Researchers suggest a new vaccine, tailored to individual “immune signatures”, may help treat eczema flares in children.
The multi-disciplinary team from Trinity College, Dublin suggests this “tailored vaccine” could affectively tame the bacteria-driven eczema.
In their findings, published in JCI Insight, the team said they identified new cellular targets for a vaccine after furthering their understanding of how the immune response works in eczema cases caused by the common staphylococcus aureusbacterium.
Characterised by dry, itchy skin and “weeping” wounds when bacteria is involved, the wounds can become more serious infections and impact someone’s quality of life, reports MedicalNewsToday.
In rare cases, eczema can lead to life-threatening systemic infections like septicaemia.
“There is a real need for new options to treat and prevent infected flares of eczema in children,” said Dr Julianne Clowry, a consultant dermatologist, visiting research fellow at Trinity, and lead author of the study.
“Current strategies are limited in their success and even when they do provide relief, the effects may be short-term as symptoms often return.
“Although antibiotics are needed in some cases, scientists are trying hard to deliver alternative options because of the growing problems posed by antimicrobial resistance.”
When combined, the detrimental factors make a tailored vaccine an attractive target to possibly limit the severity of eczema, produce longer lasting and better outcomes, and reduce the need for antibiotics “all while also reducing the risk of complications and potentially the development of other atopic diseases, such as hay fever and asthma.
Collaboration
The research team was from different departments at the college, including the schools of medicine, statistics, and computer science.
The researchers uncovered important “immune signatures” in children with infected flares of eczema. Focusing on those provided them new specific targets, which helped them to design a theoretical vaccine.
The team worked with 93 children, up to 16-years-old, and examined immune responses between three groups: those with eczema and a confirmed S. aureus skin infection, those with eczema but no S. aureus skin infection, and a group of participants without eczema.
They found that proportions of “T cells” (white blood cells that fight infection) and other biomarkers varied considerably between the groups. Human bodies contain many different types of T cells, but all play unique roles in regulating how the body responds to infections.
The immune response was impacted in those with infected flares of eczema, with the suppression of some of the important T cells that drive an effective immune response.
Potential targeted treatment
The researchers said the findings provide an early map to developing therapies that could give effective, targeted relief from recurrent eczema flares.
Rachel McLoughlin, an immunology professor at Trinity and senior author on the study, said the group identified an overall pattern of immune suppression associated with infected flares of eczema, resulting in the suppression of specific T cells that are vital to initiate an effective immune response.
“Further work is now required to broaden the scope of these results by expanding to a larger number of people,” she said. “This will help confirm if the patterns identified are consistent among different age groups and in sub-groups with greater ethnic diversity.”
Dr J Wes Ulm, a medical researcher and bioinformatics expert and analyst for the National Institutes of Health, who was not involved in the study, told MedicalNewsToday the study was an intriguing and potentially promising approach to disease management that, while still in its early stages, “may nonetheless help to open up a wider range of customised interventions for eczema and diseases like it”.
He added that was was not likely vaccination would be used as a preventative measure because eczema has a diverse source and onset of illness in different individuals.
“With that said, it’s possible further studies will reveal subpopulations – perhaps patient cohorts with genetic variations rendering them particularly susceptible to more severe eczema cases – who might benefit from such a vaccine-based approach to ward off disease onset in the first place.”
Study details
Distinct T cell signatures are associated with Staphylococcus aureus skin infection in paediatric atopic dermatitis
Julianne Clowry, Daniel Dempsey, Rachel McLoughlin et al.
Published in JCI Insight on 4 May 2024
Abstract
Atopic dermatitis (AD) is an inflammatory skin condition with a childhood prevalence of up to 25%. Microbial dysbiosis is characteristic of AD, with Staphylococcus aureus the most frequent pathogen associated with disease flares and increasingly implicated in disease pathogenesis. Therapeutics to mitigate the effects of S. aureus have had limited efficacy and S. aureus–associated temporal disease flares are synonymous with AD. An alternative approach is an anti–S. aureus vaccine, tailored to AD. Experimental vaccines have highlighted the importance of T cells in conferring protective anti–S. aureus responses; however, correlates of T cell immunity against S. aureus in AD have not been identified. We identify a systemic and cutaneous immunological signature associated with S. aureus skin infection (ADS.aureus) in a pediatric AD cohort, using a combined Bayesian multinomial analysis. ADS.aureus was most highly associated with elevated cutaneous chemokines IP10 and TARC, which preferentially direct Th1 and Th2 cells to skin. Systemic CD4+ and CD8+ T cells, except for Th2 cells, were suppressed in ADS.a, particularly circulating Th1, memory IL-10+ T cells, and skin-homing memory Th17 cells. Systemic γδ T cell expansion in ADS.aureuswas also observed. This study suggests that augmentation of protective T cell subsets is a potential therapeutic strategy in the management of S. aureus in AD.
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