I’m Lieutenant Commander Ian Myles, and our group here works on atopic dermatitis. Atopic dermatitis is an allergic skin disease which is associated with itching; rash; and an increased risk for hay fever, asthma, and food allergies. Atopic dermatitis is caused by a mixture of host factors, or the human factors; environmental causes; and the collection of all the microorganisms on the skin–all the bacteria and fungus, which we refer to as the microbiome. All of the available therapies really just address the host side of the equation. So, what we really wanted to ask was whether manipulating the microbiome might provide benefit to patients and what kind of environmental factors might contribute to this bacterial imbalance. We were able to identify a species of bacteria called Roseomonas mucosa, which in cell cultures and in mouse models was able to kill Staph aureus, which is a bacteria known to exacerbate the disease, and fix some of the immune imbalances that would be associated with atopic dermatitis. The isolates that came from healthy volunteers improved outcomes in all of our cell models and our mouse models. But the isolates that came from patients with atopic dermatitis made those models worse. So that really suggested to us that replacing the disease-associated strains with healthy Roseomonas would provide benefit to our patients. So in this publication we describe the early results from ten adults and five kids who are aged 9 to 14, all of whom I want to take a moment to thank profusely
for participating in our study. They took a live version of Roseomonas that had
been freeze-dried, added water to it to resuspend it, and then sprayed it directly onto their skin twice a week for anywhere from six to 16 weeks. The most important finding was that nobody had any adverse events or any unexpected problems. Everything seemed to be safe. But the exciting findings were that we saw a reduction in rash, itching score or pruritus, and the amount of topical steroids they felt like they needed to keep their disease under control. Then we went from the microbiome and started to look at some of the environmental factors that might create this imbalance in your skin bacteria. And we found that certain preservatives that can be found in lotions and creams and soaps, even some of the things you might use to treat atopic dermatitis, actually killed the healthy strains of Roseomonas, while allowing for the growth of disease-associated strains and Staph aureus. Although these early results are promising, we’re going to need a large-scale, placebo-controlled trial to really establish this therapy. While we’re working towards that, we are enrolling kids three and up. We’re going to try to evaluate if the treatment is safe and active in the younger cohort and to try to see a few more detailed questions about how the bacteria might be working. The major appeal of this is that it’s going to be inexpensive because you can literally grow the drug. But one of the other things that would be exciting is if you could colonize the patient. So what that means is the bacteria would set up shop on the skin and would continue to provide benefit long after the treatments have stopped. If we are able to establish colonization, what that could mean is that by intervening early you could spare the patient years of daily therapy.