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

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Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis. / Hartmann, Jan; Moitinho-Silva, Lucas; Sander, Nicole; Harder, Inken; Häsler, Robert; Rodriguez, Elke; Haufe, Eva; Kleinheinz, Andreas; Abraham, Susanne; Heratizadeh, Annice; Weisshaar, Elke; Schäkel, Knut; Handrick, Christiane; Augustin, Matthias; Wollenberg, Andreas; Staubach-Renz, Petra; Ertner, Konstantin; Sticherling, Michael; Schwarz, Beate; Quist, Sven; Wiemers, Franca; Schenck, Florian; Wildberger, Julia; Tittmann, Lukas; Lieb, Wolfgang; Schmitt, Jochen; Werfel, Thomas; Weidinger, Stephan; TREATgermany study group.

In: ALLERGY, Vol. 78, No. 8, 08.2023, p. 2290-2300.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hartmann, J, Moitinho-Silva, L, Sander, N, Harder, I, Häsler, R, Rodriguez, E, Haufe, E, Kleinheinz, A, Abraham, S, Heratizadeh, A, Weisshaar, E, Schäkel, K, Handrick, C, Augustin, M, Wollenberg, A, Staubach-Renz, P, Ertner, K, Sticherling, M, Schwarz, B, Quist, S, Wiemers, F, Schenck, F, Wildberger, J, Tittmann, L, Lieb, W, Schmitt, J, Werfel, T, Weidinger, S & TREATgermany study group 2023, 'Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis', ALLERGY, vol. 78, no. 8, pp. 2290-2300. https://doi.org/10.1111/all.15742

APA

Hartmann, J., Moitinho-Silva, L., Sander, N., Harder, I., Häsler, R., Rodriguez, E., Haufe, E., Kleinheinz, A., Abraham, S., Heratizadeh, A., Weisshaar, E., Schäkel, K., Handrick, C., Augustin, M., Wollenberg, A., Staubach-Renz, P., Ertner, K., Sticherling, M., Schwarz, B., ... TREATgermany study group (2023). Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis. ALLERGY, 78(8), 2290-2300. https://doi.org/10.1111/all.15742

Vancouver

Hartmann J, Moitinho-Silva L, Sander N, Harder I, Häsler R, Rodriguez E et al. Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis. ALLERGY. 2023 Aug;78(8):2290-2300. https://doi.org/10.1111/all.15742

Bibtex

@article{4a4b22f050a1401cacfb9a97c14fe5a4,
title = "Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis",
abstract = "BACKGROUND: Atopic dermatitis (AD) patients display an altered skin microbiome which may not only be an indicator but also a driver of inflammation. We aimed to investigate associations among AD patients' skin microbiome, clinical data, and response to systemic therapy in patients of the TREATgermany registry.METHODS: Skin swabs of 157 patients were profiled with 16S rRNA gene amplicon sequencing before and after 3 months of treatment with dupilumab or cyclosporine. For comparison, 16s microbiome data from 258 population-based healthy controls were used. Disease severity was assessed using established instruments such as the Eczema Area and Severity Index (EASI).RESULTS: We confirmed the previously shown correlation of Staphylococcus aureus abundance and bacterial alpha diversity with AD severity as measured by EASI. Therapy with Dupilumab shifted the bacterial community toward the pattern seen in healthy controls. The relative abundance of Staphylococci and in particular S. aureus significantly decreased on both lesional and non-lesional skin, whereas the abundance of Staphylococcus hominis increased. These changes were largely independent from the degree of clinical improvement and were not observed for cyclosporine.CONCLUSIONS: Systemic treatment with dupilumab but not cyclosporine tends to restore a healthy skin microbiome largely independent of the clinical response indicating potential effects of IL-4RA blockade on the microbiome.",
keywords = "Humans, Dermatitis, Atopic/genetics, Cyclosporine/pharmacology, Staphylococcus aureus/genetics, RNA, Ribosomal, 16S/genetics, Skin, Microbiota, Treatment Outcome, Severity of Illness Index",
author = "Jan Hartmann and Lucas Moitinho-Silva and Nicole Sander and Inken Harder and Robert H{\"a}sler and Elke Rodriguez and Eva Haufe and Andreas Kleinheinz and Susanne Abraham and Annice Heratizadeh and Elke Weisshaar and Knut Sch{\"a}kel and Christiane Handrick and Matthias Augustin and Andreas Wollenberg and Petra Staubach-Renz and Konstantin Ertner and Michael Sticherling and Beate Schwarz and Sven Quist and Franca Wiemers and Florian Schenck and Julia Wildberger and Lukas Tittmann and Wolfgang Lieb and Jochen Schmitt and Thomas Werfel and Stephan Weidinger and {TREATgermany study group}",
note = "{\textcopyright} 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",
year = "2023",
month = aug,
doi = "10.1111/all.15742",
language = "English",
volume = "78",
pages = "2290--2300",
journal = "ALLERGY",
issn = "0105-4538",
publisher = "Wiley-Blackwell",
number = "8",

