Atopic dermatitis (AD) is a common inflammatory disease that can negatively affect the quality of life of patients who are diagnosed. Besides having to manage the dry, itchy skin and rashes that are associated with AD, patients are also often at risk for other inflammatory diseases such as asthma and food allergies.1 Treatment of AD can also limit quality of life. Treatments for AD often need to be applied frequently, have the potential to be messy and time consuming, and can be extremely expensive.2
Impact of bacteria on the skin
While it is known that AD is an inflammatory disease, the exact cause of AD is not completely understood. There have been studies that have suggested that the bacteria that live on the skin may be a factor in the disease.1 People who have AD often have large colonies of Staphylococcus aureus bacteria living on their skin, putting them at greater risk for skin infections and worsening inflammation.
A look at the research on bacteria therapy
Researchers at the National Institute of Health (NIH) wanted to see if any other common bacteria that are found on healthy skin would affect AD and the growth of S. aureus. They found that when a strain of bacteria known as Roseomonas mucosa was applied to mice with dermatitis, there was an improvement of their skin quality, with no signs of infection, either on their skin or throughout their system.2
NIH researchers then began a Phase I/II clinical trial to test the safety of the treatment in adults with AD. Ten adult patients applied sugar-water solutions that contained R. mucosa to their skin two times a week for six weeks. The bacteria were collected from healthy volunteers and grown under specific lab conditions.1 All of the subjects started with very small doses of the bacteria that were increased gradually. The sugar-water/bacteria solution was applied to the inside surface of the elbow, and then to another area of skin of the subject’s choice. The subjects were told not to discontinue any treatments that they were currently using to treat their AD.2
Did patients in the study see an improvement in their AD symptoms?
All of the patients completed their treatment, and none had any significant side effects to report. Most of the patients reported improvement of their AD and of their itching, both at the treatment site and in other areas of the body. None of the patients had any skin or systemic R. mucosa infections after the treatment.2 There was some evidence that certain moisturizers blocked the growth of R. mucosa, which suggest that these moisturizers could affect treatment.1 There was also evidence that R. mucosa didn’t work well in AD on the hands, which could be a result of the increased use of antibacterial soaps and sanitizers.2
Clinical trials with children
This treatment was also tested in 5 children (ages 9-14), who had similar results as the adults. The children were treated for 16 weeks and were given enough sugar-water/bacteria solution to treat any area of their body that had AD. None of the children had any side effects, and most had improvement of their AD symptoms and a reduced need for steroids. The children also had fewer numbers of S. aureus on their skin after the treatment.2
This trial is still open to children ages 7-13. The goal of is to open the study to a larger population to evaluate if this treatment is effective in treating AD, and if it is more effective than treatments that are already available.1 This trial is an opportunity to find lower-cost AD therapies that may require less application than current treatments and may lead to an increased quality of life in AD patients.
Bacteria Therapy for Eczema Shows Promise in NIH Study. National Institute of Allergy and Infectious Diseases. Available at: https://www.niaid.nih.gov/news-events/bacteria-therapy-eczema-shows-promise-nih-study. Accessed 6/4/18
Myles IA, Earland NJ, Anderson ED, et al. First-in-human topical microbiome transplantation with Roseomonas mucosa for atopic dermatitis. JCI Insight. 2018;3(9):e120608. https://doi.org/10.1172/jci.insight.120608.