Tralokinumab treatment improves the skin microbiota by increasing the microbial diversity in adults with moderate-to-severe atopic dermatitis: Analysis of microbial diversity in ECZTRA 1, a randomized controlled trial
Open accessAbstract
BACKGROUND: Atopic dermatitis (AD) is characterized by microbial dysbiosis, immune dysregulation, and an impaired skin barrier. Microbial dysbiosis in AD involves a reduction in diversity primarily driven by an increased abundance of Staphylococcus aureus. Tralokinumab, an approved treatment for adults with moderate-to-severe AD, improves the skin barrier and immune abnormalities by specifically targeting the interleukin 13 cytokine, but its impact on the skin microbiome is unknown. OBJECTIVE: To investigate how tralokinumab affects the skin microbiome by examining the lesional skin of adults with moderate-to-severe AD from the phase 3 ECZTRA 1 trial (NCT03131648). METHODS: Microbiome profiling, S aureus abundance, and biomarker data were assessed in a subset of ECZTRA 1 participants (S aureus abundance at baseline and week 16; microbiome profiling at baseline, and week 8/16; and serum sampling before dose and week 4/8/16/28/52). RESULTS: Tralokinumab treatment led to increased microbial diversity, reduced S aureus abundance, and increased abundance of the commensal coagulase-negative Staphylococci. LIMITATIONS: Limitations include a lack of S aureus abundance data at week 8, sampling site variation between participants, and possible influence from concomitant systemic antiinfectives. CONCLUSION: Our findings indicate specific targeting of the interleukin 13 cytokine with tralokinumab can directly and/or indirectly improve microbial dysbiosis seen in AD skin.
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Recent therapies, such as dupilumab and tralokinumab, favor skin microbiota rebalancing in patients with AD.
“Recent therapies, such as dupilumab and tralokinumab, favor skin microbiota rebalancing in patients with AD.94, 105”
From Update on the pathogenesis of atopic dermatitis. (2024) · cites this paper as [105]
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- Authors
- Beck, L. A., Bieber, T., Weidinger, S., Tauber, M., Saeki, H., Irvine, A. D., Eichenfield, L. F., Werfel, T., Arlert, P., Jiang, L., Røpke, M., & Paller, A. S.
- Affiliations
- University of Rochester Medicine (US)
- University Hospital Bonn (DE)
- University Hospital Schleswig-Holstein (DE)
- Centre National de la Recherche Scientifique (FR)
- Nippon Medical School (JP)
- Trinity College Dublin (IE)
- University of California San Diego (US)
- Medizinische Hochschule Hannover (DE)
- Leo Pharma (Denmark) (DK)
- Northwestern University (US)
- Corresponding author
- Beck, Lisa A.
- ORCID
- Venue
- Journal of the American Academy of Dermatology
- Publisher
- Elsevier BV
- Published
- 2023-04
- Volume
- 88
- Issue
- 4
- Pages
- 816-823
- ISSN
- 0190-9622 (ISSN-L)
- OpenAlex
- W4310675662
- Cited by
- 56
- References
- 34
- Citations by year
- 2026: 12 · 2025: 15 · 2024: 18 · 2023: 11
- FWCI
- 10.76
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American Academy of Dermatology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Funders
- Eli Lilly and Company
- Pfizer
- Sanofi
- Regeneron Pharmaceuticals
- Les Laboratories Pierre Fabre
- Incyte
- Ortho Dermatologics
- Glenmark Pharmaceuticals
- Galderma
- Medac
- LEO Pharma
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- tralokinumab, atopic dermatitis, skin microbiome, microbial diversity, Staphylococcus aureus, coagulase-negative staphylococci, IL-13, dysbiosis, skin barrier
- MeSH terms
- Adult, Antibodies, Monoclonal, Dermatitis, Atopic, Humans, Skin, Staphylococcus aureus, Cytokines, Interleukin-13, Microbiota, Dysbiosis
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