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Shin JH, Kim SS, Seo SR. Pyrrolidine Dithiocarbamate Suppresses Cutibacterium acnes-Induced Skin Inflammation. Int J Mol Sci 2023; 24:ijms24054444. [PMID: 36901873 PMCID: PMC10003320 DOI: 10.3390/ijms24054444] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
Cutibacterium acnes (C. acnes), a Gram-positive anaerobic bacterium, proliferates in hair follicles and pores and causes inflammation in the skin of young people. The rapid growth of C. acnes triggers macrophages to secrete proinflammatory cytokines. Pyrrolidine dithiocarbamate (PDTC) is a thiol compound that exerts antioxidant and anti-inflammatory effects. Although the anti-inflammatory function of PDTC in several inflammatory disorders has been reported, the effect of PDTC on C. acnes-induced skin inflammation remains unexplored. In the present study, we examined the effect of PDTC on C. acnes-induced inflammatory responses and determined the mechanism by using in vitro and in vivo experimental models. We found that PDTC significantly inhibited the expression of C. acnes-induced proinflammatory mediators, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and NOD-like receptor (NLR) pyrin domain-containing 3 (NLRP3), in mouse-bone-marrow-derived macrophage (BMDM) cells. PDTC suppressed C. acnes-induced activation of nuclear factor-kappa B (NF-κB), which is the major transcription factor for proinflammatory cytokine expression. In addition, we found that PDTC inhibited caspase-1 activation and IL-1β secretion through suppressing NLRP3 and activated the melanoma 2 (AIM2) inflammasome but not the NLR CARD-containing 4 (NLRC4) inflammasome. Moreover, we found that PDTC improved C. acnes-induced inflammation by attenuating C. acnes-induced IL-1β secretion in a mouse acne model. Therefore, our results suggest that PDTC has potential therapeutic value for the amelioration of C. acnes-induced skin inflammation.
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Affiliation(s)
- Jin Hak Shin
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Seon Sook Kim
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon 24341, Republic of Korea
- Institute of Life Science, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Su Ryeon Seo
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon 24341, Republic of Korea
- Institute of Bioscience & Biotechnology, Kangwon National University, Chuncheon 24341, Republic of Korea
- Correspondence: ; Tel.: +82-33-250-8541; Fax: +82-33-241-4627
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2
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Lam M, Hu A, Fleming P, Lynde CW. The Impact of Acne Treatment on Skin Bacterial Microbiota: A Systematic Review. J Cutan Med Surg 2021; 26:93-97. [PMID: 34396785 PMCID: PMC8750125 DOI: 10.1177/12034754211037994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Microbial strains such as Cutibacterium acnes have
been examined as contributors to the pathogenesis of acne. Given
the prevalence of the disease among adolescents and adults, the
overutilization of antimicrobial agents may breed resistance and
alter commensal microflora. Objectives To characterize the impact of acne treatment on the diversity and
relative abundance of the cutaneous microbial community,
particularly of the bacterial flora Methods An electronic search was conducted of Embase, MEDLINE, and the
Cochrane Central Register of Controlled Trials (CENTRAL) on June
5, 2020. Interventional and observational studies examining
patients receiving acne treatment with culture-independent,
community-level analysis of the cutaneous microbiome were
included. Results Nine studies with 170 treated acne patients were included. Five
studies reported a significant change in alpha diversity
following treatment, 3 of which examining systemic antibiotics
reported significant increases in diversity. Two of 3 studies
examining effects of benzoyl peroxide reported a decrease in
diversity. However, trends in diversity were heterogeneous among
studies. Conclusions While individual variability in microbiome composition, and
study-level heterogeneity in study sampling techniques may limit
quantitative synthesis, our results support findings that acne
treatment, including those not considered to have antimicrobial
properties, alters the composition of the cutaneous
microbiome. PROSPERO registration: CRD42020190629
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Affiliation(s)
- Megan Lam
- 12362 Michael G. DeGroote School of Medicine, Faculty of Medicine, Hamilton, ON, Canada
| | - Angie Hu
- 2129 Faculty of Science, University of Calgary, AB, Canada
| | - Patrick Fleming
- 210484 Division of Dermatology, University of Toronto, ON, Canada
| | - Charles W Lynde
- 210484 Division of Dermatology, University of Toronto, ON, Canada.,Lynde Dermatology (Private Practice), Markham, ON, Canada
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3
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Akpinar Kara Y. Evaluation of serum insulin-like growth factor-1, insulin, glucose levels in patients with adolescent and post-adolescent acne. J Cosmet Dermatol 2021; 21:1292-1296. [PMID: 34197685 DOI: 10.1111/jocd.14327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES There are many endogenous and exogenous factors that cause acne formation. This study aimed to determine whether the acne severity in patients with various age ranges is associated with serum insulin-like growth factor, insulin, and glucose and to identify how much they affect the acne severity. MATERIALS AND METHODS In this case-control prospective study, 44 patients with acne vulgaris and 44 age- and gender-matched control subjects without acne were evaluated. Patients and the control group were divided into two age-groups as adolescence and post-adolescence. According to the Global Acne Scoring System (GASS) of the acne group, the acne score grades between 0 and 44 were calculated. The correlations between the IGF-1, insulin, glucose levels, and acne grades were calculated in each group. RESULTS In our study, the acne scores and serum IGF-1 levels were found to be significantly higher in patients under the age of 21 than patients over the age of 21. There was a statistically significant difference in acne score between the two groups. However, there was no statistically significant difference between the serum IGF-1, insulin, and glucose levels of the acne group and the control group. CONCLUSION In this study, it has been revealed that IGF-1 is effective at the pathogenesis of acne in adolescence.
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4
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van Steensel MAM, Goh BC. Cutibacterium acnes: Much ado about maybe nothing much. Exp Dermatol 2021; 30:1471-1476. [PMID: 34009698 DOI: 10.1111/exd.14394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/08/2021] [Accepted: 05/13/2021] [Indexed: 12/28/2022]
Abstract
Cutibacterium acnes (also known as Propionibacterium acnes) has long been implicated in the pathogenesis of acne, inspiring both therapeutic and personal care approaches aiming to control the disease by controlling the bacterium. The purported association has made people with acne feel dirty and led to the-at times excessive-use of cleansers, antiseptics and antibiotics for the condition. However, recent evidence seems to weaken the case for C. acnes' involvement. New genetics and molecular biology findings strongly suggest that abnormal differentiation of sebaceous progenitor cells causes comedones, the primary lesions in acne. Comodegenesis is initiated by androgens and is unlikely to be triggered by C. acnes, which probably doesn't affect sebaceous differentiation. Is there still a place for it in this understanding of acne? It is necessary to critically address this question because it has consequences for treatment. Antibiotic use for acne noticeably contributes to microbial drug resistance, which we can ill afford. In this Viewpoint, we explore if and how C. acnes (still) fits into the developing view on acne. We also briefly discuss the implications for therapy in the light of antibiotic resistance and the need for more targeted therapies.
