期刊
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
卷 86, 期 4, 页码 854-862出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2020.08.132
关键词
antimicrobial peptide; atopic dermatitis; dysbiosis; omiganan; pharmacodynamics; Staphylococcus aureus
类别
资金
- Cutanea Life Science, Wayne , Pennsylvania
Omiganan restored dysbiosis by reducing Staphylococcus abundance and increasing diversity. However, there was no significant clinical improvement observed.
Background: Dysbiosis and colonization with Staphylococcus aureus is considered to play an important role in the pathogenesis of atopic dermatitis (AD). Recovering this dysbiosis may improve AD symptoms. Omiganan is a synthetic indolicidin analogue antimicrobial peptide with activity against S aureus and could be a viable new treatment option for AD. Objective: To explore the tolerability, clinical efficacy, and pharmacodynamics of omiganan in mild to moderate AD. Methods: Eighty patients were randomized to omiganan 1%, 1.75%, or 2.5% or vehicle twice daily for 28 days on all lesions. Weekly visits included clinical scores and microbiological and pharmacodynamic assessments of 1 target lesion. Results: In all omiganan treatment groups, dysbiosis was recovered by reducing Staphylococcus species abundance and increasing diversity. A reduction of cultured S aureus was observed in all omiganan treatment groups, with a significant reduction for omiganan 2.5% compared to vehicle (-93.5%; 95% CI, 99.2 to 28.5%; P = .02). No significant clinical improvement was observed. Conclusion: Topical administration of omiganan twice daily for up to 28 days in patients with mild to moderate AD led to a recovery of dysbiosis but without clinical improvement. Therefore, a monotreatment that selectively targets the microbiome does not appear to be a successful treatment strategy in mild to moderate AD.
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