101
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Importancia de la inmunidad innata en el acné. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:801-805. [DOI: 10.1016/j.ad.2016.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 07/13/2016] [Accepted: 07/17/2016] [Indexed: 12/15/2022] Open
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102
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Sayanjali B, Christensen GJ, Al-Zeer MA, Mollenkopf HJ, Meyer TF, Brüggemann H. Propionibacterium acnes inhibits FOXM1 and induces cell cycle alterations in human primary prostate cells. Int J Med Microbiol 2016; 306:517-528. [DOI: 10.1016/j.ijmm.2016.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/17/2016] [Accepted: 06/27/2016] [Indexed: 12/29/2022] Open
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103
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Omer H, McDowell A, Alexeyev OA. Understanding the role of Propionibacterium acnes in acne vulgaris: The critical importance of skin sampling methodologies. Clin Dermatol 2016; 35:118-129. [PMID: 28274348 DOI: 10.1016/j.clindermatol.2016.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Acne vulgaris is a chronic inflammatory skin condition classified by the Global Burden of Disease Study as the eighth most prevalent disease worldwide. The pathophysiology of the condition has been extensively studied, with an increase in sebum production, abnormal keratinization of the pilosebaceous follicle, and an inflammatory immune response all implicated in its etiology. One of the most disputed points, however, is the role of the gram-positive anaerobic bacterium Propionibacterium acnes in the development of acne, particularly when this organism is also found in normal sebaceous follicles of healthy skin. Against this background, we now describe the different sampling strategies that have been adopted for qualitative and quantitative study of P acnes within intact hair follicles of the skin and discuss the strengths and weaknesses of such methodologies for investigating the role of P acnes in the development of acne.
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Affiliation(s)
- Hélène Omer
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Andrew McDowell
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, C-TRIC Building, Altnagelvin Area Hospital, University of Ulster, Londonderry, UK
| | - Oleg A Alexeyev
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden.
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104
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Kwon HH, Suh DH. Recent progress in the research aboutPropionibacterium acnesstrain diversity and acne: pathogen or bystander? Int J Dermatol 2016; 55:1196-1204. [DOI: 10.1111/ijd.13282] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/10/2015] [Accepted: 12/05/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Hyuck Hoon Kwon
- Department of Dermatology; Seoul National University College of Medicine and Acne & Rosacea Research Laboratory, Seoul National University Hospital; Seoul Korea
| | - Dae Hun Suh
- Department of Dermatology; Seoul National University College of Medicine and Acne & Rosacea Research Laboratory, Seoul National University Hospital; Seoul Korea
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105
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A possible role of IL-23/IL-17 axis in patients with lupus miliaris disseminatus faciei. Clin Immunol 2016; 171:36-37. [DOI: 10.1016/j.clim.2016.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 07/26/2016] [Accepted: 08/05/2016] [Indexed: 11/23/2022]
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106
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Reichrath J, Zouboulis CC, Vogt T, Holick MF. Targeting the vitamin D endocrine system (VDES) for the management of inflammatory and malignant skin diseases: An historical view and outlook. Rev Endocr Metab Disord 2016; 17:405-417. [PMID: 27447175 DOI: 10.1007/s11154-016-9353-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Vitamin D represents one of the major driving factors for the development of life on earth and for human evolution. While up to 10-20 % of the human organism's requirements in vitamin D can be obtained by the diet (under most living conditions in the USA and Europe), approximately 90 % of all needed vitamin D has to be photosynthesized in the skin through the action of the sun (ultraviolet-B (UV-B)). The skin represents a key organ of the human body's vitamin D endocrine system (VDES), being both the site of vitamin D synthesis and a target tissue for biologically active vitamin D metabolites. It was shown that human keratinocytes possess the enzymatic machinery (CYP27B1) for the synthesis of the biologically most active natural vitamin D metabolite 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), representing an autonomous vitamin D3 pathway. Cutaneous production of 1,25(OH)2D3 may exert intracrine, autocrine, and paracrine effects on keratinocytes and on neighboring cells. Many skin cells (including keratinocytes, sebocytes, fibroblasts, melanocytes, and skin immune cells) express the vitamin D receptor (VDR), an absolute pre-requisite for the mediation of genomic effects of 1,25(OH)2D3 and analogs. VDR belongs to the superfamily of trans-acting transcriptional regulatory factors, which includes the steroid and thyroid hormone receptors as well as the retinoid X receptors (RXR) and retinoic acid receptors (RAR). Numerous studies, including cDNA microarray analyses of messenger RNAs (mRNAs), indicate that as many as 500-1000 genes may be regulated by VDR ligands that control various cellular functions including growth, differentiation, and apoptosis. The observation that 1,25(OH)2D3 is extremely effective in inducing the terminal differentiation and in inhibiting the proliferation of cultured human keratinocytes has resulted in the use of vitamin D analogs for the treatment of psoriasis. This review gives an historical view and summarizes our present knowledge about the relevance of the VDES for the management of inflammatory and malignant skin diseases.
