{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:29:40Z","timestamp":1767374980736,"version":"3.44.0"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Dermatology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Epidermolysis bullosa (EB) is a group of rare genetic skin disorders characterised by skin fragility and chronic, painful wounds that are highly susceptible to bacterial infection, particularly by <jats:styled-content style=\"fixed-case\"><jats:italic>Staphylococcus aureus<\/jats:italic><\/jats:styled-content> (SA). This study evaluated the efficacy of an acid\u2010oxidising solution containing hypochlorous acid (HOCl) in reducing SA colonisation, promoting wound healing, and restoring a healthier microbiome in EB wounds. In a 12\u2010week open\u2010label pilot study, 15\u2009EB patients applied the HOCl\u2010based spray (APR\u2010TD011) daily to chronic wounds for 8\u2009weeks, with full\u2010length 16S rRNA sequencing of wound swabs performed before, during, and after treatment. At baseline, 87% of patients were culture\u2010positive for SA, and sequencing revealed that SA had the highest relative abundance (34%), followed by <jats:styled-content style=\"fixed-case\"><jats:italic>Acinetobacter guillouiae<\/jats:italic><\/jats:styled-content> and <jats:styled-content style=\"fixed-case\"><jats:italic>Pseudomonas poae<\/jats:italic><\/jats:styled-content>. SA relative abundance decreased precipitously by Weeks 4 (to 11%) and 8 (primary endpoint; to 10%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and this effect persisted at 4\u2009weeks post\u2010treatment (Week 12; to 9.7%), including for methicillin\u2010resistant SA. Concurrently, bacterial diversity increased, and wound sizes diminished in correlation with reduced SA levels (<jats:italic>r<\/jats:italic>\u2009=\u20090.64). Younger patients exhibited greater SA reduction trends. The treatment was well\u2010tolerated, with minimal adverse effects and high patient satisfaction. This study underscores the role of microbial dysbiosis in EB wounds and highlights HOCl\u2010based solutions as a promising therapy to mitigate pathogenic burden and enhance wound healing.<\/jats:p>","DOI":"10.1111\/exd.70147","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:04:21Z","timestamp":1755129861000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An Acid\u2010Oxidising Solution Containing Hypochlorous Acid Reduces <i>Staphylococcus aureus<\/i> and Improves Bacterial Diversity in Epidermolysis Bullosa Wounds"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6177-2472","authenticated-orcid":false,"given":"Xiaolong A.","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Dermatology Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Biology Loyola University Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7127-4197","authenticated-orcid":false,"given":"Ziyou","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Dermatology Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Stagaman","sequence":"additional","affiliation":[{"name":"Department of Biology Loyola University Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan J.","family":"Green","sequence":"additional","affiliation":[{"name":"Genomics and Microbiome Core Facility Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lok Yiu Ashley","family":"Wu","sequence":"additional","affiliation":[{"name":"Genomics and Microbiome Core Facility Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynna","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Rangel","sequence":"additional","affiliation":[{"name":"Department of Dermatology Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Rabbaa","sequence":"additional","affiliation":[{"name":"Department of Dermatology Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6187-6549","authenticated-orcid":false,"given":"Amy S.","family":"Paller","sequence":"additional","affiliation":[{"name":"Department of Dermatology Northwestern University, Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14411"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.06.039"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.matbio.2018.01.016"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.14592"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2022.01.020"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.04.026"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2009.01070.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14102"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14444"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734618795593"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000443255.73875.a3"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2016.25.8.443"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000530687.23867.bd"},{"issue":"10","key":"e_1_2_11_15_1","first-page":"265","article-title":"A New Acid\u2010Oxidizing Solution: Assessment of Its Role on Methicillin\u2010Resistant \n                     Staphylococcus aureus\n                   (MRSA) Biofilm Morphological Changes","volume":"27","author":"D'Atanasio N.","year":"2015","journal-title":"Wounds"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wndm.2018.09.001"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-7834-2_7"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.3869"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41597-022-01762-z"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00062-07"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40168-018-0605-2"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0061217"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13059-014-0550-8"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2023.10.019"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.795173"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.29392\/001c.84488"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.02.234"}],"container-title":["Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/exd.70147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T07:26:06Z","timestamp":1758093966000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/exd.70147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/exd.70147"],"URL":"https:\/\/doi.org\/10.1111\/exd.70147","archive":["Portico"],"relation":{},"ISSN":["0906-6705","1600-0625"],"issn-type":[{"type":"print","value":"0906-6705"},{"type":"electronic","value":"1600-0625"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70147"}}