Washed Microbiota Transplantation Improves Disease Severity and Microbial Profiles in Moderate-to-Severe Atopic Dermatitis
Washed microbiota transplantation (WMT) was associated with significant clinical improvement and favorable shifts in gut and skin microbiota among patients with moderate-to-severe atopic dermatitis (AD), according to a small prospective study evaluating this microbiota-centered intervention. The findings add early clinical data to support the gut-skin axis as a therapeutic target in AD.
The study included 23 patients with moderate-to-severe AD who received at least 2 courses of WMT between January 2022 and December 2023. Disease activity and quality of life were assessed using the SCORing Atopic Dermatitis (SCORAD) tool, Eczema Area and Severity Index (EASI), Itch Numeric Rating Scale, and Dermatology Life Quality Index. Investigators also evaluated blood cell counts, cytokines, lymphocyte subsets, and both gut and skin microbiota before and after treatment.
WMT was generally well tolerated, with 58 total procedures and a mild adverse event rate of 5.2%. Across the cohort, investigators observed significant improvements in SCORAD, EASI, itch severity, and quality-of-life scores. EASI reductions were more pronounced in adults than in children, suggesting potential age-related differences in response.
Systemic immune parameters were largely stable. Absolute basophil counts declined significantly following WMT, whereas other hematologic and cytokine measures did not show meaningful changes. In contrast, microbial analyses revealed consistent shifts. Gut microbiota showed increased Gut Microbiome Health Index scores and reduced Microbial Dysbiosis Index scores, along with enrichment of short-chain fatty acid–producing taxa, including Eubacterium coprostanoligenes, Lachnospiraceae, and Coprococcus.
Skin microbiota composition also changed. Staphylococcus-dominant profiles shifted toward higher relative abundances of genera such as Acinetobacter and Perlucidibaca. These changes were inversely correlated with disease severity and markers of systemic inflammation, suggesting a link between microbial balance and clinical response.
The authors concluded that “WMT appears safe and effective in alleviating clinical manifestations of AD while reshaping both gut and skin microbiota.” They further noted that “these parallel microbial shifts support the gut-skin axis as a therapeutic target.”
For dermatologists, the key takeaway is that microbiota-directed therapies may represent a future adjunctive strategy for difficult-to-control AD. While preliminary and limited by sample size, these findings warrant further controlled studies to clarify durability, patient selection, and integration with existing systemic treatments.
Reference
Deng W, Chen D, Wei Y, et al. Washed microbiota transplantation relieves atopic dermatitis via gut-skin microbiome rebalancing. BMC Microbiol. Published online January 12, 2026. doi:10.1186/s12866-026-04717-1
