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Gharamti AA, Kanafani ZA. Cutibacterium (formerly Propionibacterium) acnes infections associated with implantable devices. Expert Rev Anti Infect Ther 2017; 15:1083-1094. [PMID: 29125405 DOI: 10.1080/14787210.2017.1404452] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Cutibacterium acnes (C. acnes), a Gram-positive biofilm-forming rod implicated in acne vulgaris, is increasingly recognized for its role in implant-associated infections. The diagnosis of C. acnes implant-associated infections remains challenging. The optimal treatment is a combination of both surgical intervention and antibiotic therapy. Areas covered: In this review, we discuss the different types of implant-associated infections caused by C. acnes. We also highlight the clinical manifestations pertaining to the various sites of infection, and identify several risk factors previously reported in the literature. We then cover the diagnostic laboratory markers, such as IL-6 and AD-1, optimizing C. acnes recovery in culture, and the specific molecular techniques. Finally, we examine the various effective antibiotic regimens and identify some preventive methods against C. acnes infections. Expert commentary: Biomarkers such as IL-6 and AD-1 should be further investigated for the diagnosis of C. acnes implant-associated infections. The use of 16S rRNA gene sequencing and other molecular techniques should be further explored in this setting. Longer incubation periods should be requested whenever C. acnes infection is suspected. If the clinical suspicion is high, sonication of the excised implant should be encouraged. Research should focus on developing effective anti-biofilm agents. Finally, preventive methods such as hair removal prior to surgery should be further explored.
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Affiliation(s)
- Amal A Gharamti
- a Division of Infectious Diseases, Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon
| | - Zeina A Kanafani
- a Division of Infectious Diseases, Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon
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102
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Davidsson S, Carlsson J, Mölling P, Gashi N, Andrén O, Andersson SO, Brzuszkiewicz E, Poehlein A, Al-Zeer MA, Brinkmann V, Scavenius C, Nazipi S, Söderquist B, Brüggemann H. Prevalence of Flp Pili-Encoding Plasmids in Cutibacterium acnes Isolates Obtained from Prostatic Tissue. Front Microbiol 2017; 8:2241. [PMID: 29201018 PMCID: PMC5696575 DOI: 10.3389/fmicb.2017.02241] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/31/2017] [Indexed: 12/14/2022] Open
Abstract
Inflammation is one of the hallmarks of prostate cancer. The origin of inflammation is unknown, but microbial infections are suspected to play a role. In previous studies, the Gram-positive, low virulent bacterium Cutibacterium (formerly Propionibacterium) acnes was frequently isolated from prostatic tissue. It is unclear if the presence of the bacterium represents a true infection or a contamination. Here we investigated Cutibacterium acnes type II, also called subspecies defendens, which is the most prevalent type among prostatic C. acnes isolates. Genome sequencing of type II isolates identified large plasmids in several genomes. The plasmids are highly similar to previously identified linear plasmids of type I C. acnes strains associated with acne vulgaris. A PCR-based analysis revealed that 28.4% (21 out of 74) of all type II strains isolated from cancerous prostates carry a plasmid. The plasmid shows signatures for conjugative transfer. In addition, it contains a gene locus for tight adherence (tad) that is predicted to encode adhesive Flp (fimbrial low-molecular weight protein) pili. In subsequent experiments a tad locus-encoded putative pilin subunit was identified in the surface-exposed protein fraction of plasmid-positive C. acnes type II strains by mass spectrometry, indicating that the tad locus is functional. Additional plasmid-encoded proteins were detected in the secreted protein fraction, including two signal peptide-harboring proteins; the corresponding genes are specific for type II C. acnes, thus lacking from plasmid-positive type I C. acnes strains. Further support for the presence of Flp pili in C. acnes type II was provided by electron microscopy, revealing cell appendages in tad locus-positive strains. Our study provides new insight in the most prevalent prostatic subspecies of C. acnes, subsp. defendens, and indicates the existence of Flp pili in plasmid-positive strains. Such pili may support colonization and persistent infection of human prostates by C. acnes.
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Affiliation(s)
- Sabina Davidsson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jessica Carlsson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Paula Mölling
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Natyra Gashi
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ove Andrén
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Swen-Olof Andersson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elzbieta Brzuszkiewicz
- Department of Genomic and Applied Microbiology, Institute of Microbiology and Genetics, University of Göttingen, Göttingen, Germany
| | - Anja Poehlein
- Department of Genomic and Applied Microbiology, Institute of Microbiology and Genetics, University of Göttingen, Göttingen, Germany
| | - Munir A Al-Zeer
- Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Volker Brinkmann
- Microscopy Core Facility, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Carsten Scavenius
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark
| | - Seven Nazipi
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bo Söderquist
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Gollnick H, Abanmi A, Al-Enezi M, Al Hammadi A, Galadari I, Kibbi AG, Zimmo S. Managing acne in the Middle East: consensus recommendations. J Eur Acad Dermatol Venereol 2017; 31 Suppl 7:4-35. [DOI: 10.1111/jdv.14491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- H. Gollnick
- Universitätsklinik für Dermatologie und Venerologie; Otto-von-Guericke Universität; Magdeburg Germany
| | - A.A. Abanmi
- Dr Sulaiman Al Habib Hospital; Riyadh Saudi Arabia
| | | | | | - I. Galadari
- Faculty of Medicine; United Arab Emirates University; Dubai UAE
| | - A.-G. Kibbi
- American University of Beirut Medical Center; Beirut Lebanon
| | - S. Zimmo
- King Abdulaziz University; Jeddah Saudi Arabia
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104
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Agak GW, Kao S, Ouyang K, Qin M, Moon D, Butt A, Kim J. Phenotype and Antimicrobial Activity of Th17 Cells Induced by Propionibacterium acnes Strains Associated with Healthy and Acne Skin. J Invest Dermatol 2017; 138:316-324. [PMID: 28864077 DOI: 10.1016/j.jid.2017.07.842] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/14/2017] [Accepted: 07/26/2017] [Indexed: 12/13/2022]
Abstract
Studies of the human skin microbiome suggest that Propionibacterium acnes strains may contribute differently to skin health and disease. However, the immune phenotype and functions of T helper type 17 (Th17) cells induced by healthy (PH) versus acne (PA) skin-associated P. acnes strains are currently unknown. We stimulated peripheral blood mononuclear cells from healthy donors and observed that PA strains induce higher IL-17 levels than PH strains. We next generated PH and PA strain-specific Th17 clones and show that P. acnes strains induce Th17 cells of varied phenotype and function that are stable in the presence of IL-2 and IL-23. Although PH- and PA-specific clones expressed similar levels of LL-37 and DEFB4, only PH-specific clones secreted molecules sufficient to kill P. acnes. Furthermore, electron microscopic studies showed that supernatants derived from activated PH and not PA-specific clones exhibited robust bactericidal activity against P. acnes, and complete breaches in the bacterial cell envelope were observed. This antimicrobial activity was independent of IL-26, because both natural IL-26 released by Th17 clones and rhIL-26 lacked antimicrobial potency against P. acnes. Overall, our data suggest that P. acnes strains may differentially modulate the CD4+ T-cell responses, leading to the generation of Th17 cells that may contribute to either homeostasis or acne pathogenesis.