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Affiliation(s)
- Maurice A M van Steensel
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Skin Research Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Boon Chong Goh
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology Centre Center, Singapore, Singapore
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5
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Shen WT, Wu Y, He HQ, Yu Y, Qin HH, Fei JB, Wang GJ. Efficacy and safety of artemether emulsion for the treatment of mild-to-moderate acne vulgaris: a randomized pilot study. J DERMATOL TREAT 2019; 32:762-765. [PMID: 31884836 DOI: 10.1080/09546634.2019.1710447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of artemether emulsion treating patients with mild-to-moderate acne vulgaris. METHODS A total of 73 (randomized 1:1) patients were externally administered either artemether emulsion (1%) or fusidic acid emulsion (5g: 0.1g) twice daily for 12 weeks. Efficacy and safety evaluations were performed at weeks 0 and 12 by Global acne Grading System (GAGS), the number of acne and papule, as well as the rate of clinical respond. RESULTS After 12 weeks, patients randomized to the artemether emulsion group received artemether emulsion had significantly lower GAGS scores (5.08 ± 1.99 versus 13.75 ± 4.87, p < .001) compared to patients who received fusidic acid emulsion. Patients in the artemether emulsion group had comparable baseline acne scores (11.11 ± 3.73 versus 10.75 ± 4.66, p = .626) and papule score (16.11 ± 5.58 versus 17.03 ± 6.34, p = .356), but significantly lower acne score (3.00 ± 1.55 versus 9.08 ± 4.90, p < .001) and comparable papule score (2.81 ± 1.61 versus 12.69 ± 5.45, p < .001) compared to the fusidic acid emulsion group at 12 weeks. No major adverse events were noted in either treatment group through 12 weeks. CONCLUSIONS Artemether emulsion had better effect in improving mild-to-moderate AV compared to fusidic acid emulsion with barely AEs.
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Affiliation(s)
- Wen-Tong Shen
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Yun Wu
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Hui-Qiong He
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Yue Yu
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Hai-Hong Qin
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Jian-Biao Fei
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
| | - Guo-Jiang Wang
- Department of Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, China
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6
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Propionibacterium acnes and Acne Vulgaris: New Insights from the Integration of Population Genetic, Multi-Omic, Biochemical and Host-Microbe Studies. Microorganisms 2019; 7:microorganisms7050128. [PMID: 31086023 PMCID: PMC6560440 DOI: 10.3390/microorganisms7050128] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 12/25/2022] Open
Abstract
The anaerobic bacterium Propionibacterium acnes is believed to play an important role in the pathophysiology of the common skin disease acne vulgaris. Over the last 10 years our understanding of the taxonomic and intraspecies diversity of this bacterium has increased tremendously, and with it the realisation that particular strains are associated with skin health while others appear related to disease. This extensive review will cover our current knowledge regarding the association of P. acnes phylogroups, clonal complexes and sequence types with acne vulgaris based on multilocus sequence typing of isolates, and direct ribotyping of the P. acnes strain population in skin microbiome samples based on 16S rDNA metagenomic data. We will also consider how multi-omic and biochemical studies have facilitated our understanding of P. acnes pathogenicity and interactions with the host, thus providing insights into why certain lineages appear to have a heightened capacity to contribute to acne vulgaris development, while others are positively associated with skin health. We conclude with a discussion of new therapeutic strategies that are currently under investigation for acne vulgaris, including vaccination, and consider the potential of these treatments to also perturb beneficial lineages of P. acnes on the skin.
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7
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Perlamutrov YN, Olkhovskaia KB, Lyapon AO. Acne therapy in adolescent children. VESTNIK DERMATOLOGII I VENEROLOGII 2018. [DOI: 10.25208/0042-4609-2018-94-6-60-66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Current knowledge of the pathogenesis of acne determines the need for early use of drugs with antiinflammatory activity.Aim: to determine the effectiveness of monotherapy using Adaklin cream in the treatment of acne in adolescent children.Material and methods. All adolescents with acne of light and moderate severity were examined to determine the dermatological index of acne (DIA), determine the level of production of sebaceous glands, testing the parents of patients. Monotherapy was performed using Adaklin cream.Results. 60 patients with acne were under observation. Formation of clinical remission was registered in 78.33 % of adolescents. A good tolerability of the therapy and a high level of compliance were noted.Conclusion: the high efficacy and tolerability of therapy with the use of Adaklin cream in adolescents with acne was stated.
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8
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O’Neill AM, Gallo RL. Host-microbiome interactions and recent progress into understanding the biology of acne vulgaris. MICROBIOME 2018; 6:177. [PMID: 30285861 PMCID: PMC6169095 DOI: 10.1186/s40168-018-0558-5] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 09/11/2018] [Indexed: 05/07/2023]
Abstract
Acne is one of the most common skin diseases worldwide and results in major health care costs and significant morbidity to severely affected individuals. However, the pathophysiology of this disorder is not well understood. Host-microbiome interactions that affect both innate and adaptive immune homeostasis appear to be a central factor in this disease, with recent observations suggesting that the composition and activities of the microbiota in acne is perturbed. Staphylococcus epidermidis and Cutibacterium acnes (C. acnes; formerly Propionibacterium acnes) are two major inhabitants of the skin that are thought to contribute to the disease but are also known to promote health by inhibiting the growth and invasion of pathogens. Because C. acnes is ubiquitous in sebaceous-rich skin, it is typically labeled as the etiological agent of acne yet it fails to fulfill all of Koch's postulates. The outdated model of acne progression proposes that increased sebum production promotes over-proliferation of C. acnes in a plugged hair follicle, thereby driving inflammation. In contrast, growing evidence indicates that C. acnes is equally abundant in both unaffected and acne-affected follicles. Moreover, recent advances in metagenomic sequencing of the acne microbiome have revealed a diverse population structure distinct from healthy individuals, uncovering new lineage-specific virulence determinants. In this article, we review recent developments in the interactions of skin microbes with host immunity, discussing the contribution of dysbiosis to the immunobiology of acne and newly emerging skin microbiome-based therapeutics to treat acne.
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Affiliation(s)
- Alan M. O’Neill
- Department of Dermatology, University of California San Diego, La Jolla, CA 92037 USA
| | - Richard L. Gallo
- Department of Dermatology, University of California San Diego, La Jolla, CA 92037 USA
- Department of Dermatology, University of California San Diego, 9500 Gillman Dr., #0869, La Jolla, CA 92093 USA
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9
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Slaby O, McDowell A, Brüggemann H, Raz A, Demir-Deviren S, Freemont T, Lambert P, Capoor MN. Is IL-1β Further Evidence for the Role of Propionibacterium acnes in Degenerative Disc Disease? Lessons From the Study of the Inflammatory Skin Condition Acne Vulgaris. Front Cell Infect Microbiol 2018; 8:272. [PMID: 30155445 PMCID: PMC6103242 DOI: 10.3389/fcimb.2018.00272] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/23/2018] [Indexed: 12/15/2022] Open
Abstract
The pathogenesis of degenerative disc disease is a complex and multifactorial process in which genetics, mechanical trauma, altered loading and nutrition present significant etiological factors. Infection of the intervertebral disc with the anaerobic bacterium Propionibacterium acnes is now also emerging as a potentially new etiological factor. This human commensal bacterium is well known for its long association with the inflammatory skin condition acne vulgaris. A key component of inflammatory responses to P. acnes in acne appears to be interleukin (IL)-1β. Similarly, in degenerative disc disease (DDD) there is compelling evidence for the fundamental roles of IL-1β in its pathology. We therefore propose that P. acnes involvement in DDD is biologically very plausible, and that IL-1β is the key inflammatory mechanism driving the host response to P. acnes infection. Since there is a solid theoretical basis for this phenomenon, we further propose that the relationship between P. acnes infection and DDD is causal.
