DERMABIOME

Iatrogenic skin inflammation (ISI) induced by biologics (targeting cytokines involved in chronic inflammatory diseases) or immunotherapies (anti-PD1, anti-CTLA4 to treat cancers) is triggered by immune switches. From psoriasis-like lesions and eczema to rash and vitiligo, they often force therapy discontinuation, worsening underlying diseases. Preventing their development could critically improve current care. Unlike inflammatory skin diseases arising “unpredictibly”, ISI emerge in an expected percentage of patients, within months to years of treatment initiation, offering a model to study early inflammatory events and allowing longitudinal sampling before and after their onset. The triggering events are not well understood.

Hypothesis:

Actionable microbial and environmental factors contribute to the immune switch responsible for ISI.

Objectives:

- Identify microbial biomarkers predictive of skin inflammation by analyzing skin/Ear-Nose-Throat (ENT)/stool samples and stratifying microbiome profiles across:

o Treatment contexts: biologics versus immunotherapies;

o Skin manifestation types; revealing both shared and context–specific microbial signatures.

- Integrate atmospheric pollution (PM2.5, PM10, NO₂, O3) to explore how environmental stressors modulate microbiome composition and clinical severity.

- Establish a biobank of cultivable bacterial and fungal strains, for later HARMI–aligned research.

Methods:

- Unsupervised sequencing on skin, ENT and gut samples;

- Collection of clinical, environmental and epidemiologic data using a survey and the hospital files;

- Concentrations of four major pollutants around the patient’s home address, data from the regional Bourgogne–Franche-Comté air quality monitoring agency (ATMO BFC) using the PREV’EST modelling Platform;

- Histological analysis of ISI.

DERMABIOME proposes a multidisciplinary approach combining pan-microbial (bacteria, fungi, viruses) metagenomics, to therapy–associated manifestations, with a synergic research team.

Relevance:

- Scientific: Advance our understanding of microbiome-immune crosstalk in skin diseases (WP2), as well as the influence of air pollution (WP1);

- Clinical: Prevent or enable early prediction of ISI, reducing therapy interruptions;

- Translational: Provide a biobank of next-generation probiotic strains or antimicrobial products for HARMI partners (WP4) and actionable data for public health (e.g., air pollution alerts).