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Affiliation(s)
- George W Agak
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
| | - Stephanie Kao
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kelsey Ouyang
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Min Qin
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - David Moon
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Ahsan Butt
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jenny Kim
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA; California NanoSystems Institute, University of California, Los Angeles, California, USA
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105
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Abstract
BACKGROUND To some degree, acne vulgaris affects nearly every individual worldwide. Oral antibiotic therapy is routinely prescribed for the treatment of moderate to severe inflammatory acne; however, long-term use of oral antibiotics for acne may have unintended consequences. OBJECTIVE The aim of this study was to provide a systematic evaluation of the scientific evidence on the efficacy and appropriate use of oral antibiotics in the treatment of acne. METHODS A systematic search of MEDLINE was conducted to identify randomized controlled clinical trials, systematic reviews, and meta-analyses evaluating the efficacy of oral antibiotics for acne. Overall, 41 articles that examined oral antibiotics compared with placebo, another oral therapy, topical therapy, alternate dose, or duration were included in this study. RESULTS Tetracyclines, macrolides, and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate to severe inflammatory acne. Superior efficacy of one type or class of antibiotic could not be determined, therefore the choice of antibiotic is generally based on the side-effect profile. Although different dosing regimens have been studied, there is a lack of standardized comparator trials to determine optimal dosing and duration of each oral antibiotic used in acne. The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone. CONCLUSION This article provides a systematic evaluation of the scientific evidence of the efficacy of oral antibiotics for acne. Due to heterogeneity in the design of the trials, there is insufficient evidence to support one type, dose, or duration of oral antibiotic over another in terms of efficacy; however, due to increasing resistance to antibiotics, dermatologists should heed consensus guidelines for their appropriate use.
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106
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107
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Gold MH, Goldberg DJ, Nestor MS. Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser. J Cosmet Dermatol 2017; 16:303-318. [PMID: 28703382 DOI: 10.1111/jocd.12367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.
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Affiliation(s)
| | - David J Goldberg
- Skin Laser and Surgery Specialists of NY and NJ, Hackensack, NJ, USA
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108
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Takoudju EM, Guillouzouic A, Kambarev S, Pecorari F, Corvec S. In vitro emergence of fluoroquinolone resistance in Cutibacterium (formerly Propionibacterium) acnes and molecular characterization of mutations in the gyrA gene. Anaerobe 2017; 47:194-200. [PMID: 28602804 DOI: 10.1016/j.anaerobe.2017.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
In vitro occurrence of levofloxacin (LVX) resistance in C. acnes and characterization of its molecular background were investigated. The mutation frequency was determined by inoculation of 108 cfu of C. acnes ATCC 11827 (LVX MIC = 0.25 mg/L) on LVX-containing agar plates. The progressive emergence of resistance was studied by a second exposure to increasing LVX concentrations. For mutants, the QRDR regions including the gyrA and parC genes were sequenced and compared to both C. acnes ATCC 11827 and C. acnes KPA171202 reference sequences (NC006085). The importance of the efflux pump system in resistance was investigated by using inhibitors on selected resistant mutants with no mutation in the QRDR. C. acnes growth was observed on LVX-containing plates with mutation frequencies of 3. 8 cfu × 10-8 (8 × MIC) and 1.6 cfu × 10-7 (4 × MIC). LVX resistance emerged progressively after one-step or two-step assays. In LVX-resistant isolates, the MIC ranged from 0.75 to >32 mg/L. Mutations were detected exclusively in the gyrA gene. Ten genotypes were identified: G99 C, G99 D, D100N, D100 H, D100 G, S101L, S101W, A102 P, D105 H and A105 G. Mutants S101L and S101W were always associated with a high level of resistance. Mutants with no mutation in the QRDR were more susceptible when incubated with an efflux pump inhibitor (phenyl-arginine β-naphthylamide) only, suggesting, for the first time, the expression of such a system in C. acnes LVX-resistant mutants.
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Affiliation(s)
- Eve-Marie Takoudju
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France
| | | | - Stanimir Kambarev
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Frédéric Pecorari
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France; Nantes Study Group Member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.
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109
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Tan H, Sonam T, Shimizu K. The Potential of Triterpenoids from Loquat Leaves (Eriobotrya japonica) for Prevention and Treatment of Skin Disorder. Int J Mol Sci 2017; 18:ijms18051030. [PMID: 28492484 PMCID: PMC5454942 DOI: 10.3390/ijms18051030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/05/2017] [Accepted: 05/06/2017] [Indexed: 12/24/2022] Open
Abstract
The leaves of loquat (Eriobotrya japonica) possess high medicinal value and have been used as traditional medicines. However, there are no evidence-based studies on the skin-care effects of E. japonica leaves. To explore new biological activities of E. japonica leaves against skin disorder and to gain a better understanding of the chemical components associated with bioactivities, we evaluated 18 triterpenoids from E. japonica leaves on anti-melanogenesis, anti-acne, anti-allergy and anti-aging activities. Our results revealed that eight compounds showed anti-melanogenesis activity, of which ursolic acid (1) and maslinic acid (7) were the most potent with the similar selective index to that of arbutin. Structure–activity relationship and possible mechanism of active compounds were proposed. Twelve compounds exhibited anti-acne effect; ursolic acid (1), maslinic acid (7), corosolic acid (8) and euscaphic acid (12) showed highest activities against P. acnes. Four compounds displayed anti-allergy and anti-inflammatory activity; 3-epicorosolic acid (9) and euscaphic acid (12) showed marked activity against β-hexosaminidase release. Finally, ursolic acid (1), pomolic acid (10), colosolic acid (8) and its methylated derivative (6) exhibited the highest anti-aging activity by stimulating collagen and hyaluronic acid (HA) production. Our findings provide valuable evidence that E. japonica leaves have potential applications as ingredients of function foods or cosmetics for health benefits and a number of triterpenoids may play an important role in these bioactivities.
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Affiliation(s)
- Hui Tan
- Department of Agro-environmental Sciences, Faculty of Agriculture, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan.
| | - Tamrakar Sonam
- Department of Agro-environmental Sciences, Faculty of Agriculture, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan.
| | - Kuniyoshi Shimizu
- Department of Agro-environmental Sciences, Faculty of Agriculture, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan.
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110
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Aubin GG, Lavigne JP, Foucher Y, Dellière S, Lepelletier D, Gouin F, Corvec S. Tropism and virulence of Cutibacterium (formerly Propionibacterium) acnes involved in implant-associated infection. Anaerobe 2017; 47:73-78. [PMID: 28454760 DOI: 10.1016/j.anaerobe.2017.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/14/2017] [Accepted: 04/20/2017] [Indexed: 11/28/2022]
Abstract
The recognition of the pathogenicity of Cutibacterium acnes in implant-associated infection is not always obvious. In this paper, we aimed to distinguish pathogenic and non-pathogenic C. acnes isolates. To reach this goal, we investigated the clonal complex (CC) of a large collection of C. acnes clinical isolates through Multi-Locus Sequence Typing (MLST), we established a Caenorhabditis elegans model to assess C. acnes virulence and we investigated the presence of virulence factors in our collection. Ours results showed that CC36 and CC53 C. acnes isolates were more frequently observed in prosthetic joint infections (PJI) than CC18 and CC28 C. acnes isolates (p = 0.021). The C. elegans model developed here showed two distinct virulence groups of C. acnes (p < 0.05). These groups were not correlated to CC or clinical origin. Whole genome sequencing allowed us to identify a putative gene linked to low virulent strains. In conclusion, MLST remains a good method to screen pathogenic C. acnes isolates according to their clinical context but mechanisms of C. acnes virulence need to be assess thought transcriptomic analysis to investigate regulatory process.
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Affiliation(s)
- Guillaume Ghislain Aubin
- EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections, IRS 2, Nantes University, Nantes, France; Bacteriology and Hygiene Unit, CHU Nantes, France
| | - Jean-Philippe Lavigne
- INSERM, U1047, University of Montpellier, Nîmes, France; Department of Microbiology, Caremeau University Hospital, Nîmes, France
| | - Yohan Foucher
- EA4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, IRS 2, 22 Bd Bénoni-Goullin, University of Nantes, Nantes, France
| | | | - Didier Lepelletier
- Bacteriology and Hygiene Unit, CHU Nantes, France; MiHAR Lab, IRS 2, 22 Bd Bénoni-Goullin, University of Nantes, Nantes, France
| | - François Gouin
- Clinique Chirurgicale orthopédique et traumatique, CHU Nantes, Nantes, France
| | - Stéphane Corvec
- Bacteriology and Hygiene Unit, CHU Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France.
