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Del Rosso JQ, Armillei MK, Lomakin IB, Grada A, Bunick CG. Clindamycin: A Comprehensive Status Report with Emphasis on Use in Dermatology. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2024; 17:29-40. [PMID: 39148960 PMCID: PMC11324192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Clindamycin is a lincosamide antibiotic that has been used as a topical, oral, or injectable formulation for over five decades. It exhibits a narrow spectrum of microbiologic activity, primarily against gram-positive and anaerobic bacteria. In dermatology, clindamycin has been used primarily as a topical agent, usually for the treatment of acne vulgaris. Despite questions surrounding antibiotic resistance and/or its relative contribution to antibiotic treatment efficacy, a large body of data support the therapeutic value of topical clindamycin for acne vulgaris. As a systemic agent, clindamycin is used orally to treat a variety of cutaneous bacterial infections, and sometimes for acne vulgaris, with oral treatment for the latter less common in more recent years. The modes of action of clindamycin are supported by data showing both its anti-inflammatory and antibiotic mechanisms, which are discussed here along with pharmacokinetic profiles and structure-activity relationships. The diverse applications of clindamycin for multiple disease states, its efficacy, and safety considerations are also reviewed here, including for both topical and systemic formulations. Emphasis is placed on uses in dermatology, but other information on clindamycin relevant to clinicians is also discussed.
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Affiliation(s)
- James Q. Del Rosso
- Dr. Del Rosso is Adjunct Clinical Faculty in Dermatology at Touro University Nevada in Henderson, Nevada, JDR Dermatology Research in Las Vegas, Nevada, and Advanced Dermatology and Cosmetic Surgery in Maitland, Florida
| | - Maria K. Armillei
- Ms. Armillei is with the Translational Biomedicine Program at the Yale University School of Medicine in New Haven, Connecticut
| | - Ivan B. Lomakin
- Dr. Lomakin is with the Department of Dermatology at Yale University in New Haven, Connecticut
| | - Ayman Grada
- Dr. Grada is with the Department of Dermatology at Case Western Reserve University School of Medicine in Cleveland, Ohio
| | - Christopher G. Bunick
- Dr. Bunick is with the Translational Biomedicine Program at the Yale University School of Medicine in New Haven, Connecticut, and the Department of Dermatology at Yale University in New Haven, Connecticut
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Li L, Zhang J, Cheng W, Di F, Wang C, An Q. Saponins of Paris polyphylla for the Improvement of Acne: Anti-Inflammatory, Antibacterial, Antioxidant and Immunomodulatory Effects. Molecules 2024; 29:1793. [PMID: 38675613 PMCID: PMC11052371 DOI: 10.3390/molecules29081793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Acne is a chronic inflammatory skin disease with a recurring nature that seriously impacts patients' quality of life. Currently, antibiotic resistance has made it less effective in treating acne. However, Paris polyphylla (P. polyphylla) is a valuable medicinal plant with a wide range of chemical components. Of these, P. polyphylla saponins modulate the effects in vivo and in vitro through antibacterial, anti-inflammatory, immunomodulatory, and antioxidant effects. Acne is primarily associated with inflammatory reactions, abnormal sebum function, micro-ecological disorders, hair follicle hyperkeratosis, and, in some patients, immune function. Therefore, the role of P. polyphylla saponins and their values in treating acne is worthy of investigation. Overall, this review first describes the distribution and characteristics of P. polyphylla and the pathogenesis of acne. Then, the potential mechanisms of P. polyphylla saponins in treating acne are listed in detail (reduction in the inflammatory response, antibacterial action, modulation of immune response and antioxidant effects, etc.). In addition, a brief description of the chemical composition of P. polyphylla saponins and its available extraction methods are described. We hope this review can serve as a quick and detailed reference for future studies on their potential acne treatment.