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Affiliation(s)
- Jörg Reichrath
- Center for Clinical and Experimental Photo-Dermatology and Department of Dermatology, The Saarland University Hospital, Kirrbergerstr, 66421, Homburg, Germany.
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Thomas Vogt
- Center for Clinical and Experimental Photo-Dermatology and Department of Dermatology, The Saarland University Hospital, Kirrbergerstr, 66421, Homburg, Germany
| | - Michael F Holick
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center, 85 E Newton St M-1013, Boston, MA, 02118, USA
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107
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Coit P, Sawalha AH. The human microbiome in rheumatic autoimmune diseases: A comprehensive review. Clin Immunol 2016; 170:70-9. [DOI: 10.1016/j.clim.2016.07.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 07/30/2016] [Indexed: 12/17/2022]
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108
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Lim SK, Ha JM, Lee YH, Lee Y, Seo YJ, Kim CD, Lee JH, Im M. Comparison of Vitamin D Levels in Patients with and without Acne: A Case-Control Study Combined with a Randomized Controlled Trial. PLoS One 2016; 11:e0161162. [PMID: 27560161 PMCID: PMC4999291 DOI: 10.1371/journal.pone.0161162] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/30/2016] [Indexed: 11/18/2022] Open
Abstract
Background Vitamin D plays an important role in the immune system, and its deficiency has been implicated in various skin diseases, including atopic dermatitis and psoriasis. Acne is a common inflammatory skin disease; however, the association with vitamin D remains unclear. Objectives We evaluated vitamin D levels in patients with acne to determine the effect of vitamin D supplementation. Methods This study included 80 patients with acne and 80 healthy controls. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured, and demographic data were collected. Vitamin D-deficient patients were treated with oral cholecalciferol at 1000 IU/day for 2 months. Results Deficiency in 25(OH)D was detected in 48.8% of patients with acne, but in only 22.5% of the healthy controls. The level of 25(OH)D was inversely associated with the severity of acne, and there was a significant negative correlation with inflammatory lesions. In a subsequent trial, improvement in inflammatory lesions was noted after supplementation with vitamin D in 39 acne patients with 25(OH)D deficiency. Limitations Limitations of the study include the small number of patients in the supplementation study and the natural fluctuation of acne. Conclusions Vitamin D deficiency was more frequent in patients with acne, and serum 25(OH)D levels were inversely correlated with acne severity, especially in patients with inflammatory lesions.
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Affiliation(s)
- Seul-Ki Lim
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeong-Min Ha
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Ho Lee
- Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Joon Seo
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Chang-Deok Kim
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeung-Hoon Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Myung Im
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
- * E-mail:
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109
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Yamamoto T, Okabe H. Cutaneous Sarcoid with Livedoid Changes in a Patient with Hashimoto's Thyroiditis. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:876-878. [PMID: 27555517 DOI: 10.1016/j.ad.2016.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 05/16/2016] [Accepted: 07/24/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- T Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan.
| | - H Okabe
- Department of Dermatology, Hoshi General Hospital, Fukushima, Japan
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110
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Speeckaert R, Lambert J, Grine L, Van Gele M, De Schepper S, van Geel N. The many faces of interleukin-17 in inflammatory skin diseases. Br J Dermatol 2016; 175:892-901. [PMID: 27117954 DOI: 10.1111/bjd.14703] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 01/04/2023]
Abstract
Interleukin (IL)-17 is an emerging target for inflammatory skin disorders. Given the remarkable success of its therapeutic inhibition in psoriasis, the pathogenic role of this cytokine is being explored in other immune-mediated diseases. Interestingly, IL-17 is linked to particular skin conditions where its activation coincides with disease flares. The leading hypothesis for its contribution to proinflammatory signalling cascades is driving inflammasome activation. However, IL-17 stimulation also releases a range of noninflammasome-related cytokines from human skin. Furthermore, a role in cytotoxic responses and an important interplay with the microbiome is hypothesized. While treatment failure would be surprising in neutrophilic dermatoses, the picture might be more complex in lymphocyte-mediated conditions. Nonetheless, increasing insights into the pathogenesis suggest that beneficial responses are also probable in the latter conditions. Study of this pathway in the skin reveals some intriguing aspects of the IL-17-related immunological network.
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Affiliation(s)
- R Speeckaert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - J Lambert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - L Grine
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - M Van Gele
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - S De Schepper
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - N van Geel
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
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111
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Effects of isotretinoin on body mass index, serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients. Postepy Dermatol Alergol 2016; 33:294-9. [PMID: 27605902 PMCID: PMC5004210 DOI: 10.5114/pdia.2016.56928] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/31/2015] [Indexed: 12/21/2022] Open
Abstract
Introduction Isotretinoin has been successfully used for the treatment of acne vulgaris. Aim To investigate the effects of isotretinoin on body mass index (BMI), to determine whether isotretinoin causes any changes in serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients, and to correlate variables. Material and methods Thirty-two patients were included in this study. Oral isotretinoin was begun at a dose of 0.5–0.6 mg/kg and raised to 0.6–0.75 mg/kg. Pretreatment and posttreatment third-month BMI and adiponectin, leptin, and ghrelin serum levels were measured. Results The pre- and posttreatment BMI values were not significantly different. In addition, serum adiponectin and leptin levels were significantly increased following isotretinoin therapy while serum ghrelin levels were not different. Conclusions Isotretinoin may exert its anti-inflammatory activity by increasing leptin and adiponectin levels.
