An Introduction to the Benefits of the Skin Trust Club

In this interview, News-Medical speaks to Dr. David Caballero-Lima, Head of R&D at Labskin, about the applications and benefits of the Skin Trust Club.

Can you give a brief overview of Labskin, the products you produce, and the markets you serve?

Labskin can be defined in three different ways:

First, we have Labskin, a full-thickness skin model that we made from human keratinocytes and fibroblasts. Some people call it a synthetic model, but in reality, it is not synthetic at all because it is made from human cells. There are other skin models on the market, but nothing comparable to Labskin.

Our Labskin model has some specific features that make it very different. One such feature is that it can be colonized with human skin microbiome. We can do that in individual bacteria, mixes of bacteria, and isolating the whole microbiome (the whole community of bacteria from a person’s skin) and transferring it into our model.

We then have another way of defining Labskin, and that is a concept involving an innovative way of testing skincare and cosmetics on laboratory-made skin: Animal-free, cruelty-free testing.

Since our model is similar to natural human skin, we can do specific tests in a controlled laboratory environment that answers questions that you can ask as part of a clinical trial. That is the concept of having skin in the laboratory. We mainly focus on cosmetics and skincare, but we also work with pharmaceutical and medical device product investigation companies.

We look at how the skin responds to products, chemical compounds, and creams. We can also look at microbiomes and how the beneficial microbes that live on our skin react to those products. This allows us to see both sides of the interactions. We study prebiotics, probiotics, microbial effects of moisturizers, to name a few.

Thirdly is the Labskin team. A versatile and multidisciplinary team with deep knowledge of skin, including the microbiology of the skin. We have scientists ranging from molecular microbiologists, histologists, bioinformaticians, chemists, and engineers that can carry out several different tests.

What is the difference between the Skin Trust Club and remote clinical trials?

They are both based on the same idea. Both are a way to understand the composition of the bacteria living on our skin. The gut's microbiome effect on human health is well known, the skin microbiome less so. At Labskin we are advancing this understanding. When people think about bacteria, they often think of infection.

However, this is not always the case as there are many beneficial bacteria that help us do certain things. We have a community of bacteria and fungi that create an additional barrier that protects us from the environment. We have good bacteria that help us fight harmful bacteria and infections, and they also produce certain chemical compounds that are good for our skin.

The microbiome is the whole community that lives on our skin. Both remote clinical trials and Skin Trust Club are ways to isolate the bacteria community on our skin and carry out research. We can look at what bacteria are there and what they are doing, with two slightly different angles.

In a remote clinical trial, we can isolate the microbiome from a volunteer and put that microbiome on top of the Labskin model. To do that, we have to have a clinical setting and a clinical trial to isolate the volunteer's microbiome. This implies having ethics committee approval.

The problem we have had lately is, even if we do this in the lab, we cannot get approval from the ethics committee to do these clinical trials because of COVID restrictions. When we have gained permission, we cannot recruit volunteers because volunteers either do not want to come or cannot travel because of COVID restrictions.

Our thoughts were, what if we can isolate these microbes remotely? Therefore, we use a special design swab that we send to volunteers’ homes. We can then remotely collect the microbiome from their face with a swab. This is then frozen in their home, sent to us, and we can recover those microbes alive and put them on Labskin, as is usually done in clinical trials to isolate the microbes.

We use Labskin remotely for companies. However, we set out to provide this service for regular people to help them understand their skin’s behavior. This is when we developed the Skin Trust Club.

In this case, the swab we use is slightly different because we do not need to keep the microbes alive. Instead, we need to fix them to analyze them later. That way, we avoid it being a clinical trial because we are not keeping material from you.

You collect your microbiome, send that to us, then we analyze by sequencing, and we can identify the whole community of bacteria on your skin. The good, the bad, and the ugly.

Bioinformatics and AI mathematical modeling can be used to identify links to certain conditions in the skin. They can be linked to disease, but they can also be linked to, for instance, if there is an excess of sebum, normal or dry skin, how the environment influences your microbiome and skin health, how your skincare regimen is working.

We have created an app that brings together many different data sources. One is the microbiome, while we also collect the pollution levels where you are, and the UV irradiation climate. There are some questions that we ask to correlate all of those with the microbiome to give you an idea of your skin’s health.

It is two flavors of the same thing, but one is for companies with ethics approval as a clinical trial, and the other is for consumers, more for understanding your skin and the treatments, the regimens, the skincare creams, and products that you use.

What is the Skin Trust Club?

I think in summary: The Skin Trust Club is a new concept of personalized skincare. We use our Labskin expertise and the experience of studying the skin's microbiome to deliver a service to the customer to help them understand their skin needs.

What is the theory behind the Skin Trust Club?

There has been a lot of research in the last 12 to 15 years on the importance of the microbiome and how it is linked to certain diseases.

It is well known that the microbiome, the bacteria on our skin, changes when we have atopic dermatitis. People with this type of condition have different species on their skin, things that should not be there in healthy skin. If skin is affected by psoriasis or psoriatic plaques, the microbiome changes.

Therefore, we have developed models that can identify if you have psoriasis based on the composition of your microbiome.

