Presentation summary

Introduction :
Atopic dermatitis (AD), a chronic inflammatory skin disorder, is closely associated with gutmicrobiome dysbiosis. Acupuncture (Acu) effectively alleviates AD symptoms and improves gastrointestinalfunction. These observations suggest Acu’s therapeutic efficacy in AD may be partly mediated by gutmicrobiome modulation. This study investigated the gut microbiota’s role in Acu’s therapeutic efficacy in ADpatients.

Method :
AD patients were classified into responder (R) and non-responder (NR) groups by SCORAD scores. Gut microbiome features linked to treatment efficacy were analyzed using 16S rRNA gene sequencing andwhole metagenome sequencing (WMS). Fecal microbiota transplantation (FMT) from R donors validated thecausal role in an AD mouse model.

Results :
Verum Acu significantly reduced SCORAD in AD patients. Responders showed greater microbial diversity and balance, indicating a homeostatic gut contributing to reduced inflammation and improved outcomes. They maintained more stable gut microbiota, with lower dysbiosis. Enriched taxa (e.g., Alistipesihumii, Odoribacter splanchnicus, Bilophila wadsworthia) in R served as potential Acu responsiveness predictors. FMT from R donors restored Acu efficacy in AD mice (reducing skin lesions, hyperplasia, immunecell infiltration, TSLP), unlike NR donors. This causally links gut microbiota to patient-specific Acu responses. Rgroup microbiota were functionally enriched in metabolic pathways (e.g., UDP-N-acetyl-D-glucosamine, L-histidine, L-arginine biosynthesis) related to inflammation and immune regulation. Odoribacter splanchnicus MAGs from R showed higher genes for these pathways.

Conclusion :
These findings reinforce the gut–skin axis, highlighting the gut microbiome’s integral role inmediating Acu’s therapeutic effects. Microbiome composition is a critical determinant of Acu efficacy in AD,providing a basis for microbiome-informed, personalized acupuncture strategies.