Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate‐to‐severe atopic dermatitis

• DOI: 10.1111/all.15742
• Publication Date: 2023-04-10T03:39:48Z
• Authors: Jan Hartmann; Lucas Moitinho‐Silva; Nicole Sander; Inken Harder; Robert Häsler; Elke Rodriguez; Eva Haufe; Andreas Kleinheinz; Susanne Abraham; Annice Heratizadeh; Elke Weisshaar; Knut Schäkel; Christiane Handrick; Matthias Augustin; Andreas Wollenberg; Petra Staubach‐Renz; Konstantin Ertner; Michael Sticherling; Beate Schwarz; Sven Quist; Franca Wiemers; Florian Schenck; Julia Wildberger; Lukas Tittmann; Wolfgang Lieb; Jochen Schmitt; Thomas Werfel; Stephan Weidinger
• Keywords: Dupilumab

Abstract Background Atopic dermatitis (AD) patients display an altered skin microbiome which may not only be indicator but also a driver of inflammation. We aimed to investigate associations among AD patients' microbiome, clinical data, and response systemic therapy in the TREATgermany registry. Methods Skin swabs 157 were profiled with 16S rRNA gene amplicon sequencing before after 3 months treatment dupilumab or cyclosporine. For comparison, 16s data from 258 population‐based healthy controls used. Disease severity was assessed using established instruments such as Eczema Area Severity Index (EASI). Results confirmed previously shown correlation Staphylococcus aureus abundance bacterial alpha diversity measured by EASI. Therapy Dupilumab shifted community toward pattern seen controls. The relative Staphylococci particular S. significantly decreased on both lesional non‐lesional skin, whereas hominis increased. These changes largely independent degree improvement observed for Conclusions Systemic cyclosporine tends restore indicating potential effects IL‐4RA blockade microbiome.