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Affiliation(s)
- Ondrej Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czechia
| | - Andrew McDowell
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, Londonderry, United Kingdom
| | | | - Assaf Raz
- Laboratory of Bacterial Pathogenesis and Immunology, Rockefeller University, New York, NY, United States
| | | | - Tony Freemont
- Division of Cell Matrix Biology and Regenerative Medicine, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Peter Lambert
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Manu N Capoor
- Central European Institute of Technology, Masaryk University, Brno, Czechia.,Laboratory of Bacterial Pathogenesis and Immunology, Rockefeller University, New York, NY, United States
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10
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Niemeyer-van der Kolk T, van der Wall HEC, Balmforth C, Van Doorn MBA, Rissmann R. A systematic literature review of the human skin microbiome as biomarker for dermatological drug development. Br J Clin Pharmacol 2018; 84:2178-2193. [PMID: 29877593 PMCID: PMC6138488 DOI: 10.1111/bcp.13662] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/09/2018] [Accepted: 05/11/2018] [Indexed: 02/06/2023] Open
Abstract
AIMS To explore the potential of the skin microbiome as biomarker in six dermatological conditions: atopic dermatitis (AD), acne vulgaris (AV), psoriasis vulgaris (PV), hidradenitis suppurativa (HS), seborrhoeic dermatitis/pityriasis capitis (SD/PC) and ulcus cruris (UC). METHODS A systematic literature review was conducted according to the PRISMA guidelines. Two investigators independently reviewed the included studies and ranked the suitability microbiome implementation for early phase clinical studies in an adapted GRADE method. RESULTS In total, 841 papers were identified and after screening of titles and abstracts for eligibility we identified 42 manuscripts that could be included in the review. Eleven studies were included for AD, five for AV, 10 for PV, two for HS, four for SD and 10 for UC. For AD and AV, multiple studies report the relationship between the skin microbiome, disease severity and clinical response to treatment. This is currently lacking for the remaining conditions. CONCLUSION For two indications - AD and AV - there is preliminary evidence to support implementation of the skin microbiome as biomarkers in early phase clinical trials. For PV, UC, SD and HS there is insufficient evidence from the literature. More microbiome-directed prospective studies studying the effect of current treatments on the microbiome with special attention for patient meta-data, sampling methods and analysis methods are needed to draw more substantial conclusions.
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Affiliation(s)
- T Niemeyer-van der Kolk
- Centre for Human Drug Research, Leiden, the Netherlands.,Department of Dermatology Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | | | - C Balmforth
- Centre for Human Drug Research, Leiden, the Netherlands
| | - M B A Van Doorn
- Centre for Human Drug Research, Leiden, the Netherlands.,Department of Dermatology Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - R Rissmann
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden University Medical Center, Leiden, the Netherlands.,Leiden Academic Center for Drug Research, Leiden, the Netherlands
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11
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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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12
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Mirdamadi Y, Bommhardt U, Goihl A, Guttek K, Zouboulis CC, Quist S, Gollnick H. Insulin and Insulin-like growth factor-1 can activate the phosphoinositide-3-kinase /Akt/FoxO1 pathway in T cells in vitro. DERMATO-ENDOCRINOLOGY 2017; 9:e1356518. [PMID: 29484090 PMCID: PMC5821168 DOI: 10.1080/19381980.2017.1356518] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/09/2017] [Accepted: 07/11/2017] [Indexed: 01/06/2023]
Abstract
Hyper-glycemic food increases insulin-like growth factor 1 (IGF-1) and insulin signaling and regulates endocrine responses and thereby may modulate the course of acne. Inflammation and adaptive immune responses have a pivotal role in all stages of acne. Recent hypothesis suggests that hyperglycemic food reduces nuclear forkhead box-O1 (FoxO1) transcription factor and may eventually induces acne. The aim of our study was to investigate the role of IGF-1 and insulin on the phosphoinositide-3-kinase (PI3K)/Akt/FoxO1 pathway in human primary T cells and on the molecular functions of T cells in vitro. T cells were stimulated with 0.001 μM IGF-1 or 1 μM insulin +/- 20 μM PI3K inhibitor LY294002. T cells were also exposed to SZ95 sebocyte supernatants which were pre-stimulated with IGF-1 or insulin. We found that 0.001 µM IGF-1 and 1 µM insulin activate the PI3K pathway in T cells leading to up-regulation of p-Akt and p-FoxO1 at 15 and 30 minutes. Nuclear FoxO1 was decreased and FoxO transcriptional activity was reduced. 0.001 µM IGF-1 and 1 µM insulin increased T cell proliferation but have no significant effect on Toll-like receptor2/4 (TLR) expression. Interestingly, supernatants from IGF-1- or insulin-stimulated sebocytes activated the PI3K pathway in T cells but reduced T cell proliferation. Taken together, this study helps to support that high glycemic load diet may contribute to induce activation of the PI3K pathway and increase of proliferation in human primary T cells. Factors secreted by IGF-1- and insulin-stimulated sebocytes induce the PI3K pathway in T cells and reduce T cell proliferation, which probably can reflect a protective mechanism of the sebaceous gland basal cells.
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Affiliation(s)
- Yasaman Mirdamadi
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Ursula Bommhardt
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Alexander Goihl
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Karina Guttek
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Sven Quist
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Harald Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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13
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Manfredini M, Greco M, Farnetani F, Ciardo S, De Carvalho N, Mandel VD, Starace M, Pellacani G. Acne: morphologic and vascular study of lesions and surrounding skin by means of optical coherence tomography. J Eur Acad Dermatol Venereol 2017; 31:1541-1546. [PMID: 28556980 DOI: 10.1111/jdv.14369] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acne vulgaris is a disease of the pilosebaceous unit, characterized by hyper-keratinization process, comedos formation and inflammatory reactions. OBJECTIVE The definition of the morphology and the vascularization of acne lesions by means of dynamic optical coherence tomography (D-OCT), to non-invasively define the alterations occurring during the acne development and patient therapeutic management. METHODS A set of standardized clinical pictures and D-OCT images were acquired from 114 acne lesions of 31 volunteers, presenting mild to moderate acne and evaluated by experts. Fifteen patients treated with oral antibiotics were followed during time at 0, 20, 40, and 60 days. RESULTS Optical coherence tomography enabled to identify vascular and morphological aspects characterizing different types of acne lesions. Oral antibiotic treatment improved the morphologic features and decreased the digitally reconstructed vascular signal during time. CONCLUSION The characterization of acne lesions and the identification of vascular pattern in acne lesions through D-OCT, corresponding to blood vessel dilation and inflammatory associated hyper-vascularization, may have important clinical consequences in the assessment of acne severity, therapeutic decisions and treatment efficacy monitoring.
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Affiliation(s)
- M Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Greco
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - F Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - N De Carvalho
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - V D Mandel
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Starace
- Division of Dermatology, Department of Specialized, Clinical, and Experimental Medicine, University of Bologna, Bologna, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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14
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Zouboulis CC, Dessinioti C, Tsatsou F, Gollnick HPM. Anti-acne drugs in phase 1 and 2 clinical trials. Expert Opin Investig Drugs 2017. [PMID: 28627277 DOI: 10.1080/13543784.2017.1337745] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Despite the impressive increase of knowledge on acne etiology accumulated during the last 20 years, few efforts have been overtaken to introduce new therapeutic regiments targeting the ideal treatment of acne. The increasing emergence of microbial resistance associated with antibiotics, teratogenicity, particularly associated with systemic isotretinoin, and the need for an adverse drug profile, which can be tolerated by the patient, make the need of new pathogenesis relevant anti-acne agents an emerging issue. Areas covered: A search for phase 1 and 2 acne treatment trials in the US National Institutes of Health database of clinical trials and the European Medicines Agency database with the key words 'acne' and 'treatment' was carried out, on 6 January 2017. Expert opinion: The detected trials mostly investigate topical agents that may act via sebosuppressive effects, antimicrobial properties or anti-inflammatory actions. The compounds under investigation include olumacostat glasaretil, cortexolone 17α-propionate, stearoyl-CoA desaturase 1 inhibitors, agents affecting the melanocortin system, omiganan, and minocycline. Systemic studied anti-acne drugs include finasteride, biologics, low dose anti-inflammatory antibiotics, and leukotriene B4 inhibitors.