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Affiliation(s)
- Luyao Li
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Jiachan Zhang
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Wenjing Cheng
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Feiqian Di
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Changtao Wang
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Quan An
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, China;
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Ho HH, Chen CW, Yi TH, Huang YF, Kuo YW, Lin JH, Chen JF, Tsai SY, Chan LP, Liang CH. Novel application of a Co-Fermented postbiotics of TYCA06/AP-32/CP-9/collagen in the improvement of acne vulgaris-A randomized clinical study of efficacy evaluation. J Cosmet Dermatol 2022; 21:6249-6260. [PMID: 35818134 DOI: 10.1111/jocd.15228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/07/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acne vulgaris is a chronic inflammatory skin disease. If skin lesions are not treated well in time, they can leave a permanent impact on the appearance and a negative influence on personal confidence. The common therapy for acne symptom includes antibiotics, benzoyl peroxide, and azeleic acid. However, those medications have side effects, and the long-term use should be cautious. Therefore, it is necessary to develop a safe and effective material, which is more suitable for daily use. OBJECTIVE Collagen was selected to co-ferment with three probiotic strains TYCA06/AP-32/CP-9 (TAC) due to its excellent feature on wound healing. The fermented material was added into cosmetic gel and applied on subjects' acne lesions. The antimicrobial activity against Propionibacterium acnes and anti-inflammation effect around lesion area were investigated in a 4-week clinical study. MATERIAL AND METHODS An anti-P. acnes assay, a keratinocytes HaCaT cell-based wound healing assay, and a cytokine assay on thymic stromal lymphopoietin (TSLP) and interleukin (IL)-33 were used to evaluate the function of the fermented material in vitro. The TAC/Collagen formula was further incorporated into a cosmetic gel, and the human clinical trial was carried out by applying this gel on 20 volunteers' face with acne vulgaris. The moisture score, sebum content, inflammation, porphyrins numbers, and brown spot number of whole face were observed and recorded. RESULTS The postbiotics of the TAC/Collagen displayed a good growth inhibition against P. acnes and reduced TSLP and IL-33 inflammation in vitro. This TAC/Collagen formula enhanced the wound healing in HaCaT cell culture. The result of the clinical trial showed the TAC/Collagen gel improved the moisture score and inflammation index of the skin in vivo. In addition, this TAC/Collagen gel also improved the wound healing of acne symptom in volunteers with acne vulgaris. Moreover, this TAC/Collagen gel reduced the number of the porphyrins and brown spots on facial skin. CONCLUSION These postbiotics of TAC/Collagen have beneficial effects on skin health and are able to ameliorate the redness, inflammation, and acne symptom in acne vulgaris patients.
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Affiliation(s)
| | | | | | | | - Yi-Wei Kuo
- Glac Biotech Co., Ltd., Tainan City, Taiwan
| | | | | | | | - Leong-Perng Chan
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Hua Liang
- Department of Cosmetic Science and Institute of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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Singh AP, Arya H, Singh V, Kumar P, Gautam HK. Identification of natural inhibitors to inhibit C. acnes lipase through docking and simulation studies. J Mol Model 2022; 28:281. [PMID: 36040538 DOI: 10.1007/s00894-022-05289-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022]
Abstract
Acne vulgaris is a common skin disease affecting 80-90% of teenagers worldwide. C. acnes producing lipases are the main virulence factor that catalyzes sebum lipid into free fatty acid that is used for C. acnes growth. Recently, computational biology and bioinformatics play a significant role in drug discovery programs and the identification of novel lead(s). In this study, potential inhibitors against the C. acnes lipase have been identified via cost-effective computational investigations. Molecular docking, MD simulations, and binding affinity analysis have been performed between the active site of C. acnes lipase protein and selected natural plant constituents. First, C. acnes lipase protein was downloaded from PDB and defined the catalytically active site. Next, 16 active natural plant constituents were shortlisted from the PubChem library (based on their pharmacokinetics, pharmacodynamics, and antibacterial activity). Docking studies identified the best five active compounds that showed significantly strong binding affinity interacted through hydrogen bonding, hydrophobic interactions, and π-stacking with the active site residues of the target protein. Furthermore, a 100 ns MD simulation run showed a stable RMSD and less fluctuating RMSF graph for luteolin and neryl acetate. In silico investigation suggested that luteolin, neryl acetate, and isotretinoin were involved in stable interactions which were maintained throughout the MD run with the C. acnes lipase enzyme, virtually. The results advocated that these could potentially inhibit lipase activity and be used in the clinical management of acne.
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Affiliation(s)
- Akash Pratap Singh
- CSlR-Institute of Genomics and Integrative Biology, Mathura Road, New Delhi, 110025, India.,Academy of Innovative and Scientific Research (AcSIR), Ghaziabad, 201002, India
| | - Hemant Arya
- Department of Biotechnology, Central University of Rajasthan, Ajmer, India
| | - Vijay Singh
- CSlR-Institute of Genomics and Integrative Biology, Mathura Road, New Delhi, 110025, India
| | - Pradeep Kumar
- CSlR-Institute of Genomics and Integrative Biology, Mathura Road, New Delhi, 110025, India.,Academy of Innovative and Scientific Research (AcSIR), Ghaziabad, 201002, India
| | - Hemant K Gautam
- CSlR-Institute of Genomics and Integrative Biology, Mathura Road, New Delhi, 110025, India. .,Academy of Innovative and Scientific Research (AcSIR), Ghaziabad, 201002, India.
