Bleach baths enhance skin barrier, reduce itch but do not normalize skin dysbiosis in atopic dermatitis.
Bleach baths enhance skin barrier, reduce itch but do not normalize skin dysbiosis in atopic dermatitis.
复制标题
DOI：
10.1007/s00403-023-02723-1
复制
发表时间：
2023-12
影响因子：
3
通讯作者：
中科院分区：
文献类型：
--
作者：
研究表明，漂白水浴可改善特应性皮炎(AD)的严重程度；然而，对瘙痒、皮肤屏障和皮肤微生物组成的影响尚不清楚。我们研究了漂白浴是否能减轻皮肤瘙痒，使皮肤屏障功能正常化，降低金黄色葡萄球菌的绝对丰度，并增加非皮损皮肤上金黄色葡萄球菌定植的成年AD患者的微生物多样性。这是一项在单一学术中心进行的开放标签、非随机、对照试验。15名AD和5名非特应性健康对照(NA)被指示每周进行两次漂白浴(0.005%NaClO；5-10分钟持续时间)，作为附加治疗，总共12周。招募18至65岁(包括轻度到重度)AD的成年人，采用EASI评分 >； 6.0，金黄色葡萄球菌培养阳性，是否可以使用浴缸，以及保持当前局部或全身治疗的能力和意愿。他们在基线(漂白浴前)、干预后6周和12周进行评估，每周两次漂白浴。疗效测量包括EASI以及5-D瘙痒和ItchyQOL™。用透皮失水率(TEWL)和角质层完整性(SC)测定皮肤屏障。通过金黄色葡萄球菌培养、金黄色葡萄球菌丰度(热核酸酶基因的qPCR)和V1-V3 16S rRNA基因测序，对非皮损性和皮损性AD皮肤进行检测。经过12周的漂白浴，8/15(53.3%)的AD患者达到了EASI50，通过5-D瘙痒和瘙痒QOL衡量，瘙痒显著减少。87%的人报告睡眠质量有所改善。在研究开始时，AD受试者的非皮损TEWL值高于NA受试者，并且只有AD受试者在漂白浴中经历了下降(p = 0.006)。同样，AD受试者在漂白浴后6周，SC的完整性就有所改善。值得注意的是，漂白浴对金黄色葡萄球菌培养阳性、qPCR绝对丰度或微生物多样性没有显著影响。每周两次漂白浴的增加改善了研究人员评估的AD严重程度、患者报告的瘙痒和睡眠以及成年AD受试者皮肤屏障功能的生理指标，而对皮肤金黄色葡萄球菌的定性和定量指标没有影响。试验注册：ClinicalTrials.gov标识：NCT01996150，注册日期：2013年11月27日。网上版载有补充材料，可在10.1007/s00403-023-02723-1查阅。
Studies have demonstrated that bleach baths improve atopic dermatitis (AD) severity; however, the effects on itch, skin barrier, and cutaneous microbial composition are less clear. We examined whether bleach baths reduce itch, normalize skin barrier function, reduce S. aureus absolute abundance, and increase microbial diversity in adults with AD who were colonized with S. aureus on their non-lesional skin. This was an open label, non-randomized, controlled trial performed at a single academic center. Fifteen AD and five non-atopic healthy controls (NA) were instructed to take two bleach baths (0.005% NaClO; 5–10 min duration) per week for a total of 12 weeks as add-on therapy. Adults 18 to 65 years (inclusive) with mild to severe AD were recruited with EASI score > 6.0, S. aureus culture positivity, access to a bathtub, and ability and willingness to maintain current topical or systemic treatments. They were evaluated at baseline (before bleach baths), 6 weeks, and 12 weeks after the intervention of twice-weekly bleach baths. Efficacy measurements included EASI as well as 5-D Pruritus and ItchyQoL™. Transepidermal water loss (TEWL) and stratum corneum (SC) integrity assay were performed to assess the skin barrier. Skin dysbiosis was measured by S. aureus cultivation, S. aureus abundance (qPCR of thermonuclease gene), and V1-V3 16S rRNA gene sequencing on non-lesional and lesional AD skin. After 12 weeks of bleach baths, 8/15 (53.3%) AD subjects achieved an EASI50 and a significant reduction in itch as measured by 5-D pruritus and Itchy QoL. Eighty-seven percent reported improvements in sleep quality. At study entry, AD subjects had higher non-lesional TEWL values than NA subjects, and only AD subjects experienced a reduction with bleach baths (p = 0.006). Similarly, SC integrity improved as early as 6 weeks after bleach baths in AD subjects. Notably, bleach baths had no significant effect on S. aureus culture-positivity, qPCR absolute abundance, or microbial diversity. The addition of twice-weekly bleach baths improves investigator-assessed AD severity, patient-reported pruritus and sleep as well as physiological measures of skin barrier function in adult AD subjects while having no effect on qualitative and quantitative measures of cutaneous S. aureus. Trial Registration: ClinicalTrials.gov Identifier: NCT01996150, Date of registration: November 27th, 2013. The online version contains supplementary material available at 10.1007/s00403-023-02723-1.
登录
查看更多内容
影响因子：
5.7
作者：
Khadka VD;Key FM;Romo-González C;Martínez-Gayosso A;Campos-Cabrera BL;Gerónimo-Gallegos A;Lynn TC;Durán-McKinster C;Coria-Jiménez R;Lieberman TD;García-Romero MT
通讯作者：
García-Romero MT
影响因子：
14.2
作者：
De Benedetto, Anna;Rafaels, Nicholas M;McGirt, Laura Y;Ivanov, Andrei I;Georas, Steve N;Cheadle, Chris;Berger, Alan E;Zhang, Kunzhong;Vidyasagar, Sadasivan;Yoshida, Takeshi;Boguniewicz, Mark;Hata, Tissa;Schneider, Lynda C;Hanifin, Jon M;Gallo, Richard L;Novak, Natalija;Weidinger, Stephan;Beaty, Terri H;Leung, Donald Y M;Barnes, Kathleen C;Beck, Lisa A
通讯作者：
Beck, Lisa A
儿童特应性皮炎的氟替卡松乳膏和辅助漂白浴的皮肤微生物组作用。
影响因子：
13.8
作者：
Gonzalez ME;Schaffer JV;Orlow SJ;Gao Z;Li H;Alekseyenko AV;Blaser MJ
通讯作者：
Blaser MJ
影响因子：
13.8
作者：
Eichenfield, Lawrence F.;Tom, Wynnis L.;Berger, Timothy G.;Krol, Alfons;Paller, Amy S.;Schwarzenberger, Kathryn;Bergman, James N.;Chamlin, Sarah L.;Cohen, David E.;Cooper, Kevin D.;Cordoro, Kelly M.;Davis, Dawn M.;Feldman, Steven R.;Hanifin, Jon M.;Margolis, David J.;Silverman, Robert A.;Simpson, Eric L.;Williams, Hywel C.;Elmets, Craig A.;Block, Julie;Harrod, Christopher G.;Begolka, Wendy Smith;Sidbury, Robert
通讯作者：
Sidbury, Robert
影响因子：
14.2
作者：
Bin, Lianghua;Kim, Byung Eui;Brauweiler, Anne;Goleva, Elena;Streib, Joanne;Ji, Yinduo;Schlievert, Patrick M.;Leung, Donald Y. M.
通讯作者：
Leung, Donald Y. M.