152 Normalization of the microbiome in psoriatic skin after treatment with fumaric acid esters (FAE), TNF, IL-17 or PDE4-inhibitors but not IL-12/23 blockade

The skin forms an interface between the body and environment provides distinct niches for microbial communities. Next-generation-sequencing used to characterize cutaneous microbiome in psoriasis patients revealed over-representation of Proteobacteria a reduction Actinobacteria lesional skin, suggesting that development psoriatic plaques might be linked specific alterations successful treatment could help normalize even before clinical parameters improve. Hence, we analyzed swabs from non-lesional at different time points after with FAE or TNF, IL-17 receptor, IL-12/23 PDE4 inhibitors. Whereas significant relative abundance increase was detectable 4-8 weeks start TNF inhibitors FAE, coinciding improvement, blockade did not result microbiome. In receiving pathway immediately first administration drug, most PASI-75 response observed. Interestingly, responding were characterized by higher Firmicutes baseline compared responders, whereas who benefit showed high Staphylococci baseline. contrast inhibitors, non-responders exhibit week 4 treatment. Thus, composition early particular bacteria upon predict responses given therapy.