RT Journal Article
SR Electronic
T1 Therapeutic responses to <em>Roseomonas mucosa</em> in atopic dermatitis may involve lipid-mediated TNF-related epithelial repair
JF Science Translational Medicine
FD American Association for the Advancement of Science
SP eaaz8631
DO 10.1126/scitranslmed.aaz8631
VO 12
IS 560
A1 Myles, Ian A.
A1 Castillo, Carlo R.
A1 Barbian, Kent D.
A1 Kanakabandi, Kishore
A1 Virtaneva, Kimmo
A1 Fitzmeyer, Emily
A1 Paneru, Monica
A1 Otaizo-Carrasquero, Francisco
A1 Myers, Timothy G.
A1 Markowitz, Tovah E.
A1 Moore, Ian N.
A1 Liu, Xue
A1 Ferrer, Marc
A1 Sakamachi, Yosuke
A1 Garantziotis, Stavros
A1 Swamydas, Muthulekha
A1 Lionakis, Michail S.
A1 Anderson, Erik D.
A1 Earland, Noah J.
A1 Ganesan, Sundar
A1 Sun, Ashleigh A.
A1 Bergerson, Jenna R.E.
A1 Silverman, Robert A.
A1 Petersen, Maureen
A1 Martens, Craig A.
A1 Datta, Sandip K.
YR 2020
UL http://stm.sciencemag.org/content/12/560/eaaz8631.abstract
AB In a clinical trial, topical application of the healthy skin bacterium Roseomonas mucosa improved atopic dermatitis (AD) in children age 3 years or older. R. mucosa treatment was associated with improvements in disease symptoms, epithelial barrier function, the amount of Staphylococcus aureus growing on the skin, the need for topical steroids, and quality of life for children and their families. Clinical improvements and colonization of skin by R. mucosa persisted for up to 8 months after treatment cessation and were not associated with major adverse events. Cell culture analyses and studies in the MC903 mouse model of AD suggest that the therapeutic mechanism may involve lipid production by R. mucosa, cholinergic signaling, and flagellin expression leading to a TNFR2-mediated epithelial-to-mesenchymal transition.Dysbiosis of the skin microbiota is increasingly implicated as a contributor to the pathogenesis of atopic dermatitis (AD). We previously reported first-in-human safety and clinical activity results from topical application of the commensal skin bacterium Roseomonas mucosa for the treatment of AD in 10 adults and 5 children older than 9 years of age. Here, we examined the potential mechanism of action of R. mucosa treatment and its impact on children with AD less than 7 years of age, the most common age group for children with AD. In 15 children with AD, R. mucosa treatment was associated with amelioration of disease severity, improvement in epithelial barrier function, reduced Staphylococcus aureus burden on the skin, and a reduction in topical steroid requirements without severe adverse events. Our observed response rates to R. mucosa treatment were greater than those seen in historical placebo control groups in prior AD studies. Skin improvements and colonization by R. mucosa persisted for up to 8 months after cessation of treatment. Analyses of cellular scratch assays and the MC903 mouse model of AD suggested that production of sphingolipids by R. mucosa, cholinergic signaling, and flagellin expression may have contributed to therapeutic impact through induction of a TNFR2-mediated epithelial-to-mesenchymal transition. These results suggest that a randomized, placebo-controlled trial of R. mucosa treatment in individuals with AD is warranted and implicate commensals in the maintenance of the skin epithelial barrier.