Breakthrough means eczema could soon be treated with a vaccine

Eczema in children could be treated within years by a “personalised” vaccine, say Irish scientists. Researchers at Trinity College Dublin believe the jab may hold the key to treating the common condition’s bacteria that cause itchy, dry and cracked skin.

The Trinity team has made several leaps forward in understanding how the immune response works in cases of eczema caused by the troublesome Staphylococcus aureus bacteria. They say they have now identified new cellular targets for a vaccine.

Eczema – also known as atopic dermatitis – affects up to one in four children. Common symptoms include itchy, dry skin and, when bacteria are involved, weeping sores that can progress to more severe infections. Life-threatening systemic infections such as septicemia can sometimes occur.

Lead study author Dr Julianne Clowry, a consultant dermatologist and visiting researcher at Trinity, continued: “There is a real need for new options to treat and prevent infected eczema in children. Current strategies are limited in their success and – even when they provide relief – the effects can be short-term, as symptoms often return.

“Although antibiotics are necessary in some cases, scientists are working hard to provide alternative options because of the growing problems of antimicrobial resistance. In combination, these factors make a tailored vaccine a very attractive target because it could limit the severity of eczema, lead. to achieve better long-term outcomes and reduce the need for antibiotics – all while reducing the risk of complications and potentially the development of other atopic diseases such as hay fever and asthma.”

The Trinity team discovered important “immune signatures” in children with infected eczema. Locating the signatures gave them new targets, which they say is useful from a theoretical perspective in vaccine design.

Working with 93 children from infants to 16 years of age, the team compared immune responses between three groups of patients: eczema and a confirmed S. aureus skin infection, eczema but no S. aureus skin infection and a healthy group of volunteers. . The key finding was that the proportions of certain immune cells – known as ‘T cells’ – as well as other biomarkers, varied “considerably” in the different groups.

The research team said the main result highlighted that the immune response was impaired in those with infected eczema – with the suppression of some of the important T cells that drive an effective immune response. They say their findings, published in the journal JCI Insight, provide an early blueprint in the development of future therapies that could provide effective targeted relief of recurrent eczema flare-ups.

Dr Alan Irvine, Professor of Dermatology at Trinity, said: “Although an interaction between the Staphylococcus aureus bug and eczema has been known for many decades, new scientific approaches continue to make key discoveries about the complex relationship between these bacteria and human responses to it. Our work presents new findings about how children with eczema respond immunologically to infection with this common bacteria.”

The study’s lead author, Trinity Professor of Immunology Rachel McLoughlin, said: “This work has identified a general pattern of immune suppression associated with infected eczema, which results in the suppression of certain T cells that are vital in helping to initiate a response immune efficient. Further efforts are now needed to expand the scope of these results by extending them to a larger number of people.

“This will help to confirm whether the patterns identified are consistent across different age groups and in subgroups with greater ethnic diversity. We believe that a more comprehensive understanding of the immune response to this S. aureus bacterium in eczema has significant potential to revolutionize treatment approaches and have a major translational impact in the management of eczema.”