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. 2017 Jan 12:10:25-33.
doi: 10.2147/CCID.S121910. eCollection 2017.

Clinical efficacy of emollients in atopic dermatitis patients - relationship with the skin microbiota modification

Sophie Seité  1 , Hana Zelenkova  2 , Richard Martin  3
Affiliations

Clinical efficacy of emollients in atopic dermatitis patients - relationship with the skin microbiota modification

Sophie Seité et al. Clin Cosmet Investig Dermatol. .

Abstract

Background: We speculated that an emollient supplemented with a biomass of nonpathogenic bacteria such as Vitreoscilla filiformis (Vf), grown in a medium containing thermal spring water (LRP-TSW); (LRP-Vitreoscilla filiformis biomass [LRP-VFB]), could have a beneficial effect for patients with atopic dermatitis (AD).

Patients and methods: This double-blind, randomized, comparative study was conducted with 60 patients with moderate AD. Before starting the study, participants were pretreated for 15 days with drug therapy to improve their SCORing Atopic Dermatitis (SCORAD) by at least 25%. On Day 1, the eligible patients were randomized to either the emollient containing LRP-VFB associated with mannose (Product A) or another emollient (product B) and were treated twice daily for 1 month. Recurrence of flare-ups and microbial communities were characterized from swabs taken at Day 1 and Day 28, under axenic conditions, from affected (AF) and proximal unaffected (UAF) skin areas.

Results: At Day 1, the average SCORAD of each group and the microbial communities of AF and UAF areas for each participant were similar. One month after the end of the therapeutic treatment (Day 28), the average evolution of SCORAD at Day 28 compared to Day 1 of patients treated with product A was significantly lower than that of the patients treated with product B. A significantly increased level of Xanthomonas genus was noticed in the group treated with product A (versus product B). On the other hand, the level of Staphylococcus genus increased between Day 1 and Day 28 in the group treated with product B, but not in the group treated with product A. Interestingly, these differences were more pronounced for patients in relapse, and the associated SCORAD worsening was less in the group treated with product A versus the group treated with product B.

Conclusion: This study demonstrated that a specific emollient containing a biomass of non-pathogenic bacteria Vf grown in a medium containing TSW and associated with a selected carbon source is able to normalize skin microbiota and significantly reduce the number and severity of flare-ups compared with another emollient.

Keywords: Vitreoscilla filiformis; Xanthomonas genus; atopic dermatitis; emollient; skin microbiota; thermal spring water.

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Conflict of interest statement

This study was funded by La Roche-Posay Dermatological Laboratories and L’Oréal Research and Innovation, France. S. Seité and R. Martin are employees of L’Oréal. No conflicts of interest exists for Professor H. Zelenkova.

Figures

Figure 1
Figure 1
SCORAD at Day 1 in each treatment group A (n=26) and B (n=27). Notes: Bold line represents the median value (p-value =0.8658). Group A patients used product A (emollient containing LRP-VFB associated with mannose) and Group B patients used product B (another emollient) between D1 and D28. Abbreviations: SCORAD, SCORing Atopic Dermatitis; LRP-VFB, La Roche-Posay-Vitreoscilla filiformis biomass.
Figure 2
Figure 2
Average taxonomic composition (30 main genus) of the skin microbiota associated with UAF and AF areas in AD patients at Day 1 (n=34). Abbreviations: UAF, unaffected; AF, affected; AD, atopic dermatitis.
Figure 3
Figure 3
SCORAD variation between Day 1 and Day 28 in each treatment group A (n=26) and B (n=27). Notes: Bold line represents the median value (p-value =0.01884). Group A patients used product A (emollient containing LRP-VFB associated with mannose) and Group B patients used product B (another emollient) between D1 and D28. Abbreviations: SCORAD, SCORing Atopic Dermatitis; LRP-VFB, La Roche-Posay-Vitreoscilla filiformis biomass.
Figure 4
Figure 4
Average taxonomic composition (30 main genus) of the skin microbiota associated with UAF and AF areas in each treatment group at Day 28 (n=22 for product A and n=24 for product B). Notes: Product A = emollient containing LRP-VFB associated with mannose. Product B = another emollient. Abbreviations: UAF, unaffected; AF, affected; LRP-VFB, La Roche-Posay-Vitreoscilla filiformis biomass.
Figure 5
Figure 5
Xanthomonas genus in each treatment group A (n=17) and B (n=13). Notes: Bold line represents the median value (p-value =2.57e-02). Group A patients used product A (emollient containing LRP-VFB associated with mannose) and Group B patients used product B (another emollient) between D1 and D28. Abbreviation: LRP-VFB, La Roche-Posay-Vitreoscilla filiformis biomass.
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