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112
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Topical application of a vitamin D3 analogue and corticosteroid to psoriasis plaques decreases skin infiltration of TH17 cells and their ex vivo expansion. J Allergy Clin Immunol 2016; 138:517-528.e5. [DOI: 10.1016/j.jaci.2016.03.048] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/08/2016] [Accepted: 03/31/2016] [Indexed: 11/21/2022]
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113
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Yu Y, Champer J, Agak GW, Kao S, Modlin RL, Kim J. Different Propionibacterium acnes Phylotypes Induce Distinct Immune Responses and Express Unique Surface and Secreted Proteomes. J Invest Dermatol 2016; 136:2221-2228. [PMID: 27377696 DOI: 10.1016/j.jid.2016.06.615] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/02/2016] [Accepted: 06/20/2016] [Indexed: 12/23/2022]
Abstract
Propionibacterium acnes is a skin commensal bacterium that contributes to the development of acne vulgaris and other infections. Recent work revealed that P. acnes clinical isolates can be classified into distinct phylotypes, several of which have associations with healthy skin or acne. We sought to determine if these phylotypes induce different immunological responses and express protein factors that may contribute to their disease associations. We found that acne-associated P. acnes phylotypes induced 2- to 3-fold higher levels of IFN-γ and IL-17 in peripheral blood mononuclear cells compared with healthy phylotypes. On the other hand, P. acnes phylotypes associated with healthy skin induced 2- to 4-fold higher levels of IL-10. Comparative proteomic analysis of P. acnes phylotypes revealed a differential expression of several proteins, including an adhesion protein that was expressed at least 10-fold higher in acne-associated phylotypes and a cell surface hydrolase expressed in all phylotypes except those associated with healthy skin. Taken together, our data provide insight into how specific P. acnes phylotypes influence immune responses and the pathogenesis of acne.
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Affiliation(s)
- Yang Yu
- Division of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Jackson Champer
- Division of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - George W Agak
- Division of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Stephanie Kao
- Division of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Robert L Modlin
- Division of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Department of Microbiology, Immunology and Molecular Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Jenny Kim
- Division of Dermatology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
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114
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Al-Hammadi A, Al-Ismaily A, Al-Ali S, Ramadurai R, Jain R, McKinley-Grant L, Mughal TI. Topical, Biological and Clinical Challenges in the Management of Patients with Acne Vulgaris. Sultan Qaboos Univ Med J 2016; 16:e152-60. [PMID: 27226905 DOI: 10.18295/squmj.2016.16.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 07/02/2015] [Accepted: 01/18/2016] [Indexed: 11/16/2022] Open
Abstract
Acne vulgaris is one of the most common chronic inflammatory skin disorders among adolescents and young adults. It is associated with substantial morbidity and, rarely, with mortality. The exact worldwide incidence and prevalence are currently unknown. Current challenges involve improving understanding of the underlying pathophysiology of acne vulgaris and developing a practical treatment consensus. Expert panel discussions were held in 2013 and 2014 among a group of scientists and clinicians from the Omani and United Arab Emirate Dermatology Societies to ascertain the current optimal management of acne vulgaris, identify clinically relevant end-points and construct suitable methodology for future clinical trial designs. This article reviews the discussions of these sessions and recent literature on this topic.
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Affiliation(s)
- Anwar Al-Hammadi
- Department of Dermatology, Rashid Hospital, Dubai, United Arab Emirates
| | | | - Sameer Al-Ali
- Department of Dermatology, Abu Dhabi Dermatology Clinic, Abu Dhabi, United Arab Emirates
| | - Rajesh Ramadurai
- Department of Clinical & Medical Affairs, Glenmark Pharmaceuticals Private Ltd., Mumbai, India
| | - Rishi Jain
- Department of Clinical & Medical Affairs, Glenmark Pharmaceuticals Private Ltd., Mumbai, India
| | - Lynn McKinley-Grant
- Department of Dermatology, George Washington University Hospital, Washington D.C., USA
| | - Tariq I Mughal
- Department of Hematology & Oncology, Tufts University Medical Center, Boston, Massachusetts, USA
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115
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Assessment of serum levels of cathelicidin and vitamin D in acne vulgaris. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2016. [DOI: 10.1097/01.ewx.0000480714.99599.84] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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116
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Tan JKL, Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol 2016; 172 Suppl 1:3-12. [PMID: 25597339 DOI: 10.1111/bjd.13462] [Citation(s) in RCA: 281] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2014] [Indexed: 12/15/2022]
Abstract
Acne is estimated to affect 9.4% of the global population, making it the eighth most prevalent disease worldwide. Epidemiological studies have demonstrated that acne is most common in postpubescent teens, with boys most frequently affected, particularly with more severe forms of the disease. This paper aims to provide an update on the epidemiology of acne worldwide. Recent general and institutional studies from around the world have shown that the prevalence of acne is broadly consistent globally (with the exception of specific populations, which are discussed). However, this review highlights that there is a wide range of disparate outcome measures being applied in epidemiology studies, and we emphasize the need to develop a widely accepted, credible, standard assessment scale to address this in the future. In addition we discuss special populations, such as those devoid of acne, as well as the impact of potential determinants of acne on disease epidemiology.