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111
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Lomholt HB, Scholz CFP, Brüggemann H, Tettelin H, Kilian M. A comparative study of Cutibacterium (Propionibacterium) acnes clones from acne patients and healthy controls. Anaerobe 2017; 47:57-63. [PMID: 28434779 DOI: 10.1016/j.anaerobe.2017.04.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/22/2017] [Accepted: 04/14/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cutibacterium (Propionibacterium) acnes is assumed to play an important role in the pathogenesis of acne. OBJECTIVES To examine if clones with distinct virulence properties are associated with acne. METHODS Multiple C. acnes isolates from follicles and surface skin of patients with moderate to severe acne and healthy controls were characterized by multilocus sequence typing. To determine if CC18 isolates from acne patients differ from those of controls in the possession of virulence genes or lack of genes conducive to a harmonious coexistence the full genomes of dominating CC18 follicular clones from six patients and five controls were sequenced. RESULTS Individuals carried one to ten clones simultaneously. The dominating C. acnes clones in follicles from acne patients were exclusively from the phylogenetic clade I-1a and all belonged to clonal complex CC18 with the exception of one patient dominated by the worldwide-disseminated and often antibiotic resistant clone ST3. The clonal composition of healthy follicles showed a more heterogeneous pattern with follicles dominated by clones representing the phylogenetic clades I-1a, I-1b, I-2 and II. Comparison of follicular CC18 gene contents, allelic versions of putative virulence genes and their promoter regions, and 54 variable-length intragenic and inter-genic homopolymeric tracts showed extensive conservation and no difference associated with the clinical origin of isolates. CONCLUSIONS The study supports that C. acnes strains from clonal complex CC18 and the often antibiotic resistant clone ST3 are associated with acne and suggests that susceptibility of the host rather than differences within these clones may determine the clinical outcome of colonization.
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Affiliation(s)
- H B Lomholt
- Department of Biomedicine, Faculty of Health, Aarhus University, DK-8000 Aarhus, Denmark.
| | - C F P Scholz
- Department of Biomedicine, Faculty of Health, Aarhus University, DK-8000 Aarhus, Denmark
| | - H Brüggemann
- Department of Biomedicine, Faculty of Health, Aarhus University, DK-8000 Aarhus, Denmark
| | - H Tettelin
- Department of Microbiology and Immunology, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - M Kilian
- Department of Biomedicine, Faculty of Health, Aarhus University, DK-8000 Aarhus, Denmark
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112
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Gollnick HPM, Buer J, Beissert S, Sunderkätter C. Antibiotic stewardship: The need to reduce antibiotics in acne treatment. J Dtsch Dermatol Ges 2017. [DOI: 10.1111/ddg.13048_e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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113
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Bactericidal activity and post-antibiotic effect of ozenoxacin against Propionibacterium acnes. J Infect Chemother 2017; 23:374-380. [PMID: 28389164 DOI: 10.1016/j.jiac.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/21/2017] [Accepted: 03/06/2017] [Indexed: 01/20/2023]
Abstract
Ozenoxacin, a novel non-fluorinated topical quinolone, is used for the treatment of acne vulgaris in Japan. We investigated bactericidal activity and post-antibiotic effect (PAE) of ozenoxacin against Propionibacterium acnes, a major causative bacterium of acne vulgaris. The minimum inhibitory concentrations (MICs) of ozenoxacin against 3 levofloxacin-susceptible strains (MIC of levofloxacin; ≤4 μg/mL) and 3 levofloxacin-resistant strains (MIC of levofloxacin; ≥8 μg/mL) ranged from 0.03 to 0.06 μg/mL and from 0.25 to 0.5 μg/mL, respectively. These MICs of ozenoxacin were almost the same or lower than nadifloxacin and clindamycin. The minimum bactericidal concentrations (MBCs) of ozenoxacin against the levofloxacin-susceptible and -resistant strains were from 0.06 to 8 μg/mL and from 0.5 to 4 μg/mL, respectively. These MBCs were lower than those of nadifloxacin and clindamycin. In time-kill assay, ozenoxacin at 1/4, 1 and 4 times the respective MIC against both levofloxacin-susceptible and -resistant strains showed a concentration-dependent bactericidal activity. Ozenoxacin at 4 times the MICs against the levofloxacin-susceptible strains showed more potent and more rapid onset of bactericidal activity compared to nadifloxacin and clindamycin at 4 times the respective MICs. The PAEs of ozenoxacin at 4 times the MICs against the levofloxacin-susceptible strains were from 3.3 to 17.1 h, which were almost the same or longer than nadifloxacin and clindamycin. In contrast, the PAEs were hardly induced by any antimicrobial agents against the levofloxacin-resistant strains. The present findings suggest that ozenoxacin has a potent bactericidal activity against both levofloxacin-susceptible and -resistant P. acnes, and a long-lasting PAE against levofloxacin-susceptible P. acnes.
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114
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López-Estebaranz J, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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115
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Proteomic and transcriptomic investigation of acne vulgaris microcystic and papular lesions: Insights in the understanding of its pathophysiology. Biochim Biophys Acta Gen Subj 2017; 1861:652-663. [DOI: 10.1016/j.bbagen.2016.10.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/11/2016] [Accepted: 10/21/2016] [Indexed: 12/27/2022]
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116
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Interaction of Cutibacterium ( formerly Propionibacterium) acnes with bone cells: a step toward understanding bone and joint infection development. Sci Rep 2017; 7:42918. [PMID: 28218305 PMCID: PMC5317161 DOI: 10.1038/srep42918] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/16/2017] [Indexed: 12/22/2022] Open
Abstract
Cutibacterium acnes (formerly Propionibacterium acnes) is recognized as a pathogen in foreign-body infections (arthroplasty or spinal instrumentation). To date, the direct impact of C. acnes on bone cells has never been explored. The clade of 11 C. acnes clinical isolates was determined by MLST. Human osteoblasts and osteoclasts were infected by live C. acnes. The whole genome sequence of six isolates of this collection was analyzed. CC36 C. acnes strains were significantly less internalized by osteoblasts and osteoclasts than CC18 and CC28 C. acnes strains (p ≤ 0.05). The CC18 C. acnes ATCC6919 isolate could survive intracellularly for at least 96 hours. C. acnes significantly decreased the resorption ability of osteoclasts with a major impact by the CC36 strain (p ≤ 0.05). Genome analysis revealed 27 genes possibly linked to these phenotypic behaviors. We showed a direct impact of C. acnes on bone cells, providing new explanations about the development of C. acnes foreign-body infections.
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Abstract
Acne, one of the most common skin diseases, affects approximately 85% of the adolescent population, and occurs most prominently at skin sites with a high density of sebaceous glands such as the face, back, and chest. Although often considered a disease of teenagers, acne is occurring at an increasingly early age. Rosacea is a chronic facial inflammatory dermatosis characterized by flushing (or transient facial erythema), persistent central facial erythema, inflammatory papules/pustules, and telangiectasia. Both acne and rosacea have a multifactorial pathology that is incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and altered bacterial colonization with Propionibacterium acnes are considered to be the underlying disease mechanisms in acne, while the multifactorial pathology of rosacea is thought to involve both vasoactive and neurocutaneous mechanisms. Several advances have taken place in the past decade in the research field of acne and rosacea, encompassing pathogenesis and epidemiology, as well as the development of new therapeutic interventions. In this article, we provide an overview of current perspectives on the pathogenesis and treatment of acne and rosacea, including a summary of findings from recent landmark pathophysiology studies considered to have important implications for future clinical practice. The advancement of our knowledge of the different pathways and regulatory mechanisms underlying acne and rosacea is thought to lead to further advances in the therapeutic pipeline for both conditions, ultimately providing a greater array of treatments to address gaps in current management practices.
