The skin external layer, the stratum corneum (SC), is a semi-permeable stratified epithelium which acts as a permeability barrier, preventing dehydration and infiltration of pathogens. The SC of newborns is not fully mature until ~34 weeks’ gestation and provides poor skin barrier function before this point. Consequently, preterm infants are vulnerable to dehydration and neonatal sepsis. Research on treatments to enhance skin barrier function in preterm infants is a global priority. Topical emollients, such as essential oils, have been used to improve skin conditions and enhance skin barrier function.
We have shown, in an open label randomised controlled trial (RCT) of topical coconut oil in preterm infants from a large tertiary NICU in Western Australia (COSI-I trial), that coconut oil maintained healthier skin condition, without adverse effects. We show that the skin microbiome assembly, diversity, and succession in control and intervention using 16S rRNA sequencing. We collected swab samples from axilla, ear, and groin sites at day1, 7, 14 and 21 of intervention. Coconut oil has shown promising results as a topical emollient but had no effect on skin microbiome or enhancing the thickness of SC. Our results showed that the skin health stayed consistent in the intervention group but deteriorated in the control group during the intervention.
We are now further studying the role of microbial interactions in maintaining the skin barrier function. For this, we have established synthetic skin microbial communities using a top-down high throughput system for measuring the interactions amongst synthetic in vitro communities. We have made these communities using swabs taken from healthy adult volunteers without any diagnosed skin conditions. We culture collected swabs in a minimal media and passage it every 48 hours for a week. We characterize the synthetic communities using 16S rRNA full-length sequencing on PacBIO. Eventually, we aim to develop a topical probiotic-based coconut oil emollient that would help enhance the skin barrier function of preterm infant skin.