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Affiliation(s)
- J K L Tan
- Windsor Clinical Research Inc. and Western University, London, ON, Canada
| | - K Bhate
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
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117
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Suh DH, Kwon HH. What's new in the physiopathology of acne? Br J Dermatol 2016; 172 Suppl 1:13-9. [PMID: 25645151 DOI: 10.1111/bjd.13634] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2014] [Indexed: 12/25/2022]
Abstract
There are four central factors that contribute to acne physiopathology: the inflammatory response, colonization with Propionibacterium acnes, increased sebum production and hypercornification of the pilosebaceous duct. In addition, research in the areas of diet and nutrition, genetics and oxidative stress is also yielding some interesting insights into the development of acne. In this paper we review some of the most recent research and novel concepts revealed in this work, which has been published by researchers from diverse academic disciplines including dermatology, immunology, microbiology and endocrinology. We discuss the implications of their findings (particularly in terms of opportunities to develop new therapies), highlight interrelationships between these novel factors that could contribute to the pathology of acne, and indicate where gaps in our understanding still exist.
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Affiliation(s)
- D H Suh
- Department of Dermatology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - H H Kwon
- Department of Dermatology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, South Korea
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118
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Gollnick HPM. From new findings in acne pathogenesis to new approaches in treatment. J Eur Acad Dermatol Venereol 2016; 29 Suppl 5:1-7. [PMID: 26059819 DOI: 10.1111/jdv.13186] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/14/2015] [Indexed: 01/01/2023]
Abstract
Acne is a chronic disease of the pilosebaceous unit which is most common during adolescence. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, in order to effectively and rapidly reduce acne lesions, treatments need to address as many of these underlying factors as possible. Currently, about half of patients have poor adherence to acne treatments. To overcome this limitation, treatments need to be developed which are well tolerated by patients, and easy for them to use, handle and apply. Topical monotherapies for acne such as retinoids and antimicrobials by themselves have a restricted range of actions against the pathogenic factors of acne. Instead, the Global Alliance to Improve Outcomes in Acne Group recommends combination therapy with a topical retinoid and an antimicrobial agent as the preferred approach for almost all acne patients. The principal advantage of such combinations is that they target more of the underlying pathogenic factors of acne than individual monotherapies and this results in faster and more complete clearing of acne lesions. Fixed-dose combinations are also more convenient than applying two medications separately, which leads to improved adherence with the regimen. By normalizing desquamation, the retinoid component of these combinations allows entry of the antimicrobial agent into the pilosebaceous unit resulting in faster clearance of P. acnes. In conclusion, topical retinoid/antimicrobial fixed-dose combinations represent a rational approach for the treatment of acne. They should be considered as the cornerstone of acne management and should be used much more in the future.
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Affiliation(s)
- H P M Gollnick
- Department of Dermatology & Venereology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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119
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Kelhälä HL, Fyhrquist N, Palatsi R, Lehtimäki S, Väyrynen JP, Kubin ME, Kallioinen M, Alenius H, Tasanen K, Lauerma A. Isotretinoin treatment reduces acne lesions but not directly lesional acne inflammation. Exp Dermatol 2016; 25:477-8. [PMID: 26845242 DOI: 10.1111/exd.12971] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Hanna-Leena Kelhälä
- PEDEGO Research Center, Department of Dermatology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - Nanna Fyhrquist
- Unit for Immunotoxicology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Riitta Palatsi
- PEDEGO Research Center, Department of Dermatology, University of Oulu, Oulu, Finland
| | - Sari Lehtimäki
- Department of Dermatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Juha P Väyrynen
- Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland.,Department of Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Minna E Kubin
- PEDEGO Research Center, Department of Dermatology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - Matti Kallioinen
- Department of Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Harri Alenius
- Unit for Immunotoxicology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kaisa Tasanen
- PEDEGO Research Center, Department of Dermatology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, Oulu, Finland
| | - Antti Lauerma
- Department of Dermatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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120
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Araviiskaia E, Dréno B. The role of topical dermocosmetics in acne vulgaris. J Eur Acad Dermatol Venereol 2016; 30:926-35. [PMID: 26916232 DOI: 10.1111/jdv.13579] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/27/2015] [Indexed: 12/26/2022]
Abstract
Acne is a common chronic inflammatory disease and treatment modalities based on acne severity are well established. The role of dermocosmetics in dermatology, and in particular acne, is becoming more important as more research elucidates the mechanisms of action of products in the pathogenesis of acne. Dermocosmetics have the potential to be used as monotherapy or in combination with medical treatment. Therefore, it has become important for dermatologists to understand dermocosmetics to effectively and appropriately advise patients on their use. The objective of this review was to provide new insights into the role of traditional and novel ingredients in dermocosmetics for the treatment of acne, based on the authors' objective assessment of the published literature. The type of products discussed include: those which have a sebostatic effect, such as topical antioxidants and niacinamide; agents targeting abnormal keratinization, such as salicylic acid, lipo-hydroxy acid, alpha-hydroxy acids, retinol-based products and linoleic acid; agents targeting Propionibacterium acnes, such as lauric acid; and anti-inflammatory agents such as nicotinamide, alpha-linolenic acid and zinc salts. Despite the scientific advances in understanding these cosmetic ingredients, there still remains a lack of rigorous controlled studies in this area.