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Affiliation(s)
- Christos C Zouboulis
- a Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center , Theodore Fontane Medical University of Brandenburg , Dessau , Germany
| | - Clio Dessinioti
- b Department of Dermatology , Andreas Sygros Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Fragkiski Tsatsou
- a Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center , Theodore Fontane Medical University of Brandenburg , Dessau , Germany
| | - Harald P M Gollnick
- c Department of Venerology and Dermatology , Otto von Guericke University Magdeburg , Magdeburg , Germany
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15
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Szabó K, Erdei L, Bolla BS, Tax G, Bíró T, Kemény L. Factors shaping the composition of the cutaneous microbiota. Br J Dermatol 2017; 176:344-351. [PMID: 27518483 DOI: 10.1111/bjd.14967] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 12/12/2022]
Abstract
From birth, we are constantly exposed to bacteria, fungi and viruses, some of which are capable of transiently or permanently inhabiting our different body parts as our microbiota. The majority of our microbial interactions occur during and after birth, and several different factors, including age, sex, genetic constitution, environmental conditions and lifestyle, have been suggested to shape the composition of this microbial community. Propionibacterium acnes is one of the most dominant lipophilic microbes of the postadolescent, sebum-rich human skin regions. Currently, the role of this bacterium in the pathogenesis of the most common inflammatory skin disease, acne vulgaris, is a topic of intense scientific debate. Recent results suggest that Westernization strongly increases the dominance of the Propionibacterium genus in human skin compared with natural populations living more traditional lifestyles. According to the disappearing microbiota hypothesis proposed by Martin Blaser, such alterations in the composition of our microbiota are the possible consequences of socioeconomic and lifestyle changes occurring after the industrial revolution. Evanescence of species that are important elements of the human ecosystem might lead to the overgrowth and subsequent dominance of others because of the lack of ecological competition. Such changes can disturb the fine-tuned balance of the human body and, accordingly, our microbes developed through a long co-evolutionary process. These processes might lead to the transformation of a seemingly harmless species into an opportunistic pathogen through bacterial dysbiosis. This might have happened in the case of P. acnes in acne pathogenesis.
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Affiliation(s)
- K Szabó
- MTA-SZTE Dermatological Research Group, Szeged, Hungary
| | - L Erdei
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - B Sz Bolla
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - G Tax
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - T Bíró
- DE-MTA 'Lendület' Cellular Physiology Research Group, Departments of Physiology and Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L Kemény
- MTA-SZTE Dermatological Research Group, Szeged, Hungary.,Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
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16
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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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17
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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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18
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Sadhasivam S, Sinha M, Saini S, Kaur SP, Gupta T, Sengupta S, Ghosh S, Sardana K. Heterogeneity and antibiotic resistance in Propionibacterium acnes
isolates and its therapeutic implications: blurring the lines between commensal and pathogenic phylotypes. Dermatol Ther 2016; 29:451-454. [DOI: 10.1111/dth.12391] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Suresh Sadhasivam
- Vyome Biosciences Pvt. Ltd; Plot # 465, Ground Floor, F.I.E, Patparganj Industrial Area Delhi 110092 India
- Research Scholar, Research and Development Centre; Bharathiar University; Coimbatore 641046 India
| | - Mau Sinha
- Vyome Biosciences Pvt. Ltd; Plot # 465, Ground Floor, F.I.E, Patparganj Industrial Area Delhi 110092 India
| | - Swamini Saini
- Vyome Biosciences Pvt. Ltd; Plot # 465, Ground Floor, F.I.E, Patparganj Industrial Area Delhi 110092 India
| | - Simar Preet Kaur
- Vyome Biosciences Pvt. Ltd; Plot # 465, Ground Floor, F.I.E, Patparganj Industrial Area Delhi 110092 India
| | - Tanvi Gupta
- Maulana Azad Medical College & Lok Nayak Hospital; Bahadur Shah Zafar Marg; New Delhi 110002 India
| | - Shiladitya Sengupta
- Department of Medicine, Brigham and Women's Hospital; Boston; Massachusetts USA
- Harvard-MIT Division of Health Sciences and Technology; Harvard Medical School; Boston Massachusetts USA
| | - Shamik Ghosh
- Vyome Biosciences Pvt. Ltd; Plot # 465, Ground Floor, F.I.E, Patparganj Industrial Area Delhi 110092 India
| | - Kabir Sardana
- Maulana Azad Medical College & Lok Nayak Hospital; Bahadur Shah Zafar Marg; New Delhi 110002 India
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19
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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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20
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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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21
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Sardana K, Gupta T, Kumar B, Gautam HK, Garg VK. Cross-sectional Pilot Study of Antibiotic Resistance in Propionibacterium Acnes Strains in Indian Acne Patients Using 16S-RNA Polymerase Chain Reaction: A Comparison Among Treatment Modalities Including Antibiotics, Benzoyl Peroxide, and Isotretinoin. Indian J Dermatol 2016; 61:45-52. [PMID: 26955094 PMCID: PMC4763694 DOI: 10.4103/0019-5154.174025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Antibiotic resistance is a worldwide problem in acne patients due to regional prescription practices, patient compliance, and genomic variability in Propionibacterium acnes, though the effect of treatment on the resistance has not been comprehensively analyzed. AIMS Our primary objective was to assess the level of antibiotic resistance in the Indian patients and to assess whether there was a difference in the resistance across common treatment groups. SUBJECTS AND METHODS A cross-sectional, institutional based study was undertaken and three groups of patients were analyzed, treatment naïve, those on antibiotics and patients on benzoyl peroxide (BPO) and/isotretinoin. The follicular content was sampled and the culture was verified with 16S rRNA polymerase chain reaction, genomic sequencing, and pulsed-field gel electrophoresis. Minimum inhibitory concentration (MIC) assessment was done for erythromycin (ERY), azithromycin (AZI), clindamycin (CL), tetracycline (TET), doxycycline (DOX), minocycline (MINO), and levofloxacin (LEVO). The four groups of patients were compared for any difference in the resistant strains. RESULTS Of the 52 P. acnes strains isolated (80 patients), high resistance was observed to AZI (100%), ERY (98%), CL (90.4%), DOX (44.2%), and TETs (30.8%). Low resistance was observed to MINO (1.9%) and LEVO (9.6%). Statistical difference was seen in the resistance between CL and TETs; DOX/LEVO and DOX/MINO (P < 0.001). High MIC90 (≥256 μg/ml) was seen with CL, macrolides, and TETs; moreover, low MIC90 was observed to DOX (16 μg/ml), MINO (8 μg/ml), and LEVO (4 μg/ml). Though the treatment group with isotretinoin/BPO had the least number of resistant strains there was no statistical difference in the antibiotic resistance among the various groups of patients. CONCLUSIONS High resistance was seen among the P. acnes strains to macrolides-lincosamides (AZI and CL) while MINO and LEVO resistance was low.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi - 110 025, India
| | - Tanvi Gupta
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi - 110 025, India
| | - Bipul Kumar
- CSIR-Institute of Genomics and Integrative Biology, Department of Microbial Biotechnology, Sukhdev Vihar, Mathura Road, New Delhi - 110 025, India
| | - Hemant K Gautam
- CSIR-Institute of Genomics and Integrative Biology, Department of Microbial Biotechnology, Sukhdev Vihar, Mathura Road, New Delhi - 110 025, India
| | - Vijay K Garg
- Department of Dermatology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi - 110 025, India
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22
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Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, Bowe WP, Graber EM, Harper JC, Kang S, Keri JE, Leyden JJ, Reynolds RV, Silverberg NB, Stein Gold LF, Tollefson MM, Weiss JS, Dolan NC, Sagan AA, Stern M, Boyer KM, Bhushan R. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2016; 74:945-73.e33. [PMID: 26897386 DOI: 10.1016/j.jaad.2015.12.037] [Citation(s) in RCA: 704] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/15/2015] [Indexed: 02/06/2023]
Abstract
Acne is one of the most common disorders treated by dermatologists and other health care providers. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children. This evidence-based guideline addresses important clinical questions that arise in its management. Issues from grading of acne to the topical and systemic management of the disease are reviewed. Suggestions on use are provided based on available evidence.
