least one molecule that works really well in turning off that toxin production pathway,” said Dr. Quave.

A potential first-in-class treatment

Dr. Quave’s ultimate goal is to develop a new, first-in-class type of treatment for eczema that would differ from existing treatments in several meaningful ways. For one, this type of treatment would target bacteria, not the person with eczema’s immune system or inflammatory reaction. 

It is also a departure from other ways of dealing with harmful bacteria, which has traditionally been to kill it. Killing bacteria can lead to drug resistance, but since these molecules change the behavior of bacteria without killing it, Dr. Quave believes her approach is less likely to promote drug resistance.

She also noted that producing a treatment derived from plants is appealing to many people, especially since eczema is so prevalent among children. 

“Nature offers us so many incredible options and opportunities to discover new medicines,” said Dr. Quave. “I believe this highly innovative approach is unlikely to promote antibiotic resistance and I think it offers numerous safety advantages, especially for children, over immune-modulating therapies or topical steroids.”

NEA grants and their impact

NEA is dedicated to increasing the number of scientists, research projects and research dollars devoted to eczema, in pursuit of better therapies, better care, better outcomes — and one day, potentially, a cure. Learn more about our eczema research grants, their impact and how you can get involved.