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Microbiome-based atopic dermatitis treatment shows promise

A topical treatment containing a common “healthy” skin bacterium was found to reduce AD severity in adults and kids in an early-phase clinical trial.

Microbiome-based atopic dermatitis treatment shows promise

In an early-phase clinical trial at the National Institutes of Health (NIH), topical treatment with a common skin bacterium called Roseomonas mucosa was seen to reduce AD severity in a small group of adults and children with the disease.

This approach—introducing microbes from healthy volunteers to patients with a variety of diseases and conditions—is an emerging part of personalized medicine. It’s called microbiome-based research.

With the successful mapping of the human genome, scientists are now engaged in the much larger enterprise of mapping the human microbiome. The microbiome is estimated to contain the genomes of all the bacteria, viruses and other microbes that live inside and on the surface of our bodies. Each person’s microbiome is unique.

Our skin is home to billions of microbes. Most of the time, they get along just fine—as long as they stay balanced. But in AD, the “bad guys” tend to take over, especially Staphylococcus aureus, leading to frequent staph infections in AD skin.

That’s where applied microbiome research comes in. In their case study, the NIH team aimed to restore the microbial balance of AD skin by transplanting a “good guy” into the mix—and the results were encouraging.

The researchers enrolled 10 adults and five children in the study and treated them with topical R. mucosa twice a week for six weeks. They instructed the participants to apply the mixture to the crook of their elbow and another body surface of their choosing.

Every two to six weeks, they’d need to apply a slightly stronger mixture. At the six-week mark, they’d stop using the treatment and begin a four-week “washout” phase.

At 10 weeks, the adults showed a reduction in disease severity of 59.8 percent, while the pediatric patients experienced an even greater decrease of 70.3 percent. The enrollees’ itch reduction was even more impressive, at 78.5 percent and 78.8 percent, respectively.

Four of the adult patients didn’t respond to the treatment, owing possibly to their complex medical histories. However, the adults who showed a favorable response have continued to report improvement in their AD symptoms. The five children and teens enrolled in the study are still being evaluated as of this writing.

The authors of the study reported that, overall, the treatment reduced the patients’ rash and itch. Plus, it reduced the amount of topical steroids they felt they needed to keep their AD under control.

The NIH team have observed no problems or complications since the study’s conclusion.

In light of the treatment’s positive safety profile and its promising impact on AD severity in this small group of patients, the researchers intend to proceed with larger studies of topical R. mucosa-based therapy.

Their hope is to lay the foundation for placebo-controlled trials that will be necessary to validate this promising approach to AD treatment.

Talking Topicals with Dr. Peter Lio

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