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Affiliation(s)
| | | | | | | | | | - Diane S Berson
- Weill Cornell Medical College, New York, New York; New York Presbyterian Hospital, New York, New York
| | - Whitney P Bowe
- SUNY Down State Medical Center-Brooklyn, New York, New York
| | - Emmy M Graber
- Boston University School of Medicine, Boston, Massachusetts; Boston Medical Center, Boston, Massachusetts
| | | | - Sewon Kang
- Johns Hopkins Medicine, Baltimore, Maryland
| | - Jonette E Keri
- University of Miami Health System, Miami, Florida; Miami VA Hospital, Miami, Florida
| | | | - Rachel V Reynolds
- Harvard Medical Faculty Physicians, Boston, Massachusetts; Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nanette B Silverberg
- Mount Sinai Health System-Beth Israel, New York, New York; St. Lukes-Roosevelt, New York, New York
| | | | | | | | | | | | | | - Kevin M Boyer
- American Academy of Dermatology, Schaumburg, Illinois
| | - Reva Bhushan
- American Academy of Dermatology, Schaumburg, Illinois.
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23
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Propionibacterium acnes: Disease-Causing Agent or Common Contaminant? Detection in Diverse Patient Samples by Next-Generation Sequencing. J Clin Microbiol 2016; 54:980-7. [PMID: 26818667 PMCID: PMC4809928 DOI: 10.1128/jcm.02723-15] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/16/2016] [Indexed: 01/01/2023] Open
Abstract
Propionibacterium acnes is the most abundant bacterium on human skin, particularly in sebaceous areas. P. acnes is suggested to be an opportunistic pathogen involved in the development of diverse medical conditions but is also a proven contaminant of human clinical samples and surgical wounds. Its significance as a pathogen is consequently a matter of debate. In the present study, we investigated the presence of P. acnes DNA in 250 next-generation sequencing data sets generated from 180 samples of 20 different sample types, mostly of cancerous origin. The samples were subjected to either microbial enrichment, involving nuclease treatment to reduce the amount of host nucleic acids, or shotgun sequencing. We detected high proportions of P. acnes DNA in enriched samples, particularly skin tissue-derived and other tissue samples, with the levels being higher in enriched samples than in shotgun-sequenced samples. P. acnes reads were detected in most samples analyzed, though the proportions in most shotgun-sequenced samples were low. Our results show that P. acnes can be detected in practically all sample types when molecular methods, such as next-generation sequencing, are employed. The possibility of contamination from the patient or other sources, including laboratory reagents or environment, should therefore always be considered carefully when P. acnes is detected in clinical samples. We advocate that detection of P. acnes always be accompanied by experiments validating the association between this bacterium and any clinical condition.
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24
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Mirdamadi Y, Thielitz A, Wiede A, Goihl A, Papakonstantinou E, Hartig R, Zouboulis CC, Reinhold D, Simeoni L, Bommhardt U, Quist S, Gollnick H. Insulin and insulin-like growth factor-1 can modulate the phosphoinositide-3-kinase/Akt/FoxO1 pathway in SZ95 sebocytes in vitro. Mol Cell Endocrinol 2015; 415:32-44. [PMID: 26257240 DOI: 10.1016/j.mce.2015.08.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/27/2015] [Accepted: 08/03/2015] [Indexed: 12/16/2022]
Abstract
A recent hypothesis suggests that a high glycaemic load diet-associated increase of insulin-like growth factor-1 (IGF-1) and insulin may promote acne by reducing nuclear localization of the forkhead box-O1 (FoxO1) transcription factor via activation of the phosphoinositide-3-kinase (PI3K)/Akt pathway. Using SZ95 sebocytes as a model, we investigated the effect of the most important insulinotropic western dietary factors, IGF-1 and insulin on acne. SZ95 sebocytes were stimulated with different concentrations of IGF-1 and insulin (0.001, 0.01, 0.1 and 1 μM) for 15 to 120 min ± PI3K inhibitor LY294002 (50 μM). Cytoplasmic and nuclear protein expression of p-Akt and p-FoxO1 as well as FoxO transcriptional activity was analysed. In addition, the proliferation and differentiation of sebocytes and their TLR2/4 expression were determined. We found that high concentrations of IGF-1 and insulin differentially stimulate the PI3K/Akt/FoxO1 pathway by an early up-regulation of cytoplasmic p-Akt and delayed up-regulation of p-FoxO1 resulting in FoxO1 shift to the cytoplasm and the reduction of FoxO transcriptional activity, physiological serum concentration had no effect. IGF-1 at concentrations of 0.1 and 1 μM significantly reduced proliferation but increased differentiation of sebocytes to a greater extent than insulin (0.1 and 1 μM), but up-regulated TLR2/4 expression to comparable extent. These data provide the first in vitro evidence that FoxO1 principally might be involved in the regulation of growth-factor-stimulatory effects on sebaceous lipogenesis and inflammation in the pathological condition of acne. However, the in vivo significance under physiological conditions remains to be elucidated.
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Affiliation(s)
- Yasaman Mirdamadi
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Anja Thielitz
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Antje Wiede
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Alexander Goihl
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Eleni Papakonstantinou
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Roland Hartig
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Dirk Reinhold
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Luca Simeoni
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Ursula Bommhardt
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Sven Quist
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Harald Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
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25
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Fan Y, Hao F, Wang W, Lu Y, He L, Wang G, Chen W. Multicenter cross-sectional observational study of antibiotic resistance and the genotypes of Propionibacterium acnes isolated from Chinese patients with acne vulgaris. J Dermatol 2015; 43:406-13. [PMID: 26508505 DOI: 10.1111/1346-8138.13149] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/19/2015] [Indexed: 12/01/2022]
Abstract
Antibiotics are widely applied in management of acne vulgaris, which raises the issue of antibiotic resistance. Due to improper application and supervision of antibiotics, antibiotic resistance has become a serious problem in China. So, the efficacy of antimicrobial therapy in acne is unclear without an objective monitor of antibiotic resistance of Propionibacterium acnes. This cross-sectional, multicenter observational study is aimed at understanding the status of antibiotic resistance in P. acnes, investigating the measures of acne management in China and analyzing the genotypes of antibiotic-resistant strains of P. acnes. Altogether, 312 strains of P. acnes were collected from patients in five medical centers across central China after reviewing the corresponding medical history in detail. The samples underwent antibiotic susceptibility assays by agar dilution method with a total of 11 classes of antibiotics being tested. The antibiotic-resistant strains were screened and further analyzed by investigation of the genotypes regarding 23S rRNA, 16S rRNA and erm(X). The predominant resistance occurred in macrolides and lincomycin with an overall resistance rate of 47.8%. The resistance to tetracyclines was scarce with only two cases identified. The emergence of minimum inhibitory concentration elevation for tetracyclines is associated with its application history (P < 0.005). The genotypes of the reported macrolide-lincosamide-streptogramin B resistance strains were also spotted in Chinese subjects while other resistance determinants may also exist. The tetracyclines have been proved to be vastly susceptible while macrolides and lincomycin face a serious resistance status in China.
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Affiliation(s)
- Yukun Fan
- Department of Dermatology and Venereology, Southwest Hospital Affiliated to The Third Military Medical University, Chongqing, China
| | - Fei Hao
- Department of Dermatology and Venereology, Southwest Hospital Affiliated to The Third Military Medical University, Chongqing, China
| | - Weizhen Wang
- Department of Dermatology, The First Hospital of Wuhan, Tongji Medical College, Wuhan, China
| | - Yonghong Lu
- Department of Dermatology and Venereology, The Second People's Hospital of Chengdu, Chengdu, China
| | - Li He
- Department of Dermatology and Venereology, The First Hospital Affiliated to The Kunming Medical University, Kunming, China
| | - Gang Wang
- Department of Dermatology and Venereology, Xijing Hospital Affiliated to The Fourth Military Medical University, Xi'an, China
| | - Wenchieh Chen
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany
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26
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Furustrand Tafin U, Aubin GG, Eich G, Trampuz A, Corvec S. Occurrence and new mutations involved in rifampicin-resistant Propionibacterium acnes strains isolated from biofilm or device-related infections. Anaerobe 2015; 34:116-9. [PMID: 25999299 DOI: 10.1016/j.anaerobe.2015.05.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 12/17/2022]
Abstract
We described for the first time the amino acid substitutions conferring rifampicin resistance in eight Propionibacterium acnes strains isolated from patients with biofilm or device-related infections. We identified different mutations in cluster I and one mutation, never reported, in cluster II of the rpoB gene (I480V) associated with the most frequent one in cluster I (S442L). Half of the patients previously received treatment with rifampicin.