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Affiliation(s)
- E Araviiskaia
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - B Dréno
- Department of DermatoCancerology, Nantes University, Nantes, France
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Plasmacytoid dendritic cells and memory T cells infiltrate true sequestrations stronger than subligamentous sequestrations: evidence from flow cytometric analysis of disc infiltrates. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:1417-1427. [PMID: 26906170 DOI: 10.1007/s00586-015-4325-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE Herniated nucleus pulposus has been considered to induce an adaptive immune response. Antigen recognition by antigen-presenting-cells (APCs) represents an important step within manifestation of an adaptive immune response. Macrophages have been assumed to function as APC, while importance of plasmacytoid dendritic cells for initiation of an immune response directed towards herniated nucleus pulposus has never been examined. The aim of the present study was to assess importance of plasmacytoid dendritic cells for initiation of immune response directed towards herniated discs. METHODS Fifteen patients with true sequestrations and three patients with subligamentous sequestrations underwent surgery after their neurological examinations. Disc material was harvested, weighted and digested for 90 min. Separated single cells were counted, stained for plasmacytoid dendritic cells (CD123(+)CD4(+)), macrophages (CD14(+)CD11c(+)) and memory T cells (CD4(+)CD45RO(+)) and analysed by flow cytometry. Both patient groups were compared in cell proportions. Furthermore, patients with true sequestrations (TRUE patients) were subdivided into subgroups based on severity of muscle weakness and results in straight leg raising (SLR) test. Subgroups were compared in cell proportions. RESULTS Plasmacytoid dendritic cells and memory T cells infiltrated true sequestrations stronger than the subligamentous sequestration and plasmacytoid dendritic cells predominated over macrophages in true sequestrations. Highest proportions of plasmacytoid dendritic cells were detected in infiltrates of patients having true sequestrations, severe muscle weakness and negative result in SLR test. CONCLUSIONS The findings of the present study indicate that plasmacytoid dendritic cells are involved in initiation of an immune response directed towards herniated nucleus pulposus, while macrophages may reinforce the manifested immune response and mediate disc resorption.
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Toossi P, Azizian Z, Yavari H, Fakhim TH, Amini SHS, Enamzade R. Serum 25-hydroxy vitamin D levels in patients with acne vulgaris and its association with disease severity. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2016; 12:238-42. [PMID: 26811702 DOI: 10.11138/ccmbm/2015.12.3.238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since vitamin D is a recent known immunoregulatory factor in some diseases which are addressed in immune system disorders such as SLE, [psoriasis] and others. OBJECTIVE To determine the serum levels of 25-hydroxy vitamin D3 [25(OH)D] in patients with acne vulgaris and its association with clinical features. METHODS This cross-sectional study was conducted over months. This study included 39 patients with acne vulgaris and 40 healthy controls. Subjects who did not use alcohol, vitamin D supplements, oral steroids or PUVA and/or NBUVB for more than three months were included. Serum 25(OH)D levels were measured. Baseline demographics, family history and comorbidities like PCO were recorded. Statistical analyses were performed using SPSS 16.0.0. RESULTS The median concentration of 25(OH)D was 8.4 ng/mL (range: 1.4-99) in patients and 10.4 ng/mL (range: 3.1-56.7) in controls, with no statistical significant difference. PCOS was a significant predictor of the occurrence of acne vulgaris (OR=6.25; 95% CI: 1.52-25.66; p=0.01). There were no significant associations between severity of disease and serum 25(OH)D levels (rs=-0.12, p=0.45), age (rs=-0.28, p=0.09), BMI (rs=-0.12, p=0.46), age at onset of disease (rs=-0.08, p=0.63) and duration of disease (rs=-0.10, p=0.54). CONCLUSION Based on the previous studies this is highly suspected that vitamin D would be a prominent factor in acne patients and more performances with bigger sample size could be useful to get positive results.
