ORIGINAL RESEARCH article
Front. Allergy
Sec. Skin Allergy
Association of Intestinal Barrier Impairment with Symptom Severity and Washed Microbiota Transplantation Outcomes in Atopic Dermatitis Patients
Provisionally accepted
- 1Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- 2Department of Dermatology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
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Objective: We hypothesized that intestinal barrier impairment is a key pathophy siological feature in AD and that the degree of baseline barrier dysfunction, ref lected by serum D-lactate levels, predicts the clinical response to Washed Micr obiota Transplantation (WMT). This study aimed to test these hypotheses by in vestigating the association between intestinal barrier biomarkers and AD severit y, and their correlation with WMT outcomes. Methods :We compared intestinal barrier biomarkers (D-lactate, endotoxin, and diamine oxidase ) between 24 AD patients and 23 healthy donors. Additionally, we evaluated the clinical outcomes of 14 AD patients who underwent WMT therapy. Results:AD patients exhibited significantly elevated intestinal barrier biomarkers compared to healthy donors (P < 0.01). Following WMT, significant improvements were observed in SCORAD, EASI, and NRS scores (P < 0.05). In exploratory, uncorrected analyses, baseline D-lactate levels showed a significant negative correlation with improvements in SCORAD (R = -0.738, p = 0.037) and NRS scores (R = -0.650, p = 0.012), suggesting that higher pre-treatment levels might predict greater symptom relief. Microbiota analysis revealed a increase in Acidaminococcus and decreases in Ruminococcus_gnavus_group, Flavonifractor, and Norank_f_Oscillospiraceae following WMT. Conclusion: This study confirms significant intestinal barrier dysfunction in AD and demonstrates the potential clinical efficacy of WMT. The strong, uncorrected correlations suggest that pre-treatment D-lactate level warrants further investigation as a candidate biomarker for predicting WMT response. The clinical benefits occurred alongside a restructuring of the gut microbiota.
Keywords: washed microbiota transplantation, WMT, intestinal barrier, atopic dermatitis, D-lactate
Received: 06 Aug 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Lao, Zhang, Cai, Chen, Wu, He and Deng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Li-Hao Wu
Xing-Xiang He
Wan-Ying Deng
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