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Affiliation(s)
| | | | - Jerry Tan
- University of Western Ontario, Windsor, ON, Canada
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Ahmadi A, Farhadi E, Salimian J, Amani J. Designing a vaccine therapy candidate against Propionibacterium acnes: a bioinformatics approach. MOLECULAR GENETICS MICROBIOLOGY AND VIROLOGY 2017. [DOI: 10.3103/s0891416816030022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Antimicrobial activity of topical agents against Propionibacterium acnes: an in vitro study of clinical isolates from a hospital in Shanghai, China. Front Med 2016; 10:517-521. [DOI: 10.1007/s11684-016-0480-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/12/2016] [Indexed: 01/09/2023]
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Abstract
STUDY DESIGN Patients scheduled for spinal surgery were screened prospectively for a microbial presence associated with intervertebral disc specimens. Inclusion was limited to patients requiring surgery for any of five conditions: study patients with cervical spine intervertebral herniation (IVH), lumbar spine IVH, lumbar spine discogenic pain, and control patients with idiopathic scoliosis/Scheurermann's kyphosis or trauma/neuromuscular deformity. Exclusion criteria included ongoing systemic infection, abnormal pre-operative white cell counts, documented or suspected spinal infection, or previous surgery to the involved disc. OBJECTIVE The aim of this study was to test for an association between the presence of a bacterial entity in operated discs and a diagnosis of pathologic disc disease. SUMMARY OF BACKGROUND DATA An association has been described between microbial colonization and progressive intervertebral disc degeneration in 36 herniation patients undergoing microdiscectomies. A total of 19 patients had positive cultures on long-term incubation, with Propionibacterium acnes present in 84% of discs. MATERIALS AND METHODS Discs were harvested during surgery, using strict sterile technique. Each disc was divided, with half the sample sealed in a sterile, commercially prepared anaerobic culture transport container, and half fixed in formalin. Live specimens were cultured for bacteria at a university-affiliated laboratory in a blinded fashion. Fixed pathologic specimens were gram-stained and read by a board-certified pathologist. RESULTS A total of 169 intervertebral discs from 87 patients were evaluated (46 males, 41 females). Positive cultures were noted in 76 of 169 discs (45%), with 34 discs positive for P. acnes and 30 discs positive for Staphylococcus. No pathologic evidence was seen of microorganisms, acute or chronic inflammation, or infection. Pooling the IVH and discogenic pain patients and contrasting them with control patients showed a significant association of IVH with positive bacterial cultures (χ = 15.37; P = 0.000088). CONCLUSION Endemic bacterial biofilms are significantly associated with IVH and discogenic pain. LEVEL OF EVIDENCE N/A.
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Jahns AC, Eilers H, Alexeyev OA. Transcriptomic analysis of Propionibacterium acnes biofilms in vitro. Anaerobe 2016; 42:111-118. [DOI: 10.1016/j.anaerobe.2016.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
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Lheure C, Grange PA, Ollagnier G, Morand P, Désiré N, Sayon S, Corvec S, Raingeaud J, Marcelin AG, Calvez V, Khammari A, Batteux F, Dréno B, Dupin N. TLR-2 Recognizes Propionibacterium acnes CAMP Factor 1 from Highly Inflammatory Strains. PLoS One 2016; 11:e0167237. [PMID: 27902761 PMCID: PMC5130237 DOI: 10.1371/journal.pone.0167237] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/10/2016] [Indexed: 11/25/2022] Open
Abstract
Background Propionibacterium acnes (P. acnes) is an anaerobic, Gram-positive bacteria encountered in inflammatory acne lesions, particularly in the pilosebaceous follicle. P. acnes triggers a strong immune response involving keratinocytes, sebocytes and monocytes, the target cells during acne development. Lipoteicoic acid and peptidoglycan induce the inflammatory reaction, but no P. acnes surface protein interacting with Toll-like receptors has been identified. P. acnes surface proteins have been extracted by lithium stripping and shown to induce CXCL8 production by keratinocytes. Methodology and principal findings Far-western blotting identified two surface proteins, of 24.5- and 27.5-kDa in size, specifically recognized by TLR2. These proteins were characterized, by LC-MS/MS, as CAMP factor 1 devoid of its signal peptide sequence, as shown by N-terminal sequencing. Purified CAMP factor 1 induces CXCL8 production by activating the CXCL8 gene promoter, triggering the synthesis of CXCL8 mRNA. Antibodies against TLR2 significantly decreased the CXCL8 response. For the 27 P. acnes strains used in this study, CAMP1-TLR2 binding intensity was modulated and appeared to be strong in type IB and II strains, which produced large amounts of CXCL8, whereas most of the type IA1 and IA2 strains presented little or no CAMP1-TLR2 binding and low levels of CXCL8 production. The nucleotide sequence of CAMP factor displays a major polymorphism, defining two distinct genetic groups corresponding to CAMP factor 1 with 14 amino-acid changes from strains phylotyped II with moderate and high levels of CAMP1-TLR2 binding activity, and CAMP factor 1 containing 0, 1 or 2 amino-acid changes from strains phylotyped IA1, IA2, or IB presenting no, weak or moderate CAMP1-TLR2 binding. Conclusions Our findings indicate that CAMP factor 1 may contribute to P. acnes virulence, by amplifying the inflammation reaction through direct interaction with TLR2.
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Affiliation(s)
- Coralie Lheure
- Université Sorbonne Paris Descartes, Faculté de Médecine, INSERM, Institut Cochin, Laboratoire de Dermatologie-CNR Syphilis, Paris, France
| | - Philippe Alain Grange
- Université Sorbonne Paris Descartes, Faculté de Médecine, INSERM, Institut Cochin, Laboratoire de Dermatologie-CNR Syphilis, Paris, France
| | - Guillaume Ollagnier
- Université Sorbonne Paris Descartes, Faculté de Médecine, INSERM, Institut Cochin, Laboratoire de Dermatologie-CNR Syphilis, Paris, France
| | - Philippe Morand
- AP-HP, Groupe Hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, Service de Bactériologie-CNR Streptocoques, Paris, France
| | - Nathalie Désiré
- Sorbonne Université, UPMC Université Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris, France
| | - Sophie Sayon
- Sorbonne Université, UPMC Université Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris, France
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Nantes, France
| | | | - Anne-Geneviève Marcelin
- Sorbonne Université, UPMC Université Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris, France
| | - Vincent Calvez
- Sorbonne Université, UPMC Université Paris 06, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- AP-HP, Groupe hospitalier Pitié Salpêtrière, Laboratoire de Virologie, Paris, France
| | - Amir Khammari
- CHU, service de dermatologie, CIC, Hôtel Dieu, Nantes, Hôtel Dieu, Nantes, France
| | - Frédéric Batteux
- Université Sorbonne Paris Descartes, Faculté de Médecine, INSERM, Institut Cochin, Laboratoire de Dermatologie-CNR Syphilis, Paris, France
- AP-HP, Groupe Hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, Service d’Immunologie Biologique, Paris, France
| | - Brigitte Dréno
- CHU, service de dermatologie, CIC, Hôtel Dieu, Nantes, Hôtel Dieu, Nantes, France
| | - Nicolas Dupin
- Université Sorbonne Paris Descartes, Faculté de Médecine, INSERM, Institut Cochin, Laboratoire de Dermatologie-CNR Syphilis, Paris, France
- AP-HP, Groupe Hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, Service de Dermatologie-Vénéréologie, Paris, France
- * E-mail:
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Brandwein M, Steinberg D, Meshner S. Microbial biofilms and the human skin microbiome. NPJ Biofilms Microbiomes 2016; 2:3. [PMID: 28649397 PMCID: PMC5460139 DOI: 10.1038/s41522-016-0004-z] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/22/2016] [Accepted: 08/08/2016] [Indexed: 12/14/2022] Open
Abstract
The human skin microbiome plays an important role in both health and disease. Microbial biofilms are a well-characterized mode of surface-associated growth, which present community-like behaviors. Additionally, biofilms are a critical element in certain skin diseases. We review how the perception of the resident skin microbiota has evolved from the early linkages of certain microbes to disease states, to a more comprehensive and intricate understanding brought on by biofilm and microbiome revelations. Rapidly expanding arsenals of experimental methods are opening new horizons in the study of human-microbe and microbe-microbe interactions. Microbial community profiling has largely remained a separate discipline from that of biofilm research, yet the introduction of metatranscriptomics, metabolomics, and the ability to distinguish between dormant and active members of a community have all paved the road toward a convergent cognizance of the encounter between these two microbial disciplines.
