Persistent Neutrophil Infiltration and Unique Ocular Surface Microbiome Typify Dupilumab–Associated Conjunctivitis in Patients with Atopic Dermatitis

• DOI: 10.1016/j.xops.2023.100340
• Publication Date: 2023-05-29T06:23:58Z
• Authors: VijayKumar Patra; Nora Woltsche; Urban Cerpes; Danijela Bokanovic; Maria Repelnig; Aaroh Joshi; Isabella Perchthaler; Manuela Fischl; Marc Vocanson; Natalie Bordag; Marija Durdevic; Johannes Woltsche; Franz Quehenberger; Franz Legat; Andreas Wedrich; Jutta Horwath-Winter; Peter Wolf
• Keywords: Dupilumab; Multiplex; SCORAD

ObjectiveTo elucidate the pathogenesis of dupilumab [Dupixent®]-associated ocular surface disease (DAOSD).DesignProspective single-centre cohort study.Subjects and ControlsTwenty patients with moderate to severe atopic dermatitis (AD) who received ten age- sex-matched healthy controls were enrolled in study.MethodsThe study underwent a thorough slit lamp whole-body dermatologic examination. Conjunctival swabs smears collected at baseline, four sixteen weeks after treatment initiation, during conjunctivitis episode. 16S rRNA sequencing was performed analyse microbiome, H&E stained, serum cytokines measured by using multiplex immunobead assay.Main Outcome MeasuresComposition microbiome cellular component, as well cytokine levels.ResultsSix twenty AD developed DAOSD initiation; these responded delay quantified Eczema Area Severity Index (EASI) Investigator's Global Assessment (IGA). showed massive neutrophilic infiltration analysis revealed increased systemic levels neutrophil-priming pro-inflammatory cytokines, particular IL -1β TNF-α compared those without it. The characterised diverse persistent microbial colonisation, particularly Acetobacter aceti. In contrast, diversity decreased initiation treatment, especially abundance Staphylococcus aureus. vitro experiments substantiated potential role showing growth aceti aureus presence dupilumab.ConclusionsPersistent unique landscape on associated elevated typify DAOSD.