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Live-bacterial spray improves disease severity in children with atopic eczema

In 2018, researchers from the National Institute of Allergy and Infectious Disease, USA, performed a preclinical study in ten adults and five children with atopic eczema (AE) that involved spraying a solution containing a commensal skin organism, Roseomonas mucosa (R. mucosa), onto affected skin.

The results showed an improvement in disease severity and for their latest study, the team further tested the treatment in 15 children, with a mean age of 9 years (range 3-16) in an open label study. The live R. mucosa was grown for up to 48 hours and freeze-dried in a 3-ml self-contained spray system. Participant parents were provided with 1.5ml of sterile water and for each dose, the water added to the bacteria and the resultant mixture sprayed onto affected areas of skin. All the participants were treated with live R. mucosa twice weekly for a period of 3 months and then on alternate days for an additional four weeks, followed by a 4-12 month washout period. The primary disease severity outcome of interest was a SCORAD50 (that is, a 50% improvement in their SCORAD score) whereas a secondary disease severity outcome was an EASI50.

After 16 weeks, 85% (17/20) of children achieved the primary outcome (SCORAD50) and 90% met the secondary outcome of an EASI50 and this was observed at all affected sites. Moreover, improvements were similar in patients with both mild and moderate disease severity and the improvements persisted for at least 8 months after cessation of therapy. The authors concluded that these preliminary findings now warranted a placebo-controlled trial to fully investigate the value of the treatment.

Myles IA et al. Therapeutic responses to Roseomonas mucosa in atopic dermatitis may involve lipid-mediated TNF-related epithelial repair. Sci Transl Med 2020; Sept 9th eaaz8631. doi: 10.1126/scitranslmed.aaz8631.