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Affiliation(s)
- Michael Brandwein
- Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Ein Kerem, Jerusalem, Israel
- Dead Sea and Arava Science Center, The Dead Sea Microbiology lab, Ein Gedi, Israel
| | - Doron Steinberg
- Faculty of Dental Medicine, The Hebrew University of Jerusalem, Hadassah Ein Kerem, Jerusalem, Israel
| | - Shiri Meshner
- Dead Sea and Arava Science Center, The Dead Sea Microbiology lab, Ein Gedi, Israel
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López-Estebaranz JL, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. ACTAS DERMO-SIFILIOGRAFICAS 2016; 108:120-131. [PMID: 27816123 DOI: 10.1016/j.ad.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/14/2016] [Accepted: 10/02/2016] [Indexed: 01/24/2023] Open
Abstract
Acne is a chronic inflammatory disease whose psychosocial effects can greatly impair quality of life. Various scales are used to classify the severity of acne, and several treatment algorithms are currently applied: no consensus on a common scale or treatment guidelines has been reached. A group of Spanish experts therefore met to identify a scale the majority could accept as the most appropriate for classifying severity and treating accordingly. The group chose the following classifications: comedonal acne, mild or moderate papulopustular acne, severe papulopustular acne, moderate nodular acne, and nodular-cystic acne (or acne tending to leave scars). Consensus was reached on first- and second-choice treatments for each type and on maintenance treatment. The experts also issued specific recommendations on antibiotic use (starting with mild or moderate papulopustular acne), always in combination with retinoids and/or benzoyl peroxide. The use of isotretinoin (starting at severe papulopustular or moderate nodular acne) was also covered.
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Affiliation(s)
| | | | - B Dréno
- Hospital Universitario de Nantes, Nantes, Francia
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125
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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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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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Abstract
Acne vulgaris is a common skin condition associated with multiple factors. Although mostly presenting alone, it can likewise present with features of hyperandrogenism and hormonal discrepancies. Of note, hormonal therapies are indicated in severe, resistant-to-treatment cases and in those with monthly flare-ups and when standard therapeutic options are inappropriate. This article serves as an update to hormonal pathogenesis of acne, discusses the basics of endocrinal evaluation for patients with suspected hormonal acne, and provides an overview of the current hormonal treatment options in women.
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Affiliation(s)
- Mohamed L Elsaie
- Department of Dermatology and Venereology, National Research Centre, Cairo, Egypt
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128
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Nakajima A, Ikeda F, Kanayama S, Okamoto K, Matsumoto T, Ishii R, Fujikawa A, Takei K, Kawashima M. Antimicrobial activities of ozenoxacin against isolates of propionibacteria and staphylococci from Japanese patients with acne vulgaris. J Med Microbiol 2016; 65:745-750. [DOI: 10.1099/jmm.0.000293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Akiko Nakajima
- Strategic Research Planning & Management Department, Drug Development Laboratories, Kyoto R&D Center, Maruho Co., Ltd., 93 Awata-cho, Chudoji, Shimogyo-ku, Kyoto 600-8815, Japan
| | - Fumiaki Ikeda
- Strategic Research Planning & Management Department, Drug Development Laboratories, Kyoto R&D Center, Maruho Co., Ltd., 93 Awata-cho, Chudoji, Shimogyo-ku, Kyoto 600-8815, Japan
| | - Shoji Kanayama
- Strategic Research Planning & Management Department, Drug Development Laboratories, Kyoto R&D Center, Maruho Co., Ltd., 93 Awata-cho, Chudoji, Shimogyo-ku, Kyoto 600-8815, Japan
| | - Kazuaki Okamoto
- Strategic Research Planning & Management Department, Drug Development Laboratories, Kyoto R&D Center, Maruho Co., Ltd., 93 Awata-cho, Chudoji, Shimogyo-ku, Kyoto 600-8815, Japan
| | - Tatsumi Matsumoto
- Strategic Research Planning & Management Department, Drug Development Laboratories, Kyoto R&D Center, Maruho Co., Ltd., 93 Awata-cho, Chudoji, Shimogyo-ku, Kyoto 600-8815, Japan
| | - Ritsuko Ishii
- Strategic Research Planning & Management Department, Drug Development Laboratories, Kyoto R&D Center, Maruho Co., Ltd., 93 Awata-cho, Chudoji, Shimogyo-ku, Kyoto 600-8815, Japan
| | - Akira Fujikawa
- Clinical Development Department, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | | | - Makoto Kawashima
- Department of Dermatology, Tokyo Women’s Medical University, Tokyo, Japan
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129
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Ma Y, Chen Q, Liu Y, Wang Q, Huang Z, Xiang L. Effects of 5-aminolevulinic acid photodynamic therapy on TLRs in acne lesions and keratinocytes co-cultured with P. acnes. Photodiagnosis Photodyn Ther 2016; 15:172-81. [PMID: 27421917 DOI: 10.1016/j.pdpdt.2016.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/07/2016] [Accepted: 07/10/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on the expression of Toll like receptors (TLRs) in human keratinocytes and its role in acne treatment. METHODS TLR2 and TLR4 expression in acne lesions before and after ALA-PDT were examined by immunohistochemical assay. Primary keratinocytes were obtained from acne lesions, co-cultured with P. acnes and then treated with ALA-PDT using red or blue LED. Cytokines production were examined by ELISA, TLR2 and TLR4 gene expression by real-time PCR, and TLR2 and TLR4 protein expression by Western-blot assay. RESULTS The overexpression of TLR2 and TLR4 in acne lesion were detected, which became negative or weaker after ALA-PDT. The infection of P. acnes in keratinocytes could significantly increase the levels of early inflammatory cytokines (e.g. IL-1α, TNF-α and IL-8) (P<0.05). Such responses could be inhibited by ALA-PDT. P. acnes infection could also significantly increase TLR2 and TLR4 expressions in keratinocytes (P<0.05), which could be down-regulated by ALA-PDT. CONCLUSIONS ALA-PDT could inhibit innate immune responses in keratinocytes treated with P. acnes via TLRs pathways.
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Affiliation(s)
- Ying Ma
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Qinyi Chen
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Ye Liu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Qianqian Wang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China
| | - Zheng Huang
- University of Colorado Denver Cancer Center, Aurora, CO, USA; MOE Key Laboratory of OptoElectronic Science and Technology for Medicine, Fujian Normal University, Fuzhou 350007, PR China
| | - Leihong Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, PR China.
