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Gozali MM, Kurniawati Y, Devi M, Bahar E, Dewi L, Yahya YF, Rusmawardiana, Zulkarnain SD, Kartowigno S. Correlation between Antimicrobial Resistant Propionibacterium acnes and Severity of Acne Vulgaris: Findings from a Tertiary Hospital. Indian J Dermatol 2023; 68:488. [PMID: 37822407 PMCID: PMC10564202 DOI: 10.4103/ijd.ijd_623_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
The study of antimicrobial-resistant Propionibacterium acnes was not conducted regularly, especially in Indonesia. Conversely, regular monitoring of antibiotic efficacy through in vitro testing to assess the evolution of current resistance patterns is obligated; thus, filling the gap caused by a lack of appropriate antibiotic surveillance is required. Analyse the correlation between resistance patterns of P. acnes to doxycycline, clindamycin, erythromycin and azithromycin with the severity of acne vulgaris. This is an analytic observational laboratory study with a cross-sectional design of mild to severe acne vulgaris (AV) patients. Specimens were obtained from comedones of 71 patients, which were cultured and identified using biochemical examination. Antimicrobial resistance (doxycycline, clindamycin, erythromycin and azithromycin) to P. acnes was tested by disc diffusion method. Among 71 samples collected, 40 (56.3%) P. acnes isolates were cultured and identified. The incidence of P. acnes resistance to more than one antimicrobial was 45%. Antimicrobial resistances were clindamycin 42.5%, erythromycin 40%, azithromycin 23.5% and doxycycline 12.5%, respectively. According to the contingency coefficient test, there was moderate correlation between the resistance pattern of P. acnes to clindamycin (r = 0.485, P = <0.001) and doxycycline (r = 0.433, P = 0.002) and AV severity. There was weak correlation between the resistance pattern of P. acnes to erythromycin (r = 0.333; P = 0.025) and azithromycin (r = 0.321; P = 0.032) and AV severity. In conclusion, there is a correlation between the pattern of P. acnes resistance to doxycycline, clindamycin, erythromycin, azithromycin and severity of AV.
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Affiliation(s)
- Maria Mayfinna Gozali
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Yuli Kurniawati
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Mutia Devi
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Erial Bahar
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Lisa Dewi
- Department of Anatomy, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia
| | - Yulia Farida Yahya
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Rusmawardiana
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Sarah Diba Zulkarnain
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
| | - Soenarto Kartowigno
- From the Department of Dermatology and Venereology, Sriwijaya University, Palembang, Indonesia
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2
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LGCM and PLS-SEM in Panel Survey Data: A Systematic Review and Bibliometric Analysis. DATA 2023. [DOI: 10.3390/data8020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The application of Latent Growth Curve Model (LGCM) and Partial Least Square Structural Equation Modeling (PLS-SEM) has gained much attention in panel survey studies. This study explores the distributions and trends of LGCM, and PLS-SEM used in panel survey data. It highlights the gaps in the current and existing approaches of PLS-SEM practiced by researchers in analyzing panel survey data. The integrated bibliometric analysis and systematic review were employed in this study. Based on the reviewed articles, the LGCM and PLS-SEM showed an increasing trend of publication in the panel survey data. Though the popularity of LGCM was more outstanding than PLS-SEM for the panel survey data, LGCM has several limitations such as statistical assumptions, reliable sample size, number of repeated measures, and missing data. This systematic review identified five different approaches of PLS-SEM in analyzing the panel survey data namely pre- and post-approach with different constructs, a path comparison approach, a cross-lagged approach, pre- and post-approach with the same constructs, and an evaluation approach practiced by researchers. None of the previous approaches used can establish one structural model to represent the whole changes in the repeated measure. Thus, the findings of this paper could help researchers choose a more appropriate approach to analyzing panel survey data.
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3
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Dessinioti C, Katsambas A. Antibiotics and Antimicrobial Resistance in Acne: Epidemiological Trends and Clinical Practice Considerations. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:429-443. [PMID: 36568833 PMCID: PMC9765333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Antimicrobial resistance is an increasing public health problem worldwide. The interest of a focus on antimicrobial resistance in acne lies on the facts that acne vulgaris (acne) is the most common skin disease worldwide, that the bacterium Cutibacterium acnes (C. acnes, formerly Propionibacterium acnes) plays a key role in the pathogenesis of acne, while at the same time being part of the skin flora, and that antibiotics are commonly recommended for acne treatment. The overuse of topical and/or systemic antibiotics, the long treatment courses used for acne, and the availability of over-the-counter antibiotic preparations, have led to the worldwide emergence of resistant strains in acne patients. In this review, we discuss the epidemiological trends of antimicrobial resistance in acne, the need to avoid the perturbation of the skin microbiome caused by anti-acne antibiotics, and the clinical practice considerations related to the emergence of resistant strains in acne patients. In light of the increasing risk of antimicrobial resistance, raising concerns over the misuse of antibiotics, prescribing patterns can be a critical target for antibiotic stewardship efforts. Also, the selection of non-antibiotic therapies for acne, whenever possible, may offer significant advantages.