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5
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Koutsoumanis K, Allende A, Alvarez‐Ordóñez A, Bolton D, Bover‐Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Ru G, Simmons M, Skandamis P, Suffredini E, Andersson DI, Bampidis V, Bengtsson‐Palme J, Bouchard D, Ferran A, Kouba M, López Puente S, López‐Alonso M, Nielsen SS, Pechová A, Petkova M, Girault S, Broglia A, Guerra B, Innocenti ML, Liébana E, López‐Gálvez G, Manini P, Stella P, Peixe L. Maximum levels of cross-contamination for 24 antimicrobial active substances in non-target feed. Part 5: Lincosamides: lincomycin. EFSA J 2021; 19:e06856. [PMID: 34729085 PMCID: PMC8546522 DOI: 10.2903/j.efsa.2021.6856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The specific concentrations of lincomycin in non-target feed for food-producing animals, below which there would not be an effect on the emergence of, and/or selection for, resistance in bacteria relevant for human and animal health, as well as the specific antimicrobial concentrations in feed which have an effect in terms of growth promotion/increased yield were assessed by EFSA in collaboration with EMA. Details of the methodology used for this assessment, associated data gaps and uncertainties, are presented in a separate document. To address antimicrobial resistance, the Feed Antimicrobial Resistance Selection Concentration (FARSC) model developed specifically for the assessment was applied. However, due to the lack of data on the parameters required to calculate the FARSC, it was not possible to conclude the assessment until further experimental data become available. To address growth promotion, data from scientific publications obtained from an extensive literature review were used. Levels of lincomycin in feed that showed to have an effect on growth promotion/increased yield were reported. It was recommended to carry out studies to generate the data that are required to fill the gaps which prevented the calculation of the FARSC for lincomycin.
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Takahashi E, Lee JM, Mon H, Chieda Y, Yasunaga-Aoki C, Kusakabe T, Iiyama K. Effect of antibiotics on extracellular protein level in Pseudomonas aeruginosa. Plasmid 2016; 84-85:44-50. [DOI: 10.1016/j.plasmid.2016.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/11/2016] [Accepted: 03/16/2016] [Indexed: 11/25/2022]
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Gupta A, Singh S, Kotla NG, Webster TJ. Formulation and evaluation of a topical niosomal gel containing a combination of benzoyl peroxide and tretinoin for antiacne activity. Int J Nanomedicine 2014; 10:171-82. [PMID: 25565812 PMCID: PMC4283991 DOI: 10.2147/ijn.s70449] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A skin disease, like acne, is very common and normally happens to everyone at least once in their lifetime. The structure of the stratum corneum is often compared with a brick wall, with corneocytes surrounded by the mortar of the intercellular lipid lamellae. One of the best options for successful drug delivery to the affected area of skin is the use of elastic vesicles (niosomes) which can be transported through the skin through channel-like structures. In this study, a combination of tretinoin (keratolytic agent) and benzoyl peroxide (BPO) (a potent antibacterial) was given by using niosomes as promising carriers for the effective treatment of acne by acting on a pathogenic site. In this section, niosomal gel formulation encapsulated drugs have been evaluated for in vitro, ex vivo, and in vivo, for their predetermined characteristics; and finally the stability of the niosome gel was tested at different temperature conditions for understanding of the storage conditions required for maintaining the quality of formulation attributes. The prepared niosome was found to be in the range of 531 nm with a zeta potential of −43 mV; the entrapment efficiencies of tretinoin (TRA) and BPO niosomes were found to be 96.25%±0.56% and 98.75%±1.25%, respectively. The permeated amount of TRA and BPO from the niosomal gel after 24 hours was calculated as 6.25±0.14 μg/cm2 and 5.04±0.014 μg/cm2, respectively. A comparative drug retention study in Wistar rat skin using cream, an alcoholic solution, and a niosomal gel showed 11.54 μg, 2.68 μg, and 15.54 μg amounts of TRA and 68.85 μg, 59.98 μg, and 143.78 μg amounts of BPO were retained in the layers of skin, respectively. In vivo studies of the niosomal gel and antiacne cream of TRA and BPO showed that the niosomal gel was more efficacious than the antiacne cream because niosomal gels with a 4.16-fold lower dose of BPO provided the same therapeutic index at targeted sites in comparison to the antiacne cream.
