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**Nitrosomonas eutropha** is a live topical microbiome therapeutic based on a single strain of ammonia-oxidizing bacteria being developed by AOBiome for inflammatory skin diseases. Public company materials describe the clinical candidate as **B244**, a purified topical preparation of *Nitrosomonas eutropha* intended to repopulate the skin microbiome and modulate inflammation. Its proposed biology is that ammonia oxidation generates nitric oxide and related metabolites and downregulates type 2 inflammatory signaling, with company materials highlighting effects on IL-4, IL-5, IL-13, and IL-31, and publications noting suppression of T helper 2 polarization through IL-10. Clinical and translational work has linked this organism/product to development in acne vulgaris, atopic dermatitis, eczema, rosacea, allergic rhinitis, migraine, and hypertension, although the clearest publicly documented dermatology development is topical use in acne and atopic dermatitis.
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