Adipose-derived stem cell exosomes for treatment of dupilumab-related facial redness in patients with atopic dermatitis

Abstract

Background

Dupilumab facial redness (DFR) is a side effect of dupilumab treatment that has only been recently reported. We previously reported on two patients with DFR who were successfully treated with a topical formulation containing human adipose tissue-derived mesenchymal stem cell-derived exosomes (ASCEs).

Objectives

The study aimed to evaluate the efficacy and safety of ASCEs in DFR.

Participants and methods

We performed 12-week prospective study at single center. Twenty adult atopic dermatitis patients diagnosed with DFR were enrolled. They were treated with a topical application of the exosome formulation every week for five consecutive weeks.

Results

After exosome treatment, both the average investigator global assessment score and clinical erythema assessment scale scores decreased. 19 patients (95%) were satisfied with the treatment. Compared to baseline, erythema index at week 4 were decreased by 31, 27, 13, and 25 units on the forehead, chin, right and left cheek respectively. The analysis of stratum corneum samples revealed the expression of IL-1α and human thymic stromal lymphopoietin was suppressed after exosome treatment, whereas filaggrin and vascular endothelial growth factor expression increased.

Conclusions

This study suggests topical formulation containing ASCEs can alleviate DFR by downregulating local inflammation and restoring skin barrier function.

Keywords:

• Atopic dermatitis
• dupilumab
• dupilumab facial redness
• exosome
• filaggrin
• inflammation

Acknowledgment

The authors wish to thank all of the dermatologists and collaborators who participated in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data used to support the findings of this study are available from the corresponding author upon request.

Additional information

Funding

This study was funded by ExoCoBio Inc., Seoul, Republic of Korea, and was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government (MSIT) [No. 2022R1A2C2091741].