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Affiliation(s)
- Ulrika Furustrand Tafin
- Septic Surgical Unit, Department of Surgery and Anaesthesiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Guillaume Ghislain Aubin
- Service de Bactériologie-Hygiène Hospitalière, Nantes University Hospital, Nantes, France; Université de Nantes, EA3826 Thérapeutiques cliniques et expérimentales des infections, Nantes Medicine School, F-44000 Nantes, France
| | - Gerhard Eich
- Infectious Diseases Service, Zurich University Hospital, Zurich, Switzerland
| | - Andrej Trampuz
- Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Berlin, Germany
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène Hospitalière, Nantes University Hospital, Nantes, France; Université de Nantes, EA3826 Thérapeutiques cliniques et expérimentales des infections, Nantes Medicine School, F-44000 Nantes, France.
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Jahns AC, Eilers H, Ganceviciene R, Alexeyev OA. Propionibacterium species and follicular keratinocyte activation in acneic and normal skin. Br J Dermatol 2014; 172:981-7. [PMID: 25279837 DOI: 10.1111/bjd.13436] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND The pathogenesis of acne vulgaris is multifactorial with increased sebum production, alteration in the quality of sebum lipids, dysregulation of the hormone microenvironment, follicular hyperkeratinization and Propionibacterium acnes-driven inflammation as major contributory factors. Hyperproliferation of keratinocytes is believed to contribute to hypercornification and eventually leads to comedone development. While the distribution of P. acnes is relatively well documented in acneic and healthy skin, little is known about P. granulosum and P. avidum. OBJECTIVES To visualize directly the three major Propionibacterium in 117 control and 26 acneic skin samples. In addition, keratinocyte proliferation was evaluated. METHODS Propionibacteria were visualized by immunofluorescence microscopy, and keratinocyte proliferation was assessed by Ki67, keratin (K) 16 and p63 immunochemistry. RESULTS P. acnes was identified in 68 samples (48%), while P. granulosum was identified in 12 (8%) samples; P. avidum was not detected at all. Unexpectedly, acne samples did not show higher keratinocyte proliferation than controls, nor was there any association between bacterial colonization and expression of Ki67/K16/p63. CONCLUSIONS Our findings do not support earlier notions of follicular keratinocyte hyperproliferation as a cause of ductal hypercornification in acneic facial skin. Further studies on the mechanisms underlying hypercornification in acne pathogenesis are needed.
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Affiliation(s)
- A C Jahns
- Department of Medical Biosciences/Pathology, Umeå University, S-90185, Umeå, Sweden
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28
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Fabbrocini G, Saint Aroman M. Cosmeceuticals based on Rhealba®
Oat plantlet extract for the treatment of acne vulgaris. J Eur Acad Dermatol Venereol 2014; 28 Suppl 6:1-6. [DOI: 10.1111/jdv.12791] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/19/2014] [Indexed: 12/26/2022]
Affiliation(s)
- G. Fabbrocini
- Department of Dermatology and Venerology; University of Naples Federico II; Naples Italy
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29
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Christensen GJM, Brüggemann H. Bacterial skin commensals and their role as host guardians. Benef Microbes 2014; 5:201-15. [PMID: 24322878 DOI: 10.3920/bm2012.0062] [Citation(s) in RCA: 186] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Recent years' investigations of the co-evolution and functional integration of the human body and its commensal microbiota have disclosed that the microbiome has a major impact on physiological functions including protection against infections, reaction patterns in the immune system, and disposition for inflammation-mediated diseases. Two ubiquitous members of the skin microbiota, the Gram-positive bacteria Staphylococcus epidermidis and Propionibacterium acnes, are predominant on human epithelia and in sebaceous follicles, respectively. Their successful colonisation is a result of a commensal or even mutualistic lifestyle, favouring traits conferring persistency over aggressive host-damaging properties. Some bacterial properties suggest an alliance with the host to keep transient, potential pathogens at bay, such as the ability of S. epidermidis to produce antimicrobials, or the production of short-chain fatty acids by P. acnes. These features can function together with host-derived components of the innate host defence to establish and maintain the composition of a health-associated skin microbiota. However, depending largely on the host status, the relationship between the human host and S. epidermidis/P. acnes can also have parasitic features. Both microorganisms are frequently isolated from opportunistic infections. S. epidermidis is a causative agent of hospital-acquired infections, mostly associated with the use of medical devices. P. acnes is suspected to be of major importance in the pathogenesis of acne and also in a number of other opportunistic infections. In this review we will present bacterial factors and traits of these two key members of our skin microbiota and discuss how they contribute to mutualistic and parasitic properties. The elucidation of their roles in health-promoting or disease-causing processes could lead to new prophylactic and therapeutic strategies against skin disorders and other S. epidermidis/P. acnes-associated diseases, and increase our understanding of the delicate interplay of the skin microbiota with the human host.
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Affiliation(s)
- G J M Christensen
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, 8000 Aarhus C, Denmark
| | - H Brüggemann
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, 8000 Aarhus C, Denmark
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30
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Manfredini M, Mazzaglia G, Ciardo S, Farnetani F, Mandel VD, Longo C, Zauli S, Bettoli V, Virgili A, Pellacani G. Acne: in vivo
morphologic study of lesions and surrounding skin by means of reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2014; 29:933-9. [DOI: 10.1111/jdv.12730] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M. Manfredini
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - G. Mazzaglia
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - S. Ciardo
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - F. Farnetani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - V. D. Mandel
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - C. Longo
- Skin Cancer Unit; Arcispedale Santa Maria Nuova; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS); Reggio Emilia Italy
| | - S. Zauli
- Department of Dermatology; University of Ferrara; Ferrara Italy
| | - V. Bettoli
- Department of Dermatology; University of Ferrara; Ferrara Italy
| | - A. Virgili
- Department of Dermatology; University of Ferrara; Ferrara Italy
| | - G. Pellacani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
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31
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Abstract
The mechanisms of inflammation in acne are currently subject of intense investigation. This study focused on the activation of adaptive and innate immunity in clinically early visible inflamed acne lesions and was performed in two independent patient populations. Biopsies were collected from lesional and non-lesional skin of acne patients. Using Affymetrix Genechips, we observed significant elevation of the signature cytokines of the Th17 lineage in acne lesions compared to non-lesional skin. The increased expression of IL-17 was confirmed at the RNA and also protein level with real-time PCR (RT-PCR) and Luminex technology. Cytokines involved in Th17 lineage differentiation (IL-1β, IL-6, TGF-β, IL23p19) were remarkably induced at the RNA level. In addition, proinflammatory cytokines and chemokines (TNF-α, IL-8, CSF2 and CCL20), Th1 markers (IL12p40, CXCR3, T-bet, IFN-γ), T regulatory cell markers (Foxp3, IL-10, TGF-β) and IL-17 related antimicrobial peptides (S100A7, S100A9, lipocalin, hBD2, hBD3, hCAP18) were induced. Importantly, immunohistochemistry revealed significantly increased numbers of IL-17A positive T cells and CD83 dendritic cells in the acne lesions. In summary our results demonstrate the presence of IL-17A positive T cells and the activation of Th17-related cytokines in acne lesions, indicating that the Th17 pathway is activated and may play a pivotal role in the disease process, possibly offering new targets of therapy.
