Completed Studies

Principal Investigator:

Pranab Mukherjee, PhD – Case Western Reserve University

Overview:

Atopic dermatitis (AD) is a complex disease that affects millions of people worldwide. It has many contributing factors, including genetics, environmental factors, and the microbiome.

A recent pilot study has suggested that Halomonas species were abundant on the skin of AD patients. This unexpected, saline-loving organism led to the speculation that increased skin salinity may allow proliferation of microbes that promote itch. The objective of this study is to further examine the relationship of itching after perspiration with changes in the microbiome. Itching with perspiration is a common symptom reported in some but not all AD patients. This may be a clue to identify patients where the microbiome provokes an immune response resulting in itch. We hypothesize that the abundance of Halomonas on the skin of AD patients who itch with perspiration is higher than that of AD patients who do not itch with perspiration.

The second objective of this study is to compare microbiome and mycobiome variations in AD patients versus controls, and how this differs in adults and children. Recent literature shows that the mycobiome of children’s skin changes during puberty to become more similar to adult skin, however the microbiome and mycobiome of children with and without AD are not well understood. In our study, we compare the microbiome and mycobiome of the skin of children compared to adults with AD, and compared to that of children without AD, to see if there are different organisms that drive AD in children.

Status:

This study was funded as a 2017 PeDRA Pilot Grant and has concluded with plans to pursue related research questions in future.

Overview:

The study sought to characterize the cutaneous microbiome in a cohort of premature infants, and explore the impact of early postnatal antibiotic exposure on the cutaneous microbiome. Bacterial colonization of both the infant gut and skin are likely critical in immune system development, though little is known about the parallel assembly of the microbiome across sites. This study built on the previous work on the impact of antibiotics on the intestinal microbiome, metabolome, and inflammatory responses in premature infants. The addition of cutaneous microbiome sampling to this existing cohort allowed for comparison between the development of the microbiome in both the skin and gut within the same subject. It also allowed the exploration the impact of antibiotic exposure on cutaneous microbial diversity and adverse outcomes including sepsis. Finally, in the event of adverse outcomes, cultured pathogenic organisms will be compared to microbial profiles of the skin and intestine to explore which site was likely breached. We hypothesized that antibiotic exposure was associated with a loss of microbial diversity across both the cutaneous and intestinal microbiome, and that these effects extend beyond the duration of the antibiotic exposure. We also suspected that the altered microbial ecology would be associated with a higher incidence of adverse outcomes, including late onset sepsis (LOS), which can be associated with a breach in the intestinal, mucosal, or cutaneous barrier.

Status:

This study was funded as a 2017 PeDRA Pilot Grant and is now complete. Final results were presented at the 2019 Annual Meeting of the Society for Pediatric Dermatology.

Overview:

This survey study examined practice based differences between pediatric rheumatologists and dermatologists caring for children with discoid lupus. The study found important differences between how dermatologists and rheumatologists manage the same disease in children, underscoring the need for future study and collaboration.

A retrospective multi-centered study is currently underway, and collection of this data will set the stage for the development of consensus guidelines for treatment of discoid lupus in children.

Status:

One publication reached print in 2019 (see publications page) and planning for future studies is underway.

Principal Investigator:

Elaine Siegfried, MD – St. Louis University

Overview:

Treatment options are limited for children with atopic dermatitis (AD). This project was a consensus effort to guide clinical development programs of companies developing new therapies for AD in children. The hope that it will provide a valuable framework for efficient development and approval of desperately-needed new therapies.

Status:

This project is complete with a guidance document submitted to the FDA and paper published in Pediatric Dermatology in 2018 (see publications page).

Principal Investigator:

Kevin Yarbrough, MD – Phoenix Children’s Hospital

Overview:

This was a retrospective study exploring the effectiveness of electrocardiograms prior to treatment for screening infants considered for systemic propranolol treatment.

Status:

Complete. This study resulted in a 2016 publication in Pediatric Dermatology.

Co-Principal Investigators:

Wendy Kim, DO – Loyola University and Beth Drolet, MD – University of Wisconsin

Overview:

This was a multicenter retrospective review. A RedCap survey was designed to capture information regarding timolol and propranolol use in premature and young infants. Investigators aimed to determine whether side effects were more likely in this population and if so, which side effects were more common. Included were infants < 8 weeks corrected gestational age who were treated for infantile hemangioma with oral propranolol 0.5 mg/kg/ day or greater, as well as infants treated with transcutaneous timolol. Excluded were infants > 8 weeks corrected gestational age treated with beta blocker for infantile hemangioma. Data collected included gestational age, birth weight, sex, age at initiation of therapy, size of infantile hemangioma, type of infantile hemangioma, indication for treatment, dosing, comorbidities, screening workup, and side effects with grading.

Status:

Complete.