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Affiliation(s)
- Ankush Gupta
- Department of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sima Singh
- Department of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Niranjan G Kotla
- Department of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA ; Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Saudi Arabia
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8
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Raza K, Singh B, Singla S, Wadhwa S, Garg B, Chhibber S, Katare OP. Nanocolloidal Carriers of Isotretinoin: Antimicrobial Activity against Propionibacterium acnes and Dermatokinetic Modeling. Mol Pharm 2013; 10:1958-63. [DOI: 10.1021/mp300722f] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kaisar Raza
- UGC-Centre of Excellence in
Applications of Nanomaterials, Nanoparticles and Nanocomposites, Panjab University, Chandigarh, India 160014
| | - Bhupinder Singh
- UGC-Centre of Excellence in
Applications of Nanomaterials, Nanoparticles and Nanocomposites, Panjab University, Chandigarh, India 160014
- Division of Pharmaceutics, University
Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India 160014
| | - Saloni Singla
- Department of Microbiology, Panjab University, Chandigarh, India 160014
| | - Sheetu Wadhwa
- Division of Pharmaceutics, University
Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India 160014
| | - Babita Garg
- Division of Pharmaceutics, University
Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India 160014
| | - Sanjay Chhibber
- Department of Microbiology, Panjab University, Chandigarh, India 160014
| | - Om Prakash Katare
- Division of Pharmaceutics, University
Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India 160014
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9
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Patil V, Bandivadekar A, Debjani D. Inhibition of Propionibacterium acnes lipase by extracts of Indian medicinal plants. Int J Cosmet Sci 2012; 34:234-9. [DOI: 10.1111/j.1468-2494.2012.00706.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dupuis C, Corre C, Boyaval P. Lipase and Esterase Activities of Propionibacterium freudenreichii subsp. freudenreichii. Appl Environ Microbiol 2010; 59:4004-9. [PMID: 16349102 PMCID: PMC195859 DOI: 10.1128/aem.59.12.4004-4009.1993] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The lipase and esterase activities of eight strains of dairy Propionibacterium freudenreichii subsp. freudenreichii were studied. A lipase activity was detected on whole cells and in the culture supernatant. The highest activity was expressed at 45 degrees C and pH 6.8. An esterase activity was also detected in the culture medium. The electrophoresis of the intracellular fractions of the cells revealed from three to six different esterase activities. Two esterases were common to all the strains. The substrate specificity was dependent on each esterase, but no activity was revealed, in our experimental conditions, on ester substrates with a chain length longer than that of butyrate.
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Affiliation(s)
- C Dupuis
- Laboratoire de Recherches de Technologie Laitière, 65 Rue de Saint-Brieuc, 35042 Rennes Cédex, France
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11
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Kurokawa I, Tanaka M, Ikeda T. Topical aqua Kummelfeld containing 1% lincomycin for acne vulgaris. J DERMATOL TREAT 2009. [DOI: 10.3109/09546639209088726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
BACKGROUND Over the past 20 years, major concerns have been repeatedly expressed over antibiotic-resistant acne in Europe and in the U.S.A. However, the clinical significance of these resistance patterns is poorly defined so that topical antibiotics remain one of the cornerstones of acne management. OBJECTIVES To determine whether we are facing decreased efficacy of topical formulations of erythromycin and clindamycin in clinical trials of therapeutic interventions for acne. METHODS To review systematically the results of the clinical trials investigating topical formulations of erythromycin and clindamycin for the treatment of inflammatory acne and to establish whether or not there is a decrease in the efficacy of these topical antibiotic formulations since their widespread introduction in the mid 1970s. RESULTS Of the 50 eligible controlled trials identified using a systematic electronic database search strategy, 45 (90%) incorporated a lesion count, making comparison across trials possible. Analysis of clinical studies investigating the effect of topical erythromycin in acne patients indicates a significant decrease in the effect of this antibiotic on inflammatory and noninflammatory lesion count over time (r = -2.140, P = 0.001 and r = -2.032, P = 0.001, respectively). Efficacy of topical clindamycin remained stable during the study period. CONCLUSIONS There is a gradual decrease in the efficacy of topical erythromycin in clinical trials of therapeutic intervention for acne, which is probably related to the development of antibiotic-resistant propionibacteria.
