The microbiome in different clinical phenotypes of atopic dermatitis
Research type
Research Study
Full title
A prospective cohort study evaluating microbiota, metabolome and immune profile signatures in different clinical phenotypes of atopic dermatitis (Pheno-Biome Study)
IRAS ID
309609
Contact name
Carsten Flohr
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
2 years, 0 months, 2 days
Research summary
Atopic dermatitis (AD) affects up to 20% of children and there is wide variation in the clinical manifestation of the disease. The well-recognised phenotypes - flexural AD, follicular AD and discoid AD - have different treatment responses with follicular and discoid AD being more treatment-resistant than flexural AD. The mechanisms underlying this disease heterogeneity are poorly understood but there is increasing evidence for the role of the skin and gut microbiota and their associated metabolic and downstream immuno-modulatory effects in the disease. We hypothesise that the above three AD clinical phenotypes are associated with distinct microbiota, metabolome and immune profile signatures. The aims of this study are therefore to define these clinical phenotype-associated signatures and investigate how they change during and after disease flares.
Skin and gut microbiome and metabolome samples will be collected from paediatric AD patients (n=75) age 2-18 attending our ethnically diverse tertiary severe eczema clinic. Skin tape strip samples will be collected for cytokine assessment. Skin and gut microbiome samples will undergo shotgun metagenomic sequencing to quantify species abundances and microbial metabolic pathways in AD. NMR metabolomic analyses will quantify metabolite concentrations on the skin surface and tape strip cytokine assays will quantify AD relevant cytokine levels in the stratum corneum. The integration of these datasets with detailed clinical phenotypes will provide a comprehensive multi-level profile of the microbiota and associated metabolites and immune markers in AD and over the course of disease flares.
The outcomes of this work may identify distinct microbiome, metabolome and immune signatures associated with flexural vs follicular vs discoid AD, novel subtype-specific mechanisms of disease pathogenesis and therefore has the potential to reveal disease markers and therapeutic targets for AD clinical phenotypes. The study would last 2 years in total including data-analysis of the study.
REC name
London - Queen Square Research Ethics Committee
REC reference
22/PR/0742
Date of REC Opinion
16 Aug 2022
REC opinion
Further Information Favourable Opinion