학술논문

Development of a human skin commensal microbe for bacteriotherapy of atopic dermatitis and use in a phase 1 randomized clinical trial
Document Type
article
Source
Nature Medicine. 27(4)
Subject
Clinical Research
Emerging Infectious Diseases
Infectious Diseases
Eczema / Atopic Dermatitis
Clinical Trials and Supportive Activities
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Skin
Administration
Topical
Adolescent
Adult
Aged
Aged
80 and over
Animals
Bacterial Proteins
Bacteriocins
Colony Count
Microbial
Dermatitis
Atopic
Humans
Inflammation
Mice
Inbred BALB C
Microbial Sensitivity Tests
Microbial Viability
Middle Aged
Peptides
Cyclic
Reproducibility of Results
Staphylococcal Infections
Staphylococcus aureus
Staphylococcus hominis
Transcription
Genetic
Treatment Outcome
Virulence Factors
Young Adult
Medical and Health Sciences
Immunology
Language
Abstract
Staphylococcus aureus colonizes patients with atopic dermatitis (AD) and exacerbates disease by promoting inflammation. The present study investigated the safety and mechanisms of action of Staphylococcus hominis A9 (ShA9), a bacterium isolated from healthy human skin, as a topical therapy for AD. ShA9 killed S. aureus on the skin of mice and inhibited expression of a toxin from S. aureus (psmα) that promotes inflammation. A first-in-human, phase 1, double-blinded, randomized 1-week trial of topical ShA9 or vehicle on the forearm skin of 54 adults with S. aureus-positive AD (NCT03151148) met its primary endpoint of safety, and participants receiving ShA9 had fewer adverse events associated with AD. Eczema severity was not significantly different when evaluated in all participants treated with ShA9 but a significant decrease in S. aureus and increased ShA9 DNA were seen and met secondary endpoints. Some S. aureus strains on participants were not directly killed by ShA9, but expression of mRNA for psmα was inhibited in all strains. Improvement in local eczema severity was suggested by post-hoc analysis of participants with S. aureus directly killed by ShA9. These observations demonstrate the safety and potential benefits of bacteriotherapy for AD.