New hope for treating Eczema skin condition
SKIN MICROBES REDUCES ECZEMA FLARES
Finding provides deeper understanding of the skin disease and could lead to possible interventions for improved skin health
Singapore – Research investigators in Singapore have found distinct bacterial and eukaryotic compositional differences in inter-flare Atopic dermatitis (AD) skin microbiome and provided evidence for its impact on Staphylococcus aureus (S. aureus) colonisation and skin immune response. The differences were also functionally predicted to shape the skin microenvironment by contributing to skin dryness and reduced acidity, which favour pathogen colonisation and inflammation during AD flares. Taken together, the study demonstrates an intricate relationship between skin microbiome alterations and skin health.
AD, or eczema, is a highly prevalent skin disorder that affects one in five Singaporeans. AD patients suffer from dry, itchy skin with cyclic periods of asymptomatic non-flare and red, inflammatory, and often infected flares. While studies have been conducted previously to demonstrate near-complete colonisation of AD skin lesions during flares with the pathogen S. aureus, the between-flare skin microbiome composition and its contribution to AD pathology has remained elusive.
In AD, helpful skin microbes are missing even when the skin appears healthy. That in turn allows opportunistic and pathogenic microbes to flourish. This situation is similar to the “calm before the storm” when we see a signature in the non-flare skin. Published in scientific journal Nature Microbiology, this study was led by researchers from A*STAR’s Genome Institute of Singapore (GIS) and Institute of Medical Biology (IMB).
(L-R) Dr Angeline Tay, Colin Wong, Chenhao Li, Dr John Common, Dr Niranjan Nagarajan, Amanda Ng, Dr Kern Rei Chng.
This work could provide the beginnings of a method to look for microbial signatures that would indicate a person is at risk of disease, with between-flare time points a good opportunity to target the skin microbiome as a possible prophylactic treatment for recurrent infections often seen in AD. In the long run, this could develop into an alternative and complementary approach for a continuum of skin health treatments that would be included with emollients and moisturisers to help promote a happy skin microbiome and stable non-flare disease state.
A multi-institutional effort that brought together expertise in skin biology, genomics, immunology and dermatology, this study also involved A*STAR’s Institute of Molecular and Cell Biology (IMCB) and Singapore Immunology Network (SIgN), alongside collaborators based at the National University of Singapore and National Skin Centre.
“The skin microenvironment, microbiome and immune system cross-modulate one another, culminating into AD flare cycles. Hence, therapeutic intervention for skin microbiome in AD patients seems like a feasible and attractive alternative. This gives us the momentum to continue to investigate this part of the disease cycle for possible interventions that could ultimately improve skin health,” said Dr Niranjan Nagarajan, the study’s joint corresponding author and Principal Investigator of Computational & Systems Biology at the GIS.
The microbial yin and yang of the AD flare cycle. (Photo: A*Star)
“This study suggests that interventional treatments targeting the skin microbiome with probiotic or microbe transplants could be useful for prevention of skin diseases. We are now focusing on longitudinal clinical studies across AD flares, microbiome development in infants at high risk of developing AD and studying the various strains of microbes that we identified here,” said Dr John Common, co-lead author of the study and Project Leader at the IMB.
GIS Executive Director Prof Ng Huck Hui said, “Once again, this highlights the importance of cross-institutional efforts. By harnessing the expertise and resources within the industry and our clinical community, we can achieve more high-impact results in the shortest time possible, which would ideally lead to more timely interventions for patients in need.”