Richard Gallo, MD, PhD: Future Research Opportunities on Skin Microbiome

During a segment of his HCPLive interview for the American Academy of Allergy, Asthma & Immunology (AAAAI) 2023 Annual Meeting in San Antonio, TX, Gallo went into future research on the skin’s microbiome and more about the topic from his presentation.

Gallo works at the University of California, San Diego as a Distinguished Professor and Founding Chairman of the Department of Dermatology.

His work—specifically on the discovery of antimicrobial peptides in mammalian skin—is widely known and has strongly influenced the scientific world’s understanding of skin conditions like rosacea, AD, and acne.

“It's a very novel approach not to use an immunosuppressive or immunomodulatory drug to interfere with inflammation,” he explained. “So this is kind of an all new world. The term probiotic, of course, has been out there for quite some time, (they) are used in many applications. Principally people think about probiotics as an oral pill, but essentially what that is intended to do is to use live bacteria.”

Gallo added that most probiotics have not been screened like a chemical drug—assessing bio active molecules, receptors, mechanisms of action, etc.

He said that the bacteria in probiotics are given back to humans but without much knowledge on why they might work or not.

The overall focus of Gallo’s team in their AAAAI presentation was highlighting developments in the ways in which microbes inhabiting the skin may influence a host’s immunity and affect its allergic inflammation outcomes.

Gallo explained that this specific subfield may not be as well-established as others due to a variety of reasons.

“For a while, it wasn't particularly obvious that the skin was such a good surface area for communication with microbes, but actually, it's the largest surface area in the entire body for that because of all the pores in the skin,” he said. “Follicular openings, eccrine and apocrine ducts each go down, in some cases, several millimeters into the skin, and it presents a tremendously large surface area for all the microbes that are protected within it.”

Gallo also explained future research in the space that he believes could shed some new light on the topic and add to the growing number of studies on the microbiome and bacteriotherapy.

“In atopic dermatitis, particularly, we're looking at this as a drug-sparing treatment approach that may minimize the use of immunosuppressive, immune-modulating drugs,” he said. “Because of its safety profile, we hope to very quickly be able to introduce this in the pediatric population."

Gallo further explained the potential use of bacteriotherapy in other conditions besides atopic dermatitis.

"But these drugs have a lot of promise in other diseases" he said. "...We're looking at acne, we're looking at rare diseases such as Netherton syndrome.”

For more on Gallo’s AAAAI presentation, view the full interview segment above.