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Scholz CFP, Jensen A, Lomholt HB, Brüggemann H, Kilian M. A novel high-resolution single locus sequence typing scheme for mixed populations of Propionibacterium acnes in vivo. PLoS One 2014; 9:e104199. [PMID: 25111794 PMCID: PMC4128656 DOI: 10.1371/journal.pone.0104199] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 07/05/2014] [Indexed: 12/02/2022] Open
Abstract
The Gram-positive anaerobic bacterium Propionibacterium acnes is a prevalent member of the normal skin microbiota of human adults. In addition to its suspected role in acne vulgaris it is involved in a variety of opportunistic infections. Multi-locus sequence-typing (MLST) schemes identified distinct phylotypes associated with health and disease. Being based on 8 to 9 house-keeping genes these MLST schemes have a high discriminatory power, but their application is time- and cost-intensive. Here we describe a single-locus sequence typing (SLST) scheme for P. acnes. The target locus was identified with a genome mining approach that took advantage of the availability of representative genome sequences of all known phylotypes of P. acnes. We applied this SLST on a collection of 188 P. acnes strains and demonstrated a resolution comparable to that of existing MLST schemes. Phylogenetic analysis applied to the SLST locus resulted in clustering patterns identical to a reference tree based on core genome sequences. We further demonstrate that SLST can be applied to detect multiple phylotypes in complex microbial communities by a metagenomic pyrosequencing approach. The described SLST strategy may be applied to any bacterial species with a basically clonal population structure to achieve easy typing and mapping of multiple phylotypes in complex microbiotas. The P. acnes SLST database can be found at http://medbac.dk/slst/pacnes.
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Affiliation(s)
| | - Anders Jensen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Hans B. Lomholt
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Mogens Kilian
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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33
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Propionibacterium acnes, an emerging pathogen: From acne to implant-infections, from phylotype to resistance. Med Mal Infect 2014; 44:241-50. [DOI: 10.1016/j.medmal.2014.02.004] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 12/24/2013] [Accepted: 02/12/2014] [Indexed: 11/22/2022]
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Abstract
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit and it is observed equally in both sexes and nearly all races. It generally begins at puberty, but the healing period is variable. There is no known etiological factor, except genetic tendency. Androgens play a very limited role in some female patients. The effects of cosmetics, foods and drinks are also discussible and too limited. There are four factors in acne pathogenesis: Increase of the sebum excretionKeratinization of infrainfundibulumBacterial colonization of the follicleInflammation It is mainly observed on the face and back, shoulders and chest. Initial lesions are comedons. Papules, pustules and cysts of severe types follow it. The most important factor in treatment is a very good patient-physician communication. Topical or systemic treatment or both can be used depending on the severity of acne. Benzoyl peroxyde, azelaic acid, AHA's antibiotics, retinoic acid and derivatives are the topical choices. For systemic treatment antibiotics are the most commonly used medicines, but isotretinoine has a very spesific place with the possibility of permanent healing. All kind of treatments need approximately six months for a good result.
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Affiliation(s)
- Ertuğrul H Aydemir
- Department of Dermatology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
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35
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Lwin SM, Kimber I, McFadden JP. Acne, quorum sensing and danger. Clin Exp Dermatol 2014; 39:162-7. [DOI: 10.1111/ced.12252] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2013] [Indexed: 12/25/2022]
Affiliation(s)
- S. M. Lwin
- St John's Institute of Dermatology; St Thomas’ Hospital; London UK
| | - I. Kimber
- Faculty of Life Sciences; University of Manchester; Manchester UK
| | - J. P. McFadden
- St John's Institute of Dermatology; St Thomas’ Hospital; London UK
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36
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Kwon H, Yoon J, Park S, Suh D. Analysis of distribution patterns ofPropionibacterium acnesphylotypes andPeptostreptococcusspecies from acne lesions. Br J Dermatol 2013; 169:1152-5. [DOI: 10.1111/bjd.12486] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- H.H. Kwon
- Department of Dermatology; Seoul National University College of Medicine; 28 Yongon-dong Seoul 110-744 Korea
- Acne Research Laboratory; Seoul National University Hospital; Seoul Korea
| | - J.Y. Yoon
- Acne Research Laboratory; Seoul National University Hospital; Seoul Korea
| | - S.Y. Park
- Department of Dermatology; Seoul National University College of Medicine; 28 Yongon-dong Seoul 110-744 Korea
- Acne Research Laboratory; Seoul National University Hospital; Seoul Korea
| | - D.H. Suh
- Department of Dermatology; Seoul National University College of Medicine; 28 Yongon-dong Seoul 110-744 Korea
- Acne Research Laboratory; Seoul National University Hospital; Seoul Korea
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A honey trap for the treatment of acne: manipulating the follicular microenvironment to control Propionibacterium acnes. BIOMED RESEARCH INTERNATIONAL 2013; 2013:679680. [PMID: 23762853 PMCID: PMC3666392 DOI: 10.1155/2013/679680] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 04/12/2013] [Indexed: 01/13/2023]
Abstract
Today, as 40 years ago, we still rely on a limited number of antibiotics and benzoyl peroxide to treat inflammatory acne. An alternative way of suppressing the growth of Propionibacterium acnes is to target the environment in which it thrives. We conjecture that P. acnes colonises a relatively “extreme” habitat especially in relation to the availability of water and possibly related factors such as ionic strength and osmolarity. We hypothesise that the limiting “nutrient” within pilosebaceous follicles is water since native sebum as secreted by the sebaceous gland contains none. An aqueous component must be available within colonised follicles, and water may be a major factor determining which follicles can sustain microbial populations. One way of preventing microbial growth is to reduce the water activity (aw) of this component with a biocompatible solute of very high water solubility. For the method to work effectively, the solute must be small, easily diffusible, and minimally soluble in sebaceous lipids. Xylose and sucrose, which fulfil these criteria, are nonfermentable by P. acnes and have been used to reduce water activity and hence bacterial colonisation of wounds. A new follicularly targeted topical treatment for acne based on this approach should be well tolerated and highly effective.
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Khorvash F, Abdi F, Kashani HH, Naeini FF, Narimani T. Staphylococcus aureus in Acne Pathogenesis: A Case-Control Study. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2012. [PMID: 23181229 PMCID: PMC3503376 DOI: 10.4103/1947-2714.103317] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is considerable evidence which suggests a possible pathogenetic role for Staphylococcus aureus (S. aureus) in acne vulgaris. AIM The study was to determine S. aureus colonization and antibiotic susceptibility patterns in patients with acne and of healthy people. MATERIALS AND METHODS In the case-control study, a total of 324 people were screened for nasal carriage of S. aureus: 166 acne patients and 158 healthy persons. One control subject was individually matched to one case. Nasal swabs from anterior nares of individuals were cultured and identified as S. aureus. Antibiotic sensitivity was performed with recognized laboratory techniques. RESULTS S. aureus was detected in 21.7% of the subjects in acne, and in 26.6% of control groups. There was no statistical difference in colonization rates between two groups (P=0.3). In patient group, most of S. aureus isolates were resistant to doxicycline and tetracycline (P=0.001), and were more sensitive to rifampicin compared to other drugs. In control samples, the isolated demonstrated higher resistance to cotrimoxazole compared to patient samples (P=0.0001). There was no difference between groups regarding resistance to rifampicin, vancomycin, methicillin, and oxacillin. CONCLUSION It is still unclear whether S. aureus is actually a causal agent in the pathogenesis of acne. Based on microbiological data of both healthy and acne-affected persons, we propose that contribution of S. aureus in acne pathogenesis is controversial.