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Affiliation(s)
- Parviz Toossi
- Professor of dermatology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Azizian
- Resident of Dermatology, Rasoul-e-akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Yavari
- Young Researchers Club, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | | | | | - Ramin Enamzade
- Dermatologist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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123
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Mostafa WZ, Hegazy RA. Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res 2015; 6:793-804. [PMID: 26644915 PMCID: PMC4642156 DOI: 10.1016/j.jare.2014.01.011] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 01/29/2014] [Accepted: 01/30/2014] [Indexed: 12/19/2022] Open
Abstract
The "sunshine" vitamin is a hot topic that attracted ample attention over the past decades, specially that a considerable proportion of the worldwide population are deficient in this essential nutrient. Vitamin D was primarily acknowledged for its importance in bone formation, however; increasing evidence point to its interference with the proper function of nearly every tissue in our bodies including brain, heart, muscles, immune system and skin. Thereby its deficiency has been incriminated in a long panel of diseases including cancers, autoimmune diseases, cardiovascular and neurological disorders. Its involvement in the pathogenesis of different dermatological diseases is no exception and has been the subject of much research over the recent years. In the current review, we will throw light on this highly disputed vitamin that is creating a significant concern from a dermatological perspective. Furthermore, the consequences of its deficiency on the skin will be in focus.
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Affiliation(s)
- Wedad Z. Mostafa
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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124
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Kadler BK, Mehta SS, Funk L. Propionibacterium acnes infection after shoulder surgery. INTERNATIONAL JOURNAL OF SHOULDER SURGERY 2015; 9:139-44. [PMID: 26622132 PMCID: PMC4640005 DOI: 10.4103/0973-6042.167957] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Propionibacterium acnes has been implicated as a cause of infection following shoulder surgery, may occur up to 2 years after the index operation and has been shown to be responsible for up to 56% of shoulder infections after orthopedic implant. Male patients within the population undergoing shoulder surgery are particularly at risk, especially if their shoulder surgery involved prosthesis or was posttraumatic. P. acnes infection can be difficult to diagnose clinically and laboratory techniques require prolonged and specialized cultures. Usual inflammatory markers are not raised in infection with this low virulence organism. Delayed diagnosis with P. acnes infection can result in significant morbidity prior to prosthesis failure. Early diagnosis of P. acnes infection and appropriate treatment can improve clinical outcomes. It is important to be aware of P. acnes infection in shoulder surgery, to evaluate risk factors, to recognize the signs of P. acnes infection, and to promptly initiate treatment. The signs and symptoms of P. acnes infection are described and discussed. Data were collected from PubMed™, Web of Science, and the NICE Evidence Healthcare Databases - AMED (Ovid), BNI (Ovid), CINAHL (EBSCO), Embase (Ovid), HMIC: DH-Data and Kings Fund (Ovid), Medline (Ovid), and PsycINFO (Ovid). The search terms used were "P. acnes," "infection," "shoulder," and "surgery." In this review, we summarize the current understanding of the prevention and management of P. acnes infection following shoulder surgery.
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Affiliation(s)
- Benjamin K. Kadler
- Faculty of Medicine and Human Sciences, University of Manchester, Manchester, UK
| | - Saurabh S. Mehta
- Upper Limb Unit, Wrightington Hospital, Appley Bridge, WN6 9EP, UK
| | - Lennard Funk
- Upper Limb Unit, Wrightington Hospital, Appley Bridge, WN6 9EP, UK
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125
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Abstract
Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.
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126
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Kwon HH, Yoon JY, Park SY, Min S, Kim YI, Park JY, Lee YS, Thiboutot DM, Suh DH. Activity-Guided Purification Identifies Lupeol, a Pentacyclic Triterpene, As a Therapeutic Agent Multiple Pathogenic Factors of Acne. J Invest Dermatol 2015; 135:1491-1500. [DOI: 10.1038/jid.2015.29] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 01/12/2015] [Accepted: 01/21/2015] [Indexed: 12/25/2022]
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Buhl T, Sulk M, Nowak P, Buddenkotte J, McDonald I, Aubert J, Carlavan I, Déret S, Reiniche P, Rivier M, Voegel JJ, Steinhoff M. Molecular and Morphological Characterization of Inflammatory Infiltrate in Rosacea Reveals Activation of Th1/Th17 Pathways. J Invest Dermatol 2015; 135:2198-2208. [PMID: 25848978 DOI: 10.1038/jid.2015.141] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/11/2015] [Accepted: 03/18/2015] [Indexed: 02/07/2023]
Abstract
Rosacea is a common chronic inflammatory skin disease of unknown etiology. Our knowledge about an involvement of the adaptive immune system is very limited. We performed detailed transcriptome analysis, quantitative real-time reverse-transcriptase-PCR, and quantitative immunohistochemistry on facial biopsies of rosacea patients, classified according to their clinical subtype. As controls, we used samples from patients with facial lupus erythematosus and healthy controls. Our study shows significant activation of the immune system in all subtypes of rosacea, characterizing erythematotelangiectatic rosacea (ETR) already as a disease with significant influx of proinflammatory cells. The T-cell response is dominated by Th1/Th17-polarized immune cells, as demonstrated by significant upregulation of IFN-γ or IL-17, for example. Chemokine expression patterns support a Th1/Th17 polarization profile of the T-cell response. Macrophages and mast cells are increased in all three subtypes of rosacea, whereas neutrophils reach a maximum in papulopustular rosacea. Our studies also provide evidence for the activation of plasma cells with significant antibody production already in ETR, followed by a crescendo pattern toward phymatous rosacea. In sum, Th1/Th17 polarized inflammation and macrophage infiltration are an underestimated hallmark in all subtypes of rosacea. Therapies directly targeting the Th1/Th17 pathway are promising candidates in the future treatment of this skin disease.
