Debajyoti Ghosh, PhD: Antibiotic Exposure in Pregnant Women and AD Development in Offspring

Several sessions at the American Academy of Allergy, Asthma & Immunology Annual Meeting (AAAAI) 2022 have examined the relationship between atopic dermatitis, a skin condition with increasing prevalence in recent years.

In an interview with HCPLive, Debajyoti Ghosh, PhD, University of Cincinnati College of Medicine, spoke of how atopic dermatitis has affected pregnant women, and the environmental factors associated with the disease.

“The prevalence of atopic dermatitis is one the rise, it’s been about a 2 to 3 times increase over the last couple of decades,” Ghosh said. “The human genome is pretty stable to explain this phenomena. There is ample evidence that there is skin and gut dysbiosis linked to AD, so this can be a great environmental factor behind this increase in prevalence.”

Among the factors related to increased prevalence of the skin disease, such as cesarean section in pregnant women and smoking, Ghosh noted that antibiotic medications have the potential to cause dysbiosis in pregnant women leading to greater risk of AD development.

Currently, antibiotics comprise roughly 80% of prescribed pregnancy medications, and recent epidemiological studies have indicated a link between antibiotic use and dysbiosis.

However, the mechanistic link between perinatal dysbiosis and atopic dermatitis had not been investigated prior to the study, which prompted Ghosh and investigators from the University of Cincinnati and Cincinnati Children’s Hospital do collaborate on a murine model that tested dysbiosis with 3 antibiotics widely used in human patients.

“We adopted this model to find out the skin gene changes in AD,” Ghosh said. “Once we get some mechanistic understanding, we will try to reverse the changes using either probiotic bacteria or metabolites in order to reverse the changes, and that could be directly helpful for human health.”

Ghosh noted that data from the current study, including previous mother-child cohort studies, indicated that the timing of antibiotic exposure in pregnant women is crucial. He noted thatin some current studies, antibiotic exposure during the second and third trimester is recommended.

Additionally, changes to the skin in pregnant patients appears to be manageable, and new methods for atopic dermatitis treatment are currently being explored by the University of Cincinnati.

“These changes can be manageable, or can be reversed by use of probiotic bacterial strains or live bacterial metabolites,” Ghosh said. “We are actually collaborating with our colleagues over at NIH who have identified certain bacterial strains that can survive about 6 to 8 months on the skin, and that can used to prevent the skin conditions. We would like to use those probiotics to manage AD associated with perinatal antibiotic exposure.”