}

RIS

TY - JOUR

T1 - Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate-to-severe atopic dermatitis

AU - Hartmann, Jan

AU - Moitinho-Silva, Lucas

AU - Sander, Nicole

AU - Harder, Inken

AU - Häsler, Robert

AU - Rodriguez, Elke

AU - Haufe, Eva

AU - Kleinheinz, Andreas

AU - Abraham, Susanne

AU - Heratizadeh, Annice

AU - Weisshaar, Elke

AU - Schäkel, Knut

AU - Handrick, Christiane

AU - Augustin, Matthias

AU - Wollenberg, Andreas

AU - Staubach-Renz, Petra

AU - Ertner, Konstantin

AU - Sticherling, Michael

AU - Schwarz, Beate

AU - Quist, Sven

AU - Wiemers, Franca

AU - Schenck, Florian

AU - Wildberger, Julia

AU - Tittmann, Lukas

AU - Lieb, Wolfgang

AU - Schmitt, Jochen

AU - Werfel, Thomas

AU - Weidinger, Stephan

AU - TREATgermany study group

N1 - © 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2023/8

Y1 - 2023/8

N2 - BACKGROUND: Atopic dermatitis (AD) patients display an altered skin microbiome which may not only be an indicator but also a driver of inflammation. We aimed to investigate associations among AD patients' skin microbiome, clinical data, and response to systemic therapy in patients of the TREATgermany registry.METHODS: Skin swabs of 157 patients were profiled with 16S rRNA gene amplicon sequencing before and after 3 months of treatment with dupilumab or cyclosporine. For comparison, 16s microbiome data from 258 population-based healthy controls were used. Disease severity was assessed using established instruments such as the Eczema Area and Severity Index (EASI).RESULTS: We confirmed the previously shown correlation of Staphylococcus aureus abundance and bacterial alpha diversity with AD severity as measured by EASI. Therapy with Dupilumab shifted the bacterial community toward the pattern seen in healthy controls. The relative abundance of Staphylococci and in particular S. aureus significantly decreased on both lesional and non-lesional skin, whereas the abundance of Staphylococcus hominis increased. These changes were largely independent from the degree of clinical improvement and were not observed for cyclosporine.CONCLUSIONS: Systemic treatment with dupilumab but not cyclosporine tends to restore a healthy skin microbiome largely independent of the clinical response indicating potential effects of IL-4RA blockade on the microbiome.

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

KW - Humans

KW - Dermatitis, Atopic/genetics

KW - Cyclosporine/pharmacology

KW - Staphylococcus aureus/genetics

KW - RNA, Ribosomal, 16S/genetics

KW - Skin

KW - Microbiota

KW - Treatment Outcome

KW - Severity of Illness Index

U2 - 10.1111/all.15742

DO - 10.1111/all.15742

M3 - SCORING: Journal article

C2 - 37032440

VL - 78

SP - 2290

EP - 2300

JO - ALLERGY

JF - ALLERGY

SN - 0105-4538

IS - 8

ER -