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Skin in the game: Innovations in boosting immunity and fighting off pathogens

Skin is the largest organ, and scientists are discovering new ways to harvest the healthy bacteria that lives on our skin to help fight harmful bacteria. A team at the University of California, San Diego is in the early stages of developing and testing skin creams that may guard patients with eczema against risky bacteria that gather on cracked skin. The research may shed new light on how the microbiome – communities of microorganisms, including bacteria, fungi, and yeast that live all around us – influences health.

Bacteria on our skin can cause infection when common skin disorders such as eczema break down the skin. In particular, the health care community is concerned about the rise of a harmful bacteria called Staphylococcus aureus that is increasingly resistant to antibiotics.

The California research team discovered that certain strains of protective bacteria on the skin secrete antimicrobial peptides, a type of natural antibiotic. In lab tests and in animals, these substances have been shown to selectively kill Staphylococcus aureus, even a drug-resistant strain known as MRSA, without killing neighboring and healthy bacteria like typical antibiotics do.

Because people with eczema for unknown reasons have a lot of the wrong kind of bacteria on their skin and not enough of the healthy bacteria, replenishing the healthy kind with a cream may help them.

So far the team has tested just five patients who had a colonization of Staphylococcus aureus on their skin without a full blown infection. After culturing some of the rare protective bacteria from their skin and growing a large supply in a lab, researchers mixed a dose into an over-the-counter moisturizer for the patients to try. A day later, much of the staph was wiped out compared to the untreated arms. Clinical trials in larger groups of patients are currently underway.

Analysis: The World Health Organization recently released a list of 12 antibiotic-resistant “superbugs” or priority pathogens that pose the greatest risk to human health. The agency has ranked the pathogens for which there is greatest need for new antibiotics. The purpose of the list is to help ensure antibiotic manufacturers and researchers are aware of the research and development priorities and to serve as a reminder that in the next decade if new, effective antibiotics are not developed, drug-resistant infections could cause more deaths than cancer.

Patients most at risk are those who are hospitalized and may require blood catheters or ventilators. These bacteria can cause severe and deadly infections and are resistant to even the most powerful antibiotics. Certain strains of Staphylococcus aureus are listed as a high priority (ranked below the critical category).

Innovation in antimicrobials has slowed in recent years. 21st Century Cures, the bipartisan legislation to modernize drug and device development and approval that was signed into law in December 2016, creates an expedited pathway for antimicrobials that treat serious or life-threatening infections. The pathway could help encourage the development of new antibiotics. The populations affected by multidrug-resistant infections are small, so being able to have smaller clinical trials than typically required may help companies enroll enough participants to study the drug.

(Source: Teruaki Nakatsuji et al, Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis, Journal of Translational Medicine, February 22, 2017)

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Author bio

Doug leads Deloitte Consulting LLP’s Life Sciences and Health Care practice. With 24 years of experience, he works closely with multiple top health care organizations on major clinical and enterprise transformation efforts and on large-scale technology implementation projects. Doug has extensive experience in comprehensive quality and patient safety transformations, turnaround and performance improvement in academic medical centers as well as organization/workflow redesign and technology enablement. He has served as the lead on a number of enterprise transformation initiatives with some of Deloitte’s most largest and most complex clients.