{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T10:37:50Z","timestamp":1794134270942,"version":"4.8.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Atopic Dermatitis (AD), a chronic inflammatory skin disease characterized by pruritus, dryness, redness, edema, scratching, and lichenification, ranks as the leading cause of non-fatal skin disease burden globally. Current therapeutic strategies for AD primarily act by inhibiting inflammatory pathways, yet largely fail to address\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (\n                      <jats:italic>S. aureus<\/jats:italic>\n                      ) control unless exudative lesions are present. However, concerns over treatment-related adverse effects, long-term safety profiles, and emerging drug resistance underscore the remaining substantial unmet clinical needs in this field.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the safety and efficacy of endolysin gel in treating AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An infection-driven dermatitis model with AD-like features was established. Following treatment with Staphyrase\n                      <jats:sup>\u00ae<\/jats:sup>\n                      or in other control groups, skin disease severity scores,\n                      <jats:italic>S. aureus<\/jats:italic>\n                      CFU, and key inflammatory cytokines were assessed. An open-label, single-center, investigator-initiated clinical study (ChiCTR25001192) was conducted in which participants, who received the endolysin gel twice daily, underwent follow-up assessments at baseline, treatment weeks 1 and 2, with an optional extension up to 3 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Statistically significant reductions in skin lesion scores,\n                      <jats:italic>S. aureus<\/jats:italic>\n                      load, and AD-related immune mediators (i.e., IgE, TSLP, IL-33) were observed in the Staphyrase\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group relative to the model group. All 20 enrolled adult subjects completed the clinical study, with no tolerability issues reported, indicating a favorable safety profile of the endolysin gel. Compared to baseline, EASI, SCORAD, IGA, VAS, and DLQI scores demonstrated significant decreases at both Day 7 and Day 14 (all P &amp;lt; 0.05). Notably, Participant No. 11, who underwent extended follow-up until Week 8, exhibited substantial improvements in redness, lichenification, severe scratching, oozing, and dryness. The Endolysin gel showed consistent safety and efficacy in improving both acute and chronic AD lesions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Topical endolysin gel is a well-tolerated, effective, and promising agent for the treatment and proactive maintenance of mild-to-moderate AD in adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1667195","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:33:02Z","timestamp":1761111182000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Endolysin significantly improves symptoms with atopic dermatitis: bridging the gap from research to clinical 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