WMT appears safe and effective in alleviating clinical manifestations of AD while reshaping both gut and skin microbiota, supporting the gut-skin axis as a therapeutic target.
Key Findings
Results
Washed microbiota transplantation was well tolerated in atopic dermatitis patients with a low rate of mild adverse events.
23 patients with moderate-to-severe AD received at least two courses of WMT between January 2022 and December 2023
SCORAD, EASI, DLQI, and NRS scores all improved significantly after treatment
EASI reductions were greater in adults than in children
Disease activity was evaluated using SCORing Atopic Dermatitis (SCORAD) index, Eczema Area and Severity Index (EASI), Numeric Rating Scale (NRS) for itch, and Dermatology Life Quality Index (DLQI)
Assessments were performed before and after treatment
Results
Absolute basophil counts decreased significantly after WMT treatment, while other hematologic and cytokine parameters remained stable.
Absolute basophil counts showed a statistically significant decrease post-WMT
Other peripheral blood counts did not change significantly
Cytokine profiles remained stable after treatment
Lymphocyte subsets did not show significant changes
Results
WMT improved gut microbiota health indices and enriched short-chain fatty acid-producing taxa in AD patients.
Gut Microbiome Health Index increased after WMT
Microbial Dysbiosis Index decreased after WMT
Enriched taxa included the Eubacterium coprostanoligenes group, Lachnospiraceae, and Coprococcus
These taxa are associated with short-chain fatty acid production
Gut and skin microbiota were assessed before and after treatment
Results
Skin microbiota composition shifted from Staphylococcus dominance to higher abundances of potentially protective genera after WMT.
Pre-treatment skin microbiota was dominated by Staphylococcus
Post-treatment skin microbiota showed higher abundances of Acinetobacter, Perlucidibaca, and other potentially protective genera
The relative abundance of these genera was inversely correlated with disease severity
The relative abundance of these genera was inversely correlated with systemic inflammation markers
Background
Gut and skin microbiota dysbiosis are implicated in the pathogenesis and severity of atopic dermatitis.
AD is described as a chronic, relapsing inflammatory skin disease
Dysbiosis of both gut and skin microbiota contributes to AD pathogenesis and severity
WMT is an improved form of fecal microbiota transplantation with enhanced safety and microbiota quality control
Prior to this study, clinical data on WMT in AD were limited to a single reported adolescent case
Discussion
Parallel microbial shifts in both gut and skin microbiota following WMT support the gut-skin axis as a therapeutic target for immune-mediated skin diseases.
Both gut and skin microbiota underwent concurrent compositional changes after WMT
Skin microbiota changes inversely correlated with disease severity and systemic inflammation
Findings highlight WMT as a promising microbiota-centered intervention for immune-mediated skin diseases
Results suggest the gut-skin axis can be therapeutically modulated through WMT