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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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Totté JEE, van der Feltz WT, Bode LGM, van Belkum A, van Zuuren EJ, Pasmans SGMA. A systematic review and meta-analysis on Staphylococcus aureus carriage in psoriasis, acne and rosacea. Eur J Clin Microbiol Infect Dis 2016; 35:1069-77. [PMID: 27151386 PMCID: PMC4902839 DOI: 10.1007/s10096-016-2647-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 04/09/2016] [Indexed: 10/28/2022]
Abstract
Staphylococcus aureus might amplify symptoms in chronic inflammatory skin diseases. This study evaluates skin and mucosal colonization with S. aureus in patients with psoriasis, acne and rosacea. A systematic literature search was conducted. Both odds ratios (OR) for colonization in patients versus controls and the prevalence of colonization in patients are reported. Fifteen articles about psoriasis and 13 about acne (12 having a control group) were included. No study in rosacea met our inclusion criteria. For psoriasis, one study out of three controlled studies showed increased skin colonization (OR 18.86; 95 % confidence interval [CI] 2.20-161.99). Three out of the five studies that reported on nasal colonization showed significant ORs varying from 1.73 (95 % CI 1.16-2.58) to 14.64 (95 % CI 2.82-75.95). For acne one of the three studies that evaluated skin colonization reported a significant OR of 4.16 (95 % CI 1.74-9.94). A relation between nasal colonization and acne was not found. Limitations in study design and low sample sizes should be taken into consideration when interpreting the results. Colonisation with S. aureus seems to be increased in patients with psoriasis. This bacterial species, known for its potential to induce long-lasting inflammation, might be involved in psoriasis pathogenesis. Information on acne is limited. Prospective controlled studies should further investigate the role of S. aureus in chronic inflammatory skin diseases.
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Affiliation(s)
- J E E Totté
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - W T van der Feltz
- Molecular and Cellular Life Sciences, Utrecht University, Utrecht, The Netherlands
| | - L G M Bode
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A van Belkum
- bioMérieux, Scientific Office, La Balme Les Grottes, France
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - E J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - S G M A Pasmans
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Lazic Mosler E, Leitner C, Gouda MA, Carter B, Layton AM, KhalafAllah MT. Topical antibiotics for acne. Hippokratia 2016. [DOI: 10.1002/14651858.cd012263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Elvira Lazic Mosler
- General Hospital "Dr. Ivo Pedišić"; Department for Dermatology and Venereology; J.J. Strossmayera 59 Sisak Croatia 44000
- University of Zagreb School of Medicine; Department of Anatomy; Zagreb Croatia
- Catholic University of Croatia; Zagreb Croatia
| | - Christina Leitner
- University Hospitals Coventry and Warwickshire NHS Trust; Department of Dermatology; Clifford Bridge Road Coventry UK
| | - Mohamed A Gouda
- Menoufia University; Faculty of Medicine; Shebin Al-Kom Menoufia Egypt
| | - Ben Carter
- Cardiff University School of Medicine; Institute of Primary Care & Public Health; 3rd Floor, Neuadd Meirionnydd, Heath Park Cardiff UK CF14 4YS
| | - Alison M Layton
- Harrogate and District NHS Foundation Trust; Department of Dermatology; Harrogate UK
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Karlapudi AP, Kodali VP, Kota KP, Shaik SS, Sampath Kumar NS, Dirisala VR. Deciphering the effect of novel bacterial exopolysaccharide-based nanoparticle cream against Propionibacterium acnes. 3 Biotech 2016; 6:35. [PMID: 28330105 PMCID: PMC4724354 DOI: 10.1007/s13205-015-0359-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 08/17/2015] [Indexed: 02/03/2023] Open
Abstract
Acne vulgaris (acne) is a chronic inflammatory disease prevalent among adolescents and adults, with significant psychological effects. The aetiology of acne is multifactorial. Several pathophysiological associations have been identified in which Propionibacterium acnes plays a major role. This bacteria primarily affects areas containing oil glands including the face, back and trunk, where it causes the formation of seborrhoea and inflammatory lesions. The treatment methods currently in place have side effects. A novel alternative method with no side effects is hence required. In this study, we report the synthesis of an exopolysaccharide (EPS)-producing bacterial-based nanoparticle as a stable biocompatible material for drug delivery. We then evaluated the effectiveness of EPS-based nanoparticle cream against P. acnes. Our results demonstrate that EPS nanoparticles have great potential as a safe and effective topical treatment for acne vulgaris and other associated infections.
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134
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Kokhan MM, Keniksfest YUV, Polishchuk AI. Reasonable selection of a topical therapy for different forms of acne. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-2-81-86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Modern data of the acne pathogenesis, including the role of Propionibacterium acnes in the early stages of the acne formation and their provocative role in the development of the inflammatory process are presented. Priority importance of topical retinoids and combination products containing fixed combinations adapalene with benzoyl peroxide or antibiotic clindamycin in the acne treatment are shown. There are presented the facts of the effectiveness of Clenzit gel (adapalene 0.1%) and Clenzit-C (adapalene 0.1% and clindamycin phosphate 1.0%) and an algorithm for the choice of drug depending on clinical and morphological features of the skin process that allows to optimize the treatment of patients with various forms of acne.
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135
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Staphylococcus aureus carriage rates and antibiotic resistance patterns in patients with acne vulgaris. J Am Acad Dermatol 2016; 74:673-8. [DOI: 10.1016/j.jaad.2015.11.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/12/2015] [Accepted: 11/16/2015] [Indexed: 11/20/2022]
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136
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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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137
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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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138
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Walsh TR, Efthimiou J, Dréno B. Systematic review of antibiotic resistance in acne: an increasing topical and oral threat. THE LANCET. INFECTIOUS DISEASES 2016; 16:e23-33. [PMID: 26852728 DOI: 10.1016/s1473-3099(15)00527-7] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/03/2015] [Indexed: 12/19/2022]
Abstract
Topical and oral antibiotics are routinely used to treat acne. However, antibiotic resistance is increasing, with many countries reporting that more than 50% of Propionibacterium acnes strains are resistant to topical macrolides, making them less effective. We reviewed the current scientific literature to enable proposal of recommendations for antibiotic use in acne treatment. References were identified through PubMed searches for articles published from January, 1954, to March 7, 2015, using four multiword searches. Ideally, benzoyl peroxide in combination with a topical retinoid should be used instead of a topical antibiotic to minimise the impact of resistance. Oral antibiotics still have a role in the treatment of moderate-to-severe acne, but only with a topical retinoid, benzoyl peroxide, or their combination, and ideally for no longer than 3 months. To limit resistance, it is recommended that benzoyl peroxide should always be added when long-term oral antibiotic use is deemed necessary. The benefit-to-risk ratio of long-term antibiotic use should be carefully considered and, in particular, use alone avoided where possible. There is a need to treat acne with effective alternatives to antibiotics to reduce the likelihood of resistance.
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Affiliation(s)
- Timothy R Walsh
- Department of Medical Microbiology and Infectious Diseases, Heath Hospital, Cardiff, UK.
| | | | - Brigitte Dréno
- Department of Dermatology, Nantes University Hospital, Nantes, France
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139
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Phadnis J, Gordon D, Krishnan J, Bain GI. Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics. J Shoulder Elbow Surg 2016; 25:304-10. [PMID: 26456428 DOI: 10.1016/j.jse.2015.08.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/06/2015] [Accepted: 08/09/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND In vitro, Propionibacterium acnes (P acnes) is highly susceptible to commonly used antibiotics and antiseptics, yet in vivo, it still causes postsurgical infections of the shoulder. We hypothesized that the local environment within the pilosebaceous glands protects P acnes and that incision of the skin transects these glands, exposing viable P acnes to the wound. METHODS Fifty consecutive patients undergoing open shoulder surgery were prospectively studied. Prophylactic antibiotics were administered to all patients. Microbiologic swabs of the skin surface were taken before and after skin preparation with 70% alcoholic chlorhexidine. The skin was incised, and a further swab and dermal biopsy specimen were taken. RESULTS P acnes was cultured in 21 of 50 prepreparation skin surface swabs (42%), 7 of 50 postpreparation skin surface swabs (14%), 26 of 50 dermal swabs (52%), and 20 of 50 dermal biopsy specimens (40%). There was a significantly higher incidence of P acnes growth from the skin surface (P = .009) and dermis (P = .01) of patients aged ≤50 years old and in the dermal biopsy specimens of patients undergoing revision surgery (P = .01) and a trend toward increased incidence of P acnes in men. P acnes growth from a prepreparation skin surface swab had a sensitivity of 69%, specificity of 88%, positive predictive value of 86%, and negative predictive value of 72% at predicting subsequent P acnes growth from the dermal swab or biopsy specimen. CONCLUSIONS Viable P acnes persists within the skin dermis, despite standard antimicrobial precautions. These findings suggest that incising the skin is likely to lead to deep seeding of the surgical wound, which has implications for the pathogenesis and prevention of postsurgical shoulder infections.
