Dupilumab is a fully human antibody to interleukin-4 receptor α that improves the signs and symptoms of moderate to severe atopic dermatitis (AD). To determine the effects of dupilumab on Staphylococcus aureus colonization and microbial diversity on the skin, bacterial DNA was analyzed from swabs collected from lesional and nonlesional skin in a double-blind, placebo-controlled study of 54 patients with moderate to severe AD randomized (1:1) and treated with either dupilumab (200 mg weekly) or placebo for 16 weeks. Microbial diversity and relative abundance of Staphylococcus were assessed by DNA sequencing of 16S ribosomal RNA, and absolute S. aureus abundance was measured by quantitative PCR. Before treatment, lesional skin had lower microbial diversity and higher overall abundance of S. aureus than nonlesional skin. During dupilumab treatment, microbial diversity increased and the abundance of S. aureus decreased. Pronounced changes were seen in nonlesional and lesional skin. Decreased S. aureus abundance during dupilumab treatment correlated with clinical improvement of AD and biomarkers of type 2 immunity. We conclude that clinical improvement of AD that is mediated by interleukin-4 receptor α inhibition and the subsequent suppression of type 2 inflammation is correlated with increased microbial diversity and reduced abundance of S. aureus.

中文翻译：

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Dupilumab对IL-4Rα的阻滞作用会减少金黄色葡萄球菌的定殖并增加特应性皮炎中微生物的多样性。

Dupilumab是针对白介素4受体α的完全人类抗体，可改善中度至重度特应性皮炎（AD）的体征和症状。为了确定dupilumab对金黄色葡萄球菌定植和皮肤微生物多样性的影响，对54例中度至重度AD患者进行了一项双盲，安慰剂对照研究，分析了从病灶和非病灶皮肤拭子中收集的拭子中的细菌DNA（1 ：1），并用dupilumab（每周200 mg）或安慰剂治疗16周。通过16S核糖体RNA的DNA测序评估葡萄球菌的微生物多样性和相对丰度，并通过定量PCR测量金黄色葡萄球菌的绝对丰度。在治疗之前，与非病变皮肤相比，病变皮肤的微生物多样性较低，金黄色葡萄球菌的总体丰度较高。在dupilumab治疗期间，微生物多样性增加，金黄色葡萄球菌的丰度降低。在非病变和病变皮肤中观察到明显的变化。dupilumab治疗期间金黄色葡萄球菌丰度降低与AD的临床改善和2型免疫的生物标志物相关。我们得出结论，由白介素4受体α抑制介导的AD的临床改善以及随后对2型炎症的抑制与微生物多样性增加和金黄色葡萄球菌丰度降低相关。