Many things can be studied with these models, including environmental factors and genetic factors, the creams you are using, and if you are using antibiotics. These things are essential to consider as a cause of a microbiome change.

Something that we bring from other parts of the company, the AI analyses, are very complex sets of data and extensive data sets. We use AI to help find the features that define the microbiome to link them to certain states, either healthy or diseased.

What benefits will the Skin Trust Club bring to the user?

The real value for the users is to follow the evolution of their skin health in real-time. If you do only one test you will have a still picture of your skin health. The really interesting things only begin to emerge when you follow the composition of the microbiome over time.

By testing several times a year on a regular basis, you can see changes in your microbiome depending on the dryness of your skin due to environmental factors or seasonal change.

You can investigate different skincare regimes. If you are using creams or wash and clean, a regimen you have been using for a year, and we followed your skin microbiome with that treatment, but then you suddenly change and use a different set of creams, we can see how those changes affect the microbiome. It is a scientific way to measure how the skincare regimen is working for you.

How easy is it to use the Skin Trust Club platform?

We have made the platform very user-friendly.

There is a downloadable mobile app and a dedicated website where you are able to book your test. We send you the skin kit. You then read a QR code that will launch a video that gives you instructions on doing the swab. You then put the swab in the tube provided, put it in the box again and into the envelope, and send it back to us.

When we receive the swab, we extract the bacteria and then the DNA.  We carry out the sequencing. We have a bioinformatics pipeline and an AI model that runs through the composition of that microbiome and automatically generates a report that goes to your mobile app.

It is all safe, secure, GDPR-protected,  anonymized, and it runs automatically. What you get on your app at the end is an entire report with several species of genus families, a complex understanding of the microbiome, and simplified graphs and conclusions of what is there.

Why did Labskin develop remote clinical skin trials?

We knew we could do this, we had data showing we could transplant or clone the microbiome of volunteers, but we could not get microbiomes from volunteers because of COVID-19, which was the main driver.

Suppose you do a clinical trial to test the skin or in the microbiome in volunteers. In that case, you need to test one product on one volunteer and another product, or the control, on a different volunteer. People and microbiomes are not identical. They are similar but not identical.

What we can do is reproduce that exact microbiome several times in different pieces of Labskin so that you can test the products under a controlled environment in the same microbiome.

That is the difference between carrying out a lab-based clinical trial and a remote clinical trial; we bring the microbiome to our controlled environment.

How does Labskin ensure each remote clinical trial is performed correctly?

When you carry out a clinical trial, you have something called good clinical practice, where you follow several requirements to make sure that the data you collect is accurate and correct. You also need to be very careful with the anonymity of the volunteers.

The clinical trial works in a slightly different way than the Skin Trust Club. There is a very secure and entirely separate portal that records you when you are doing the clinical trial.

When you are doing the swab in your home, we record you to ensure that it has been done correctly. Several steps, e.g., track and trace, make sure that all processes and procedures are done correctly. It is very secure, anonymous, and very protected.

What does the future hold for Labskin?

We do a lot of different things in the skin space and skin microbiome space.

In regards to the Skin Trust Club, we are going to be very successful. We can do more complex things by looking at the skin conditions without using the volunteers' genetic material by analyzing the products that both the skin and the microbiome produce. This will avoid issues with having the genetic material and the people.

For instance, for the clinical trials, we are going to be constantly carrying out hybrid trials. It is a bit more complex now we have clients that want to investigate the effects of all their products on people and Labskin at the same time.

We can send them the creams, but then we swap the microbiomes, bring them to Labskin, study the Labskin microbiomes from the volunteers, and send them cream or product. They then use the product, and we carry out the process again.

We can test the product in vitro, on Labskin with the microbiome, and on the person with the microbiome. This requires an additional step in terms of ethics approval because you do need to put a product onto people's skin.

We are also developing diseased models. We have a skin model that can make psoriatic plaque. We can induce psoriasis, and we are also creating a model that causes eczema. We are collaborating with universities to extensively study the interaction between these models in conjunction with volunteers’ microbiomes that have those diseases.

We are making models of disease, starting with eczema and psoriasis. We are also very keen to work on wound care, chronic wounds, and the microbiome.

About Dr. David Caballero-Lima

David received his undergraduate degree in Biology and his Ph.D. in Biomedical Sciences from the Universidad de Extremadura in Spain.

David took postdoctoral research positions at the University of Sheffield and the University of Manchester, with both roles focussing on studying human/pathogen interaction via tissue models and the development of diagnostic devices and obtaining a greater understanding of the regulation of vesicle transportation in morphological changes.

David was initially Services Manager at Labskin, responsible for all microbiology work and service projects, bringing his 18 years of experience working with microbiology and host-pathogen interactions.

As Head of R&D, David now leads the research department, focusing on the development of new methods for studying the native skin microflora, prebiotics, probiotics, and antimicrobial effects of ingredients and formulation for pharmaceutical and cosmeceutical studies.

He is also the scientific lead for the development of Labskin's new venture; Skin Trust Club, a new concept of personalized skincare based on the analysis of the skin microbiome.  David is a key collaborator on international research bids, as a peer with leading international experts from academia and industry.

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