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Affiliation(s)
- Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany; Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland; Department of Dermatology and Surgery, University of California, San Francisco, California, USA
| | - Mathias Sulk
- Department of Dermatology and Surgery, University of California, San Francisco, California, USA; Department of Dermatology, University of Münster, Münster, Germany
| | - Pawel Nowak
- Department of Dermatology, University of Münster, Münster, Germany
| | - Jörg Buddenkotte
- Department of Dermatology, University of Münster, Münster, Germany
| | - Ian McDonald
- Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| | - Jérôme Aubert
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Isabelle Carlavan
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Sophie Déret
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Pascale Reiniche
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Michel Rivier
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Johannes J Voegel
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France.
| | - Martin Steinhoff
- Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland; Department of Dermatology and Surgery, University of California, San Francisco, California, USA; Department of Dermatology, University of San Diego, USA.
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128
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SanMiguel A, Grice EA. Interactions between host factors and the skin microbiome. Cell Mol Life Sci 2015; 72:1499-515. [PMID: 25548803 PMCID: PMC4376244 DOI: 10.1007/s00018-014-1812-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/15/2014] [Accepted: 12/19/2014] [Indexed: 01/12/2023]
Abstract
The skin is colonized by an assemblage of microorganisms which, for the most part, peacefully coexist with their hosts. In some cases, these communities also provide vital functions to cutaneous health through the modulation of host factors. Recent studies have illuminated the role of anatomical skin site, gender, age, and the immune system in shaping the cutaneous ecosystem. Alterations to microbial communities have also been associated with, and likely contribute to, a number of cutaneous disorders. This review focuses on the host factors that shape and maintain skin microbial communities, and the reciprocal role of microbes in modulating skin immunity. A greater understanding of these interactions is critical to elucidating the forces that shape cutaneous populations and their contributions to skin homeostasis. This knowledge can also inform the tendency of perturbations to predispose and/or bring about certain skin disorders.
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Affiliation(s)
- Adam SanMiguel
- Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, 421 Curie Blvd, 1007 Biomedical Research Building II/III, Philadelphia, PA 19104 USA
| | - Elizabeth A. Grice
- Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, 421 Curie Blvd, 1007 Biomedical Research Building II/III, Philadelphia, PA 19104 USA
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129
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Pentobra: A Potent Antibiotic with Multiple Layers of Selective Antimicrobial Mechanisms against Propionibacterium Acnes. J Invest Dermatol 2015; 135:1581-1589. [PMID: 25668237 PMCID: PMC4430421 DOI: 10.1038/jid.2015.40] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 01/21/2014] [Accepted: 01/26/2015] [Indexed: 02/08/2023]
Abstract
Although antibiotics are a common treatment for acne, the difficulties inherent to effective antimicrobial penetration in sebum and selective antimicrobial action in skin are compounded by increasing resistance of Propionibacterium acnes clinical isolates. To address these problems, we engineered Pentobra, a peptide-aminoglycoside molecule which has multiple mechanisms of antibacterial action, and investigated whether it can be a potential candidate for the treatment of acne. Pentobra combines the potent ribosomal activity of aminoglycosides with the bacteria-selective membrane-permeabilizing abilities of antimicrobial peptides (AMPs). Pentobra demonstrated potent and selective killing of P. acnes, but not against human skin cells in vitro. In direct comparison, Pentobra demonstrated bactericidal activity and drastically outperformed free tobramycin (by 5–7 logs) against multiple P. acnes clinical strains. Moreover, EM studies showed that Pentobra had robust membrane activity, as treatment with Pentobra killed P. acnes cells and caused leakage of intracellular contents. Pentobra may also have potential anti-inflammatory effects as demonstrated by suppression of some P. acnes-induced chemokines. Importantly, the killing activity was maintained in sebaceous environments as Pentobra was bactericidal against clinical isolates in comedones extracts isolated from human donors. Our work demonstrates that equipping aminoglycosides with selective membrane activity is a viable approach for developing antibiotics against P. acnes that are effective in cutaneous environments.
