085 Dupilumab treatment shifts the microbiome towards a healthy skin flora - a TREATgermany study

The identification of diagnostic, prognostic and predictive biomarkers is an essential task in the development implementation treatment atopic dermatitis (AD). Integrating molecular data from high-quality patient samples with associated clinical central to this task. Here, we aimed investigate associations AD patients’ skin microbiome, response TREATgermany registry. Skin swabs 130 patients were profiled 16S rRNA amplicon sequencing before after dupilumab. After 3 months treatment, responder (at least 75% decrease EASI) showed a significant increase alpha diversity more pronounced change beta compared non-responders (less than 50% EASI). Comparing lesional non-lesional samples, effect was even drastic showing clear by dupilumab therapy similar trend skin. inclusion healthy (KORA FF4 PopGen cohorts) revealed shift towards control state both responders indicating partial recovery microbiome therapy. Further analysis potential discriminating factors between non-responders, such as commensal Staphylococcus species including hominis, epidermidis capitis, which significantly increased abundances non-responder samples. To conclude, our findings document beneficial effects on microbial parameters successful systemic dupilumab, approached, but not fully recovered states