Derma/OSM Pilot Project - Effects of the Dupilumab therapy on the Ocular Surface Miorobiome

Background Atopic dermatitis (AD) has been defined as chronic inflammatory skin disease characterized by eczematous lesions, a relapsing disease course and intense pruritus as well as associated atopic diseases in the personal or family history. The development of AD is based on a genetic predisposition that determines both, the skin barrier function and the T helper 2-type inflammatory reaction. In particular, it has been shown that IL-13 is highly expressed in the blood and skin of AD patients. Dupilumab, blocking the IL-4/IL-13 receptor, is the first biologic that has been approved for the treatment of AD worldwide. Thus, it is a great breakthrough in the therapy of AD. According to phase 2 and 3 as well as real-life studies, the improvement of AD clinical signs and symptoms upon dupilumab exceed that of other therapies used for AD so far. However, trials have also shown an increased incidence of conjunctivitis in dupilumab treated patients, probably associated with dry eyes, leading to cessation of treatment in some cases. Objective: The Objective of this project is to investigate the severity, the clinical course and the pathogenesis of conjunctivitis in AD patients treated with dupilumab in terms of quantification of pro-inflammatory cytokines and characterization of the ocular surface microbiome. Method: Of 4 Participants, two samples have been collected from the conjuctiva and the lid seperately. Per participant, samples have been been collected at two time points: at baseline (before/on the day of the injection) and a few months after the injection (Visit 1). Of one patient, a third sample was taken while he developed conjuctivitis (Visit 2).