An acid-oxidizing solution containing hypochlorous acid reduces Staphylococcus aureus and improves bacterial diversity in epidermolysis bullosa wounds

ABSTRACT: Epidermolysis bullosa (EB) is a group of rare inherited skin disorders characterized by mechanobullous skin fragility and painful wounds that are readily infected by bacteria, particularly Staphylococcus (S.) aureus. More effective approaches for decreasing wound colonization and infection by pathogenic bacteria are necessary to reduce EB morbidity and mortality. To assess the ability of a low pH, hypochlorous acid (HOCl)-based spray to reduce S. aureus burden, promote wound healing, and restore a healthier skin microbiome. Pilot 12-week open-label study of APR-TD011, a low pH (2.5-3) acid-oxidizing spray containing HOCl (0.0038%), on chronic wounds of EB patients. Patients used the spray daily for 8 weeks on designated wounds. Wounds were assessed clinically and swabbed for microbiome analysis using full-length 16S rRNA sequencing before, at Weeks 4 and 8 of treatment, and at 4 weeks post-treatment. Thirteen of 15 enrolled patients, most of whom had dystrophic EB, were culture-positive for S. aureus at baseline. Sequencing data showed S. aureus had the highest relative abundance (34%), followed by Acinetobacter guillouiae and Pseudomonas poae. S. aureus relative abundance was reduced by Weeks 4 (to 11%), 8 (primary endpoint; to 10%, p<0.01), and still at Week 12 (to 9.7%), including for methicillin-resistant S. aureus. Overall, bacterial diversity increased with treatment and wound sizes decreased, correlating with reduction in S. aureus (p=0.64). These findings suggest that acid-oxidizing HOCl sprays may be an effective adjunctive therapy to reduce bacterial dysbiosis and infection risk in EB wounds, while promoting wound healing.

ORGANISM(S): Homo sapiens

PROVIDER: GSE288051 | GEO | 2025/08/20

REPOSITORIES: GEO