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Affiliation(s)
- Joideep Phadnis
- Department of Trauma & Orthopaedics, Brighton and Sussex University Hospitals, UK.
| | - David Gordon
- Department of Microbiology and Infectious Diseases, Flinders University, Adelaide, SA, Australia
| | - Jeganath Krishnan
- Department of Orthopaedics and Trauma, Flinders University, Adelaide, SA, Australia; International Musculoskeletal Research Institute, Adelaide, SA, Australia
| | - Gregory Ian Bain
- Department of Orthopaedics and Trauma, Flinders University, Adelaide, SA, Australia
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140
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Okamoto K, Ikeda F, Kanayama S, Nakajima A, Matsumoto T, Ishii R, Umehara M, Gotoh N, Hayashi N, Iyoda T, Matsuzaki K, Matsumoto S, Kawashima M. In vitro antimicrobial activity of benzoyl peroxide against Propionibacterium acnes assessed by a novel susceptibility testing method. J Infect Chemother 2016; 22:426-9. [PMID: 26806150 DOI: 10.1016/j.jiac.2015.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/17/2015] [Accepted: 12/09/2015] [Indexed: 11/28/2022]
Abstract
Benzoyl peroxide (BPO), a therapeutic agent for acne vulgaris, was assessed for in vitro antimicrobial activity against Propionibacterium acnes using a novel broth microdilution testing that improved BPO solubility. We searched for a suitable culture medium to measure the minimum inhibitory concentration (MIC) of BPO against P. acnes and finally found the Gifu anaerobic medium (GAM) broth supplemented with 0.1(v/v)% glycerol and 2(v/v)% Tween 80, in which BPO dissolved up to 1250 μg/mL and P. acnes grew well. The MICs and minimum bactericidal concentrations (MBCs) of BPO against 44 clinical isolates of P. acnes collected from Japanese patients with acne vulgaris were determined by our testing method using the supplemented GAM broth. The MICs of BPO were 128 or 256 μg/mL against all isolates of P. acnes regardless of susceptibility to nadifloxacin or clindamycin. The MBCs of BPO were also 128 or 256 μg/mL against the same isolates. Moreover, BPO at the MIC showed a rapid bactericidal activity against P. acnes ATCC11827 in time-kill assay. In conclusion, we could develop a novel assay for the MIC and MBC determinations of BPO against P. acnes, which is reliable and reproducible as a broth microdilution testing and the present results suggest that BPO has a potent bactericidal activity against P. acnes.
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Affiliation(s)
- Kazuaki Okamoto
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan; Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan.
| | - Fumiaki Ikeda
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Shoji Kanayama
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan; Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan
| | - Akiko Nakajima
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Tatsumi Matsumoto
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Ritsuko Ishii
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Masatoshi Umehara
- CMC Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Naomasa Gotoh
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan
| | - Naoki Hayashi
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan
| | - Takako Iyoda
- Clinical Trial Testing Department, LSI Medience Co., Japan
| | | | | | - Makoto Kawashima
- Department of Dermatology, Tokyo Women's Medical University, Japan
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141
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Auffret N, Claudel JP, Leccia MT, Poli F, Farhi D, Dréno B. AFAST - Adult Female Acne Scoring Tool: an easy-to-use tool for scoring acne in adult females. J Eur Acad Dermatol Venereol 2015; 30:824-8. [PMID: 26642798 DOI: 10.1111/jdv.13518] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/17/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Acne is a concern in adults, especially in women. The specifications in current acne grading systems are not applicable to this particular population. OBJECTIVE To develop and validate a measurement tool (AFAST: adult female acne scoring tool) for acne in women by taking into account the specific locations of adult female acne, and to evaluate the impact of the photographic modalities on rating reproducibility. METHODS Six experts in dermatology rated pictures of 54 women with a phototype from I to IV during two sessions, with an interval of 24 h. They rated the acne severity on the face using the GEA scale (Score 1) together with a new scale to assess acne on the mandibular zone (Score 2). Pictures of 30 women were taken using a standardized photographic device; pictures of the other 24 women were taken by their own dermatologists during daily practice. RESULTS At session 1, the inter-rater's reproducibility was good for Score 1 with an ICC of 0.77 [0.72-0.83], and excellent for Score 2 with an ICC of 0.87 [0.82-0.91]. Between sessions 1 and 2, the mean intra-rater's reproducibility was excellent for both scores with an ICC of 0.88 [0.84-0.92] for Score 1, and an ICC of 0.87 [0.78-0.92] for Score 2. Photographic modalities had no significant effect on the inter- and intra-rater's reproducibility. CONCLUSION For the first time, it has been demonstrated that AFAST can accurately rate acne severity in women. It is a promising, easy-to-use tool for both daily practice and clinical investigation.
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Affiliation(s)
| | | | - M-T Leccia
- Clinique de Dermatologie, Allergologie et Photobiologie, CHU A Michallon, Grenoble, France
| | - F Poli
- Private Practice, Paris, France
| | - D Farhi
- Private Practice, Paris, France
| | - B Dréno
- Clinique de Dermatologie, Hôtel Dieu, Place Alexis Ricordeau, Nantes, France
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142
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Lood R, Waldetoft KW, Nordenfelt P. Localization-triggered bacterial pathogenesis. Future Microbiol 2015; 10:1659-68. [PMID: 26437846 DOI: 10.2217/fmb.15.89] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Bacterial infections are becoming an increasing problem worldwide and there is a need for a deeper understanding of how bacteria turn pathogenic. Here, we suggest that one answer may be found by taking into account the localization of the bacteria, both at an anatomical level and at a microenvironment level. Both commensals and traditional pathogens alter their interaction with the human host depending on the local surroundings--turning either more or less virulent. These localization effects could derive from the characteristics of different anatomical sites but also from local differences within a microenvironment. In order to understand the adaptive functions of bacterial virulence factors, we need to study the bacteria in the environments where they have evolved.
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Affiliation(s)
- Rolf Lood
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, SE-221 84 Lund, Sweden
| | | | - Pontus Nordenfelt
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, SE-221 84 Lund, Sweden
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143
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Foti C, Romita P, Borghi A, Angelini G, Bonamonte D, Corazza M. Contact dermatitis to topical acne drugs: a review of the literature. Dermatol Ther 2015; 28:323-9. [PMID: 26302055 DOI: 10.1111/dth.12282] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Acne vulgaris is a chronic dermatological disorder that affects the majority of teenagers in the Western world. Topical therapy is widely used to treat mild-moderate acne and is known as well-tolerated thanks to its low systemic toxicity, although associated to skin adverse effects. Acne seems to be associated also to an intrinsic alteration of the epidermal barrier, regarding both the upper and the follicular stratum corneum that promotes the onset of such local side effects. The commonest one is irritant contact dermatitis, an event of frequent observation occurring with erythema, burning, dryness, scaling, and itching, usually characterized by low severity and limited duration. Among topical acne drugs, retinoids are the most irritating ones. Another side effect is allergic contact dermatitis: it is rare and mainly associated to benzoyl peroxide.