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Affiliation(s)
- Farzin Khorvash
- Department of Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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40
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Sampling and detection of skin Propionibacterium acnes: Current status. Anaerobe 2012; 18:479-83. [DOI: 10.1016/j.anaerobe.2012.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 07/16/2012] [Accepted: 07/24/2012] [Indexed: 01/28/2023]
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Garner SE, Eady A, Bennett C, Newton JN, Thomas K, Popescu CM. Minocycline for acne vulgaris: efficacy and safety. Cochrane Database Syst Rev 2012; 2012:CD002086. [PMID: 22895927 PMCID: PMC7017847 DOI: 10.1002/14651858.cd002086.pub2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Minocycline is an oral antibiotic used for acne vulgaris. Its use has lessened due to safety concerns (including potentially irreversible pigmentation), a relatively high cost, and no evidence of any greater benefit than other acne treatments. A modified-release version of minocycline is being promoted as having fewer side-effects. OBJECTIVES To assess new evidence on the effects of minocycline for acne vulgaris. SEARCH METHODS Searches were updated in the following databases to November 2011: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE (from 1946), EMBASE (from 1974), and LILACS (from 1982). We also searched trials registers and checked reference lists for further references to relevant randomised controlled trials (RCTs).The Cochrane Skin Group's Trials Search Co-ordinator undertook searches exploring minocycline's adverse effects in EMBASE and MEDLINE in February 2012. SELECTION CRITERIA We selected randomised controlled trials (RCTs) comparing minocycline, at any dose, to an active or a placebo control, in participants with inflammatory acne vulgaris. For adverse effects, we selected additional studies that reported the number of adverse effects and the number of participants treated. DATA COLLECTION AND ANALYSIS Outcome measures used in the trials included lesion counts, acne grades/severity scores, doctors' and participants' global assessments, adverse effects, and dropout rates. Two authors independently assessed the quality of each study. Effect sizes were calculated, and meta-analyses were undertaken where possible.Sixteen studies met the inclusion criteria for the review of adverse effects. MAIN RESULTS We included 12 new RCTs for this update, giving a total of 39 RCTs (6013 participants). These additional 12 RCTs have not changed the original conclusions about the clinical efficacy of minocycline.The identified RCTs were generally small and poor quality. Meta-analysis was rarely possible because of the lack of data and different outcome measures and trial durations. Although minocycline was shown to be an effective treatment for moderate to moderately-severe acne vulgaris, there was no evidence that it is better than any of the other commonly-used acne treatments. One company-sponsored RCT found minocycline to be less effective than combination treatment with topical erythromycin and zinc. No trials have been conducted using minocycline in those participants whose acne is resistant to other therapies. Also, there is no evidence to guide what dose should be used.The adverse effects studies must be interpreted with caution. The evidence suggests that minocycline is associated with more severe adverse effects than doxycycline. Minocycline, but not other tetracyclines, is associated with lupus erythematosus, but the risk is small: 8.8 cases per 100,000 person-years. The risk of autoimmune reactions increases with duration of use. The evidence does not support the conclusion that the more expensive extended-release preparation is safer than standard minocycline preparations. AUTHORS' CONCLUSIONS Minocycline is an effective treatment for moderate to moderately-severe inflammatory acne vulgaris, but there is still no evidence that it is superior to other commonly-used therapies. This review found no reliable evidence to justify the reinstatement of its first-line use, even though the price-differential is less than it was 10 years ago. Concerns remain about its safety compared to other tetracyclines.
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Affiliation(s)
- Sarah E Garner
- Research and Development, National Institute for Health and Clinical Excellence (NICE), London, UK.
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Moon SH, Roh HS, Kim YH, Kim JE, Ko JY, Ro YS. Antibiotic resistance of microbial strains isolated from Korean acne patients. J Dermatol 2012; 39:833-7. [PMID: 22779738 DOI: 10.1111/j.1346-8138.2012.01626.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Over several decades, topical and systemic antibiotics have been the mainstay of treatment for acne vulgaris. The widespread and long-term use of antibiotics in the treatment of acne has resulted in the spread of resistant bacterial strains and treatment failure. We aimed to examine the bacteriology of acne vulgaris and to evaluate its susceptibility to the antibiotics widely used for acne in Korea. We examined the species of bacteria aerobically and anaerobically isolated from 100 Korean acne patients. Among the bacteria isolated, Staphylococcus epidermidis (36 patients) was the most common, followed by Propionibacterium acnes (30 patients). Eleven strains of P. acnes (36.7%) and 25 strains of S. epidermidis (69.4%) were resistant to one or other of the antibiotics tested. A higher proportion of P. acnes isolates were resistant to clindamycin (30%) and erythromycin (26.7%), than to any other antibiotics tested (P = 0.0003). Some S. epidermidis isolates were resistant to tetracycline and doxycycline in addition to clindamycin and erythromycin. In the previous studies, few strains of P. acnes were found to be resistant to any of the antibiotics, but this study shows that antibiotic-resistant strains have been increasing in Korea acne patients.
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Affiliation(s)
- Sang Ho Moon
- Areumdaun Dermatologic Clinic Department of Dermatology, Hanyang University College of Medicine LeeJiHam Dermatologic Clinic, Seoul, Korea
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Jahns A, Lundskog B, Ganceviciene R, Palmer R, Golovleva I, Zouboulis C, McDowell A, Patrick S, Alexeyev O. An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case-control study. Br J Dermatol 2012; 167:50-8. [DOI: 10.1111/j.1365-2133.2012.10897.x] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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CHIA HY, TEY HL, LEE JSS. Reply: “Follicular spicules associated with Propionibacterium acneswith response to erythromycin”: Lack of evidence for the species? J Dermatol 2012. [DOI: 10.1111/j.1346-8138.2011.01472.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Luk NMT, Hui M, Lee HCS, Fu LH, Liu ZH, Lam LY, Eastel M, Chan YKA, Tang LSN, Cheng TS, Siu FYC, Ng SC, Lai YKD, Ho KM. Antibiotic-resistant Propionibacterium acnes among acne patients in a regional skin centre in Hong Kong. J Eur Acad Dermatol Venereol 2011; 27:31-6. [PMID: 22103749 DOI: 10.1111/j.1468-3083.2011.04351.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There has been no study on antibiotic-resistant Propionibacterium acnes in Hong Kong. OBJECTIVE We investigated the prevalence and pattern of antibiotic-resistant P. acnes and to identify any associated factors for harbouring the resistant strains. METHODS Culture and sensitivity testing of P. acnes to commonly used antibiotics were performed. Resistance to tetracycline was defined at a minimal inhibitory concentration (MIC) of 2 μg/mL or more; erythromycin at an MIC of 0.5 μg/mL or more; clindamycin at an MIC of 0.25 μg/mL or more according to EUCAST. For breakpoints of doxycycline and minocycline, those with an MIC of 1 μg/mL or more were defined as resistant strains. RESULTS Among the 111 specimens collected from 111 patients, 86 strains of P. acnes were recovered, one from each specimen. Twenty-five specimens had no growth. Forty-seven (54.8%) strains were found to be resistant to one or more antibiotics. Forty-six (53.5%), 18 (20.9%), 14 (16.3%), 14(16.3%) and 14 (16.3%) strains were resistant to clindamycin (CL), erythromycin (EM), tetracycline (TET), doxycycline (DOX) and minocycline (MR) respectively. Ten strains (11.6%) had cross resistance between the MLS antibiotics (erythromycin or clindamycin), one strain (1.2%) had cross resistance among the cyclines and 14 strains (16.4%) had cross resistance between the MLS and cycline antibiotics. Binary logistic regression showed an association between MLS antibiotic resistance with an increased age whereas cycline resistance was associated with the duration of treatment. CONCLUSION Antibiotic-resistant P. acnes is prevalent in Hong Kong. Dermatologists should be more vigilant in prescribing antibiotics for acne patients.
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Affiliation(s)
- N-M T Luk
- Dermatology Research Centre Department of Microbiology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong.
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