Are Bacteria Transplants the Future of Eczema Therapy?
JAMA. Sep 2018. doi: 10.1001/jama.2018.12334
COMMENT: Within the section Medical News & Perspectives of JAMA the author selects interesting new findings around the microbiome-based treatments for eczema.
The relationship between ezcema and skin microbiome is known from 1970s:
Eczema, also known as atopic dermatitis, hasbeenlinkedsince the 1970s with changes in the skin microbiome. In particular, people with the condition tend to have more gram-positive bugs—the other category of bacteria—on their skin than those without eczema.
Based in different works, gram-negative bacteria appears as decisive microbiome components related with eczema:
Some categories of gram-negative bacteria, like those found on the skin, are known to produce beneficial lipids that are deficient in patients with eczema. And the fact that children usually outgrow eczema could be explained by acquiring healthy bacterial strains in day care, preschool, and beyond.
The bacteria Roseomonas mucosa, more abundant in healthy skin that in skin affected with eczema appeared to be a differential microbiome component:
One of the 9 species they identified in their study, Roseomonas mucosa, jumped out at them. It was the predominant gram-negative bacterium they found on skin, but although around 70% of people with healthy skin had it, only 20% of those with eczema did.
Curiosly the Roseomonas mucosa bacteria from patients with ezcema were different in the production of a special kind of lipids:
When sampled from healthy skin, R. mucosa inhibited S. aureus and improved eczema markers and outcomes in mice and human cells. But when taken from patients with eczema, it did the opposite. The oily-looking bacteria from healthy individuals produce lipids that are known to kill S. aureus, improve skin barrier function, and enhance immunity. The desiccated R. mucosa from patients with eczema, on the other hand, produce irritants including histidine.
Under the idea of restoring the skin’s beneficial bacteria some ongoing studies are centred on skin bacteria transplants from healthy individuals. With respect toan ongoing small, proof-of-concept study applying bacteria transplants from healthy volunteers Gallo said:
... the study is “very encouraging” and points to a potential role for beneficial bacteria in treating eczema. Beyond that, he’s waiting for more evidence.
Widening the perspective of the microbiome application to dermatology Bruckner said:
... although more studies are needed to establish long-term efficacy and safety, there could be a larger role for bacteria therapy in dermatology