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Affiliation(s)
- T Simonart
- Department of Dermatology, Erasme University Hospital, 808 Route de Lennik, B-1070 Brussels, Belgium.
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Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, Shalita AR, Thiboutot D. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2003; 49:S1-37. [PMID: 12833004 DOI: 10.1067/mjd.2003.618] [Citation(s) in RCA: 413] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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16
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Herbert S, Barry P, Novick RP. Subinhibitory clindamycin differentially inhibits transcription of exoprotein genes in Staphylococcus aureus. Infect Immun 2001; 69:2996-3003. [PMID: 11292717 PMCID: PMC98253 DOI: 10.1128/iai.69.5.2996-3003.2001] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2000] [Accepted: 01/29/2001] [Indexed: 11/20/2022] Open
Abstract
It has long been known that certain antibiotics, at subinhibitory concentrations, differentially inhibit the synthesis of alpha-hemolysin and other staphylococcal virulence factors. In this report, we show that subinhibitory clindamycin (SBCL) eliminates production of nearly all exoproteins by Staphylococcus aureus but has virtually no effect on cytoplasmic proteins. The effect was abolished by a gene conferring resistance to macrolides-lincosamides-streptogramin B, showing that differential inhibition of protein synthesis is responsible; remarkably, however, subinhibitory clindamycin blocked production of several of the individual exoprotein genes, including spa (encoding protein A), hla (encoding alpha-hemolysin), and spr (encoding serine protease), at the level of transcription, suggesting that the primary effect must be differential inhibition of the synthesis of one or more regulatory proteins. In contrast to earlier reports, however, we found that subinhibitory clindamycin stimulates synthesis of coagulase and fibronectin binding protein B, also at the level of transcription. agr and sar expression was minimally affected by subinhibitory clindamycin. These effects varied from strain to strain and do not seem to be responsible for the effects of subinhibitory clindamycin on the overall exoprotein pattern.
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Affiliation(s)
- S Herbert
- Program in Molecular Pathogenesis, Skirball Institute, New York University School of Medicine, New York, New York 10016, USA
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17
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Abstract
BACKGROUND A new topical antibiotic preparation, clindamycin in a lotion base, was compared with oral tetracycline in the treatment of rosacea. Forty-three patients clinically diagnosed as having rosacea were examined in an investigator-blinded study. METHODS Patients used topical clindamycin lotion applied twice daily or the usual oral dose of tetracycline hydrochloride (250 mg four times a day for 3 weeks, then 250 mg twice a day for the remaining 9 weeks). Patients' lesions were examined clinically at 3-week intervals over a period of 12 weeks. RESULTS Topical clindamycin treatment produced similar clinical results to oral tetracycline and was superior in the eradication of pustules. CONCLUSIONS These results show topical clindamycin in a lotion base to be a safe and effective alternative to oral tetracycline therapy in the treatment of rosacea.
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Affiliation(s)
- J K Wilkin
- Department of Medicine, Ohio State University
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18
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McGregor JA, Lawellin D, Franco-Buff A, Todd JK, Makowski EL. Protease production by microorganisms associated with reproductive tract infection. Am J Obstet Gynecol 1986; 154:109-14. [PMID: 3004213 DOI: 10.1016/0002-9378(86)90404-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Factors influencing pathogenicity of various microbes found in the female lower genital tract remain incompletely understood. Protease production by cervico/vaginal microorganisms may alter or inactivate a variety of proteins important in host defense and structural-functional integrity including collagen-containing chorioamniotic membranes and uterine cervix. Host tissues may be made more susceptible to other organisms' virulence factors by protease-producing members of genital tract local flora. Microorganisms themselves may also be influenced by the presence of other microbial protease. Nonspecific protease, gelatinase, collagenase, and elastase production was examined for in vitro with use of aerobic (30) and anaerobic (25) strains of microorganisms typical of those isolated from the lower genital tract of women with premature rupture of membranes, chorioamnionitis, and puerperal infection. Microorganisms including Bacteroides bivius, Bacteroides melaninogenicus, Bacteroides fragilis, Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Proteus species, and Propionibacterium acnes produce various proteases. Protease production by both acknowledged pathogenic and commensal bacteria may contribute to the occurrence of reproductive tract morbidity including premature rupture of membranes and preterm labor.
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