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Affiliation(s)
- Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy
| | - Alessandro Borghi
- Department of Medical Science, Unit of Dermatology and Infectious Diseases, University of Ferrara, Via Savonarola 9, Ferrara, Italy
| | - Gianni Angelini
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy
| | - Domenico Bonamonte
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, Bari, Italy
| | - Monica Corazza
- Department of Medical Science, Unit of Dermatology and Infectious Diseases, University of Ferrara, Via Savonarola 9, Ferrara, Italy
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144
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Matin N, Tabatabaie O, Mohammadinejad P, Rezaei N. Therapeutic targeting of Toll-like receptors in cutaneous disorders. Expert Opin Ther Targets 2015; 19:1651-63. [DOI: 10.1517/14728222.2015.1069275] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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145
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Analysis of the Surface, Secreted, and Intracellular Proteome of Propionibacterium acnes. EUPA OPEN PROTEOMICS 2015; 9:1-7. [PMID: 28083470 DOI: 10.1016/j.euprot.2015.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Propionibacterium acnes , plays an important role in acne vulgaris and other diseases. However, understanding of the exact mechanisms of P. acnes pathogenesis is limited. Few studies have investigated its proteome, which is essential for vaccine development. Here, we comprehensively investigate the proteome of P. acnes strain ATCC 6919, including secreted, cell wall, membrane, and cytosolic fractions in three types of growth media. A total of 531 proteins were quantified using an Orbitrap mass spectrometer and bioinformatically categorized for localization and function. Several, including PPA1939, a highly expressed surface and secreted protein, were identified as potential vaccine candidates.
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146
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Is the current model for acne pathogenesis backwards? J Am Acad Dermatol 2015; 72:e167. [DOI: 10.1016/j.jaad.2015.01.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 01/26/2015] [Indexed: 11/20/2022]
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147
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A Derivative of the Thiopeptide GE2270A Highly Selective against Propionibacterium acnes. Antimicrob Agents Chemother 2015; 59:4560-8. [PMID: 25987631 DOI: 10.1128/aac.05155-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 05/11/2015] [Indexed: 11/20/2022] Open
Abstract
A chemical derivative of the thiopeptide GE2270A, designated NAI003, was found to possess a substantially reduced antibacterial spectrum in comparison to the parent compound, being active against just a few Gram-positive bacteria. In particular, NAI003 retained low MICs against all tested isolates of Propionibacterium acnes and, to a lesser extent, against Enterococcus faecalis. Furthermore, NAI003 showed a time- and dose-dependent killing of both a clindamycin-resistant and a clindamycin-sensitive P. acnes isolate. Gel shift experiments indicated that, like the parent compound, NAI003 retained the ability to bind to elongation factors Tu (EF-Tus) derived from Escherichia coli, E. faecalis, or P. acnes, albeit with reduced efficiency. In contrast, EF-Tus derived from the NAI003-insensitive Staphylococcus aureus or Streptococcus pyogenes did not bind this compound. These results were confirmed by in vitro studies using a hybrid translation system, which indicated that NAI003 can inhibit most efficiently protein synthesis driven by the P. acnes EF-Tu. P. acnes mutants resistant to NAI003 were isolated by direct plating. With one exception, all analyzed strains carried mutations in the tuf gene, encoding EF-Tu. Because of its selective effect on P. acnes in comparison to resident skin flora, NAI003 represents a promising candidate for the topical treatment of acne, which has already completed a phase 1 clinical study.
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148
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Yu Y, Champer J, Garbán H, Kim J. Typing of Propionibacterium acnes: a review of methods and comparative analysis. Br J Dermatol 2015; 172:1204-9. [PMID: 25600912 DOI: 10.1111/bjd.13667] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2015] [Indexed: 02/06/2023]
Abstract
Propionibacterium acnes is a major commensal of the human skin. However, it is also the pathogen responsible for acne vulgaris and other diseases, such as medical-device infections. Strains of Propionibacterium acnes have long been classified into several different types. Recently, typing systems for this bacterium have taken on an increased importance as different types of P. acnes have been found to be associated with different disease states, including acne. Genetic approaches based on individual or multiple genes have classified P. acnes into types, which have been supported by the sequencing of nearly 100 P. acnes genomes. These types have distinct genetic, transcriptomic and proteomic differences. Additionally, they may have different immune response profiles. Taken together, these factors may account for the different disease associations of P. acnes types.
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Affiliation(s)
- Y Yu
- Division of Dermatology and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, U.S.A.,Irvine School of Medicine, University of California, Irvine, CA, U.S.A
| | - J Champer
- Division of Dermatology and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, U.S.A
| | - H Garbán
- Division of Dermatology and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, U.S.A
| | - J Kim
- Division of Dermatology and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, U.S.A.,Department of Dermatology, Greater Los Angeles Healthcare System Veterans Affairs, Los Angeles, CA, U.S.A
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149
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Leccia MT, Auffret N, Poli F, Claudel JP, Corvec S, Dreno B. Topical acne treatments in Europe and the issue of antimicrobial resistance. J Eur Acad Dermatol Venereol 2015; 29:1485-92. [PMID: 25677763 DOI: 10.1111/jdv.12989] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/06/2015] [Indexed: 12/31/2022]
Abstract
Acne vulgaris (acne) is a chronic inflammatory disease of the sebaceous gland, characterized by follicular hyperkeratinization, excessive colonization by Propionibacterium acnes (P. acnes) as well as immune reactions and inflammation. Despite an armamentarium of topical treatments available including benzoyl peroxide, retinoids and azelaic acid, topical antibiotics in monotherapies, especially erythromycin and clindamycin, are still used in Europe to treat acne. This intensive use led to antimicrobial-resistant P. acnes and staphylococci strains becoming one of the main health issues worldwide. This is an update on the current topical acne treatments available in Europe, their mechanism of action, their potential to induce antimicrobial resistance and their clinical efficacy and safety.
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Affiliation(s)
- M T Leccia
- Clinique de Dermatologie, Allergologie et Photobiologie, CHU A Michallon, Grenoble, France
| | - N Auffret
- Hôpital Européen Georges Pompidou, Paris, France
| | - F Poli
- Hôpital Européen Georges Pompidou, Paris, France
| | | | - S Corvec
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie-Hygiène, CHU de Nantes, Nantes, France
| | - B Dreno
- Clinique de Dermatologie, University Hospital, Nantes, France
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150
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Multiplex touchdown PCR for rapid typing of the opportunistic pathogen Propionibacterium acnes. J Clin Microbiol 2015; 53:1149-55. [PMID: 25631794 DOI: 10.1128/jcm.02460-14] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The opportunistic human pathogen Propionibacterium acnes is composed of a number of distinct phylogroups, designated types IA1, IA2, IB, IC, II, and III, which vary in their production of putative virulence factors, their inflammatory potential, and their biochemical, aggregative, and morphological characteristics. Although multilocus sequence typing (MLST) currently represents the gold standard for unambiguous phylogroup classification and individual strain identification, it is a labor-intensive and time-consuming technique. As a consequence, we developed a multiplex touchdown PCR assay that in a single reaction can confirm the species identity and phylogeny of an isolate based on its pattern of reaction with six primer sets that target the 16S rRNA gene (all isolates), ATPase (types IA1, IA2, and IC), sodA (types IA2 and IB), atpD (type II), and recA (type III) housekeeping genes, as well as a Fic family toxin gene (type IC). When applied to 312 P. acnes isolates previously characterized by MLST and representing types IA1 (n=145), IA2 (n=20), IB (n=65), IC (n=7), II (n=45), and III (n=30), the multiplex displayed 100% sensitivity and 100% specificity for detecting isolates within each targeted phylogroup. No cross-reactivity with isolates from other bacterial species was observed. This multiplex assay will provide researchers with a rapid, high-throughput, and technically undemanding typing method for epidemiological and phylogenetic investigations. It will facilitate studies investigating the association of lineages with various infections and clinical conditions, and it will serve as a prescreening tool to maximize the number of genetically diverse isolates selected for downstream higher-resolution sequence-based analyses.
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