New clinical testing to “investigate microbial roots of various skin conditions”

Image: Getty Microbiome testing company Sequential has just launched ‘targeted skin condition panels’, which are designed to address conditions like acne, rosacea, atopic dermatitis and malodour, as well as UV exposure.

According to the company’s co-founder and CEO Dr Oliver Worsley, these panels are an ‘industry first’ and offer a targeted approach to skin research by “focusing on the underlying microbial significance of each condition.”  

The biotech firm said it utilised a proprietary qPCR approach for these targeted panels with its in-house Smart Probes to ensure that results “include species and subspecies level analysis as well as absolute quantification.”  

The offering is supported by a database of over 25,000 microbial samples and many scientific studies.   

We spoke to Dr Worsley to discover more… 

Why have you decided to offer microbiome targeted panels? Was there a customer demand for it? ​

Oliver Worsley (OW):​ Sequential’s high-resolution skin microbiome panels address skin conditions affecting over 1.5 billion people globally, including acne, atopic dermatitis, and rosacea. We believe these conditions are often overlooked, and misdiagnoses occur, so we need a more refined molecular diagnosis to help these individuals.  

In doing so, we are also enabling and empowering companies to develop more effective treatments, in clinical studies, by measuring these microbiome subspecies and strain-level, at absolute abundance and quantification directly on the skin.  

Besides chronic inflammatory skin conditions, the global sunscreen market is valued at around $10bn, with projections suggesting it could reach approximately $15bn by 2027, growing at a compound annual growth rate (CAGR) of about 5-7%.  

There is a need for more effective microbial-based solutions to improve UV-filters, reducing sun damage to skin for consumers.  

Equally, by studying the composition of the axillary (armpit) skin microbiome, we can understand how products could be shifting the malodorous type (Corynebacterium and Staphylococcus species and strains, among others), which may inspire innovation for ingredients that could replace aluminium or irritants found in conventional deodorant or antiperspirants. 

Is this designed to help with the creation of topical skin care products, beauty-from-within nutraingredients, or both?  ​

OW: ​Instead of a one-size-fits-all approach, our microbiome panels allow for a more targeted strategy by identifying specific microbial strains that are over-represented, under-represented, or thought to be contributing to chronic inflammatory conditions like acne vulgaris, atopic dermatitis, or rosacea.  

This enables for the development of products specifically designed to restore microbial balance. By levering microbiome-targeted panels, companies gain a scientific and strategic foundation to develop more effective and innovative products that stand out from conventional skin care. 

Why do you think that looking at ‘microbiome targeted panels’ is the best way to go in terms of creating products designed to work on these particular skin issues/areas of interest (eg acne, rosacea, sun care)? ​

OW:​ Clinical microbiome testing, or in vivo, is the only way to go to test how products are impacting the human microbiome. Taking this further, traditional sequencing methods may capture general taxonomy and relative abundance but are not very useful in characterising dysbiosis.  

We have characterised high resolution microbes at subspecies and strain level, which means going much further into understanding the cause of some of these inflammatory skin conditions.  

For example, we know now that Cutibacterium acnes subspecies do not function alike. There are certain subtypes that drive a more ‘acneic skin’ and those that drive towards a healthy skin. 

How long has Sequential been working on this offering? ​

OW​: ​Since launching our consumer kits in 2019, we have been carefully testing our skin microbiome dataset reaching 25K+ samples and developing what we call Smart Probes, which can bind to the target of interest (e.g. C. acnes defendens) to fully characterise the skin not only from a diversity-level but also from a subspecies level.  

In the process of continual validation on clinical skin samples from US, UK and Singapore, we have ensured the accuracy of over 100 Smart Probes that fall into their relevant panels. 

What kinds of challenges have you faced when creating these specific panels? ​

OW:​ Collecting a significant database of ethnically diverse skin types has always been a challenge for us, and indeed the world of genomics.  

As much of the database for disease related genetics, are biased in the Caucasian genome reference database, we have made efforts to ensure the clinical studies we’ve participated in have been highly diverse, and our panels are based on probes validated on under-represented groups such as those found in South East Asian skin types, Latin American and African skin types.  

Taking a step back, the technical steps with developing probes is significant, as you have to ensure the Smart Probe is only targeting the unique segment of microbial DNA from the microbe of interest. Fortunately, our senior team’s expertise falls in developing these probes and ensuring their accuracy and efficiency. 

Are there some potential ‘issues/dangers’ of only looking at specific bacteria in terms of its relation to a specific skin issue? Isn’t it more ‘holistic’ than this?  ​

OW: ​We are constantly scanning the literature to include important skin microbiome subspecies/strains in our panels. In addition, we have several academic collaborations in place with groups like A*STAR, Weizmann Institute, and Imperial University, to ensure we are collecting sufficient information from large sequencing datasets using what’s called deep shotgun sequencing and long-read sequencing to differentiate strains. 

How are you considering ethics and data privacy when working with these samples?  ​

OW:​ We use the highest security for our clinical samples and data, all digital samples are stored encrypted on the cloud and de-identified from the individual.  

Can you go into more detail about the sun care microbiome panel, as this is a hotbed of innovation right now? ​

OW:​ Certain skin microbes are believed to contribute to protection against UV-damage, caused by the sun, by producing metabolites or modulating immune responses.  

Work produced by Prof Catherine O’Neill at the University of Manchester, and other academic groups around the world, are identifying specific microbes resistant to UV damage, and by eliciting an anti-inflammatory response to UV they’re in turn benefiting the skin.  

Others have found the common C. acnes to produce propionic acid, which modulates inflammation caused by UV, and others have identified a Sphingomonas strain showing it is able to reduce reactive oxygen species levels in human keratinocytes upon UV exposure.  

Taken together, these results provide a proof-of-concept for the role of the skin microbiome in protection from solar radiation. And using the sun care microbiome panel to evaluate the effect of a UV-filter/formulation, is warranted where we can quantify the effect using predefined Smart Probes we’ve generated through extensive research. 

What else is in the pipeline for Sequential?  ​

OW: With the accumulation of significant skin microbiome sequencing data, we are also attempting to work out what ingredients across 200+ clinical studies we’ve been involved in that may influence specific skin microbes at subspecies/strain level. 

Since we have this information on our databases, it’s a relatively easy task and we’ve already worked with major brands and pharmaceutical companies to support them in microbiome-modulating formulations.