Clinical oral investigations · 2026
Characterization of oral microbiome in atopic dermatitis patients treated with dupilumab or upadacitinib.
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Wnuk Maciej, Szczęch Justyna, Żuk Gabriela, Szmatoła Tomasz, Oklejewicz Bernadetta, Samotij Dominik, Lewińska Anna, Reich Adam
Аннотация
OBJECTIVES: Dysbiosis, an imbalanced state of microbial communities in the human body, may contribute to autoimmune diseases such as atopic dermatitis (AD). While the role of affected skin-gut microbiome axis in AD is well established, still little is known about the relationship between oral microflora-based dysbiosis and AD progression and treatment.
MATERIALS AND METHODS: 16S rRNA gene amplicon sequencing of the V3-V4 hypervariable region was used to characterize the bacterial profiles of saliva samples from fifteen AD patients treated with dupilumab, an antibody against interleukin-4 receptor, or upadacitinib, an inhibitor of JAK1 kinase, for sixteen weeks. Oral microbiome data were compared with the Eczema Area and Severity Index (EASI).
RESULTS: Analysis revealed that at phylum level, Actinomycetota decreased significantly upon treatment (from a median of 11.87% to 6.15%; q = 0.0094), with a reciprocal increase in Bacteroidota (from 19.78% to 28.39%; q = 0.0185).
CONCLUSIONS: Although all patients showed clinical improvement, the cohort did not permit assessment of a dose-response relationship between EASI score and Actinomycetota abundance. Thus, larger, more heterogeneous cohorts and mechanistic data (e.g., metabolomics-based identification of microbiome-derived metabolites) are needed to validate these findings and clarify their relevance as a potential therapeutic marker in AD.
CLINICAL RELEVANCE: The parallel decline in oral Actinomycetota abundance and EASI score highlights a potential link between the oral microbiome and treatment response in AD, warranting further investigation. In the absence of non-responders, this association does not yet support Actinomycetota as a potential biomarker of treatment efficacy.
MATERIALS AND METHODS: 16S rRNA gene amplicon sequencing of the V3-V4 hypervariable region was used to characterize the bacterial profiles of saliva samples from fifteen AD patients treated with dupilumab, an antibody against interleukin-4 receptor, or upadacitinib, an inhibitor of JAK1 kinase, for sixteen weeks. Oral microbiome data were compared with the Eczema Area and Severity Index (EASI).
RESULTS: Analysis revealed that at phylum level, Actinomycetota decreased significantly upon treatment (from a median of 11.87% to 6.15%; q = 0.0094), with a reciprocal increase in Bacteroidota (from 19.78% to 28.39%; q = 0.0185).
CONCLUSIONS: Although all patients showed clinical improvement, the cohort did not permit assessment of a dose-response relationship between EASI score and Actinomycetota abundance. Thus, larger, more heterogeneous cohorts and mechanistic data (e.g., metabolomics-based identification of microbiome-derived metabolites) are needed to validate these findings and clarify their relevance as a potential therapeutic marker in AD.
CLINICAL RELEVANCE: The parallel decline in oral Actinomycetota abundance and EASI score highlights a potential link between the oral microbiome and treatment response in AD, warranting further investigation. In the absence of non-responders, this association does not yet support Actinomycetota as a potential biomarker of treatment efficacy.