Bacteria therapy for eczema shows promise in NIH study

Topical treatment with live Roseomonas mucosa — a bacterium naturally present on the skin — was safe for adults and children with atopic dermatitis (eczema) and was associated with reduced disease severity, according to initial findings from an ongoing early-phase clinical trial at the National Institutes of Health.

A scientist demonstrates application of the experimental therapy to the inner elbow. For demonstration purposes, the bacteria solution has been replaced with purple dye. Photo: NIAID

Atopic dermatitis is an inflammatory skin disease that can make skin dry and itchy, cause rashes and lead to skin infections. The disease is linked to an increased risk of developing asthma, hay fever and food allergy. Atopic dermatitis is common in children and sometimes resolves on its own, but it also can persist into or develop during adulthood.

The cause of atopic dermatitis is unknown, but studies suggest that the skin microbiome—the community of bacteria and other microbes living on the skin—plays a key role. For years, scientists have known that people with atopic dermatitis tend to have large populations of Staphylococcus aureus bacteria on their skin. These bacteria can cause skin infections and trigger immune responses that increase inflammation and worsen symptoms.

Recent work revealed that treatment with isolates of R. mucosa collected from the skin of healthy people improved disease outcomes in the models. In contrast, R. mucosa isolates from people with atopic dermatitis either had no impact or worsened outcomes in the models.

Based on these preclinical findings, NIAID investigators designed an early stage clinical trial to test the safety and potential benefit of a treatment containing live R. mucosa in people with atopic dermatitis.

The researchers first tested the experimental treatment in 10 adult volunteers with atopic dermatitis. Twice a week for six weeks, the volunteers sprayed a solution of sugar water containing increasing doses of live R. mucosa onto their inner elbows and one additional skin area of their choice.

The R. mucosa strains included in the treatment were originally isolated from the skin of healthy individuals and grown under carefully controlled laboratory conditions.

Participants did not report any adverse reactions or complications. Most participants experienced improvements in their atopic dermatitis, and four weeks after stopping the bacteria therapy, some reported needing fewer topical steroids.

The investigators next enrolled five volunteers aged 9 to 14 years with atopic dermatitis. Treatments were applied to all affected skin areas twice weekly for 12 weeks and every other day for an additional four weeks. Consistent with the findings in adults, there were no complications or adverse effects, and most participants experienced improvements in their eczema, including a reduced need for topical steroids.

The researchers also found that treatment was associated with decreases in the S. aureus population on the children’s skin. (National Institutes of Health)

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