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130
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Tilles G. Acne Pathogenesis: History of Concepts. Dermatology 2014; 229:1-46. [DOI: 10.1159/000364860] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/23/2014] [Indexed: 11/19/2022] Open
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131
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Abstract
The mechanisms of inflammation in acne are currently subject of intense investigation. This study focused on the activation of adaptive and innate immunity in clinically early visible inflamed acne lesions and was performed in two independent patient populations. Biopsies were collected from lesional and non-lesional skin of acne patients. Using Affymetrix Genechips, we observed significant elevation of the signature cytokines of the Th17 lineage in acne lesions compared to non-lesional skin. The increased expression of IL-17 was confirmed at the RNA and also protein level with real-time PCR (RT-PCR) and Luminex technology. Cytokines involved in Th17 lineage differentiation (IL-1β, IL-6, TGF-β, IL23p19) were remarkably induced at the RNA level. In addition, proinflammatory cytokines and chemokines (TNF-α, IL-8, CSF2 and CCL20), Th1 markers (IL12p40, CXCR3, T-bet, IFN-γ), T regulatory cell markers (Foxp3, IL-10, TGF-β) and IL-17 related antimicrobial peptides (S100A7, S100A9, lipocalin, hBD2, hBD3, hCAP18) were induced. Importantly, immunohistochemistry revealed significantly increased numbers of IL-17A positive T cells and CD83 dendritic cells in the acne lesions. In summary our results demonstrate the presence of IL-17A positive T cells and the activation of Th17-related cytokines in acne lesions, indicating that the Th17 pathway is activated and may play a pivotal role in the disease process, possibly offering new targets of therapy.
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132
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Garzorz N, Papanagiotou V, Atenhan A, Andres C, Eyerich S, Eyerich K, Ring J, Brockow K. Pyoderma gangrenosum, acne, psoriasis, arthritis and suppurative hidradenitis (PAPASH)-syndrome: a new entity within the spectrum of autoinflammatory syndromes? J Eur Acad Dermatol Venereol 2014; 30:141-3. [PMID: 25070077 DOI: 10.1111/jdv.12631] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/10/2014] [Indexed: 12/28/2022]
Affiliation(s)
- N Garzorz
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
| | - V Papanagiotou
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
| | - A Atenhan
- ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - C Andres
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
| | - S Eyerich
- ZAUM - Center of Allergy and Environment, Technische Universität and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
| | - J Ring
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
| | - K Brockow
- Department of Dermatology and Allergy, Technische Universität Munich, Munich, Germany
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Kistowska M, Meier B, Proust T, Feldmeyer L, Cozzio A, Kuendig T, Contassot E, French LE. Propionibacterium acnes promotes Th17 and Th17/Th1 responses in acne patients. J Invest Dermatol 2014; 135:110-118. [PMID: 25010142 DOI: 10.1038/jid.2014.290] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/27/2014] [Accepted: 06/04/2014] [Indexed: 12/12/2022]
Abstract
Propionibacterium acnes is a Gram-positive commensal bacterium thought to be involved in the pathogenesis of acne vulgaris. Although the ability of P. acnes in the initiation of pro-inflammatory responses is well documented, little is known about adaptive immune responses to this bacterium. The observation that infiltrating immune cells consist mainly of CD4(+) T cells in the perifollicular space of early acne lesions suggests that helper T cells may be involved in immune responses caused by the intra-follicular colonization of P. acnes. A recent report showing that P. acnes can induce IL-17 production by T cells suggests that acne might be a T helper type 17 (Th17)-mediated disease. In line with this, we show in this work that, in addition to IL-17A, both Th1 and Th17 effector cytokines, transcription factors, and chemokine receptors are strongly upregulated in acne lesions. Furthermore, we found that, in addition to Th17, P. acnes can promote mixed Th17/Th1 responses by inducing the concomitant secretion of IL-17A and IFN-γ from specific CD4(+) T cells in vitro. Finally, we show that both P. acnes-specific Th17 and Th17/Th1 cells can be found in the peripheral blood of patients suffering from acne and, at lower frequencies, in healthy individuals. We therefore identified P. acnes-responding Th17/Th1 cells as, to our knowledge, a previously unreported CD4(+) subpopulation involved in inflammatory acne.
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Affiliation(s)
| | - Barbara Meier
- Department of Dermatology, University Hospital, Zürich, Switzerland
| | - Tatiana Proust
- Department of Dermatology, University Hospital, Zürich, Switzerland
| | - Laurence Feldmeyer
- Department of Dermatology and Venereology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Antonio Cozzio
- Department of Dermatology, University Hospital, Zürich, Switzerland
| | - Thomas Kuendig
- Department of Dermatology, University Hospital, Zürich, Switzerland
| | | | - Lars E French
- Department of Dermatology, University Hospital, Zürich, Switzerland.
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134
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Could adult female acne be associated with modern life? Arch Dermatol Res 2014; 306:683-8. [DOI: 10.1007/s00403-014-1482-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 05/19/2014] [Accepted: 05/22/2014] [Indexed: 11/25/2022]
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135
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Abstract
Recent advances in our understanding of inflammatory skin diseases now afford an opportunity to delve deeper into microbial/host interactions in acne. Agak et al. report that Propionibacterium acnes induces IL-17 expression in peripheral blood mononuclear cells and present new evidence that IL-17+ cells are found in the perifollicular infiltrate of comedones. Additional studies are needed to assess the clinical relevance of IL-17 in acne.
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