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Affiliation(s)
- Clio Dessinioti
- 1st Department of Dermatology, Andreas Sygros Hospital,
University of Athens, Athens, Greece,To whom all correspondence should be addressed:
Clio Dessinioti, 1st Department of Dermatology, Andreas Sygros Hospital,
University of Athens, Athens, Greece;
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4
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Bowman S, Sadowski CK. Antibiotic use and bacterial resistance in patients with acne vulgaris. JAAPA 2022; 35:34-39. [PMID: 35881716 DOI: 10.1097/01.jaa.0000840500.37136.e5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Acne vulgaris is a prevalent chronic skin disease caused by obstruction and/or inflammation of pilosebaceous follicles. Each year, about 50 million people in the United States are affected. The use of topical and oral antibiotics to manage acne has been associated with the development of bacterial resistance. This article reviews concerns about antimicrobial use, current treatment recommendations, and emerging research in unconventional treatments.
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Affiliation(s)
- Shelby Bowman
- At the time this article was written, Shelby Bowman was a student in the PA program at Mercer University in Atlanta, Ga. She now practices in breast surgical oncology at Atlanta Breast Care. Catherine K. Sadowski is a clinical associate professor in the PA program at Mercer University. The authors have disclosed no potential conflicts of interest, financial or otherwise
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5
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Nano-Therapeutics to Treat Acne Vulgaris. Indian J Microbiol 2022; 62:167-174. [DOI: 10.1007/s12088-022-01001-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/10/2022] [Indexed: 11/05/2022] Open
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6
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Nenoff P, Koch D, Krüger C, Neumeister C, Götz MR, Schwantes U, Bödeker RH, Borelli C. Activity of nadifloxacin and three other antimicrobial agents against Cutibacterium acnes isolated from patients with acne vulgaris. J Eur Acad Dermatol Venereol 2021; 35:e682-e684. [PMID: 34018651 PMCID: PMC8518973 DOI: 10.1111/jdv.17386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/27/2021] [Accepted: 05/07/2021] [Indexed: 12/01/2022]
Affiliation(s)
- P Nenoff
- Laboratory for Medical Microbiology, Rötha OT Mölbis, Germany
| | - D Koch
- Laboratory for Medical Microbiology, Rötha OT Mölbis, Germany
| | - C Krüger
- Laboratory for Medical Microbiology, Rötha OT Mölbis, Germany
| | | | - M R Götz
- Dr. Pfleger Arzneimittel GmbH, Bamberg, Germany
| | - U Schwantes
- Dr. Pfleger Arzneimittel GmbH, Bamberg, Germany
| | - R-H Bödeker
- TransMit Project Area for Medical Statistics, Justus Liebig University, Giessen, Germany
| | - C Borelli
- Unit of Aesthetic Dermatology and Laser Treatment, Department of Dermatology, Eberhard-Karls-University of Tübingen, Tübingen, Germany
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7
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Skowron K, Bauza-Kaszewska J, Kraszewska Z, Wiktorczyk-Kapischke N, Grudlewska-Buda K, Kwiecińska-Piróg J, Wałecka-Zacharska E, Radtke L, Gospodarek-Komkowska E. Human Skin Microbiome: Impact of Intrinsic and Extrinsic Factors on Skin Microbiota. Microorganisms 2021; 9:543. [PMID: 33808031 PMCID: PMC7998121 DOI: 10.3390/microorganisms9030543] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
The skin is the largest organ of the human body and it protects the body from the external environment. It has become the topic of interest of researchers from various scientific fields. Microorganisms ensure the proper functioning of the skin. Of great importance, are the mutual relations between such microorganisms and their responses to environmental impacts, as dysbiosis may contribute to serious skin diseases. Molecular methods, used for microorganism identification, allow us to gain a better understanding of the skin microbiome. The presented article contains the latest reports on the skin microbiota in health and disease. The review discusses the relationship between a properly functioning microbiome and the body's immune system, as well as the impact of internal and external factors on the human skin microbiome.
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Affiliation(s)
- Krzysztof Skowron
- Department of Microbiology, Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (Z.K.); (N.W.-K.); (K.G.-B.); (J.K.-P.); (E.G.-K.)
| | - Justyna Bauza-Kaszewska
- Department of Microbiology and Food Technology, UTP University of Science and Technology, 85-029 Bydgoszcz, Poland;
| | - Zuzanna Kraszewska
- Department of Microbiology, Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (Z.K.); (N.W.-K.); (K.G.-B.); (J.K.-P.); (E.G.-K.)
| | - Natalia Wiktorczyk-Kapischke
- Department of Microbiology, Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (Z.K.); (N.W.-K.); (K.G.-B.); (J.K.-P.); (E.G.-K.)
| | - Katarzyna Grudlewska-Buda
- Department of Microbiology, Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (Z.K.); (N.W.-K.); (K.G.-B.); (J.K.-P.); (E.G.-K.)
| | - Joanna Kwiecińska-Piróg
- Department of Microbiology, Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (Z.K.); (N.W.-K.); (K.G.-B.); (J.K.-P.); (E.G.-K.)
| | - Ewa Wałecka-Zacharska
- Department of Food Hygiene and Consumer Health, Wrocław University of Environmental and Life Sciences, 31 C.K. Norwida St., 50-375 Wrocław, Poland;
| | - Laura Radtke
- Faculty of Civil and Environmental Engineering and Architecture, UTP University of Science and Technology in Bydgoszcz, Al. prof. S. Kaliskiego 7, 85-796 Bydgoszcz, Poland;
| | - Eugenia Gospodarek-Komkowska
- Department of Microbiology, Nicolaus Copernicus University in Toruń, L. Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (Z.K.); (N.W.-K.); (K.G.-B.); (J.K.-P.); (E.G.-K.)
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8
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Abstract
Oral antibiotics are integral for treating inflammatory acne based on what is understood about the pathogenesis as well as the role of Cutibacterium acnes. However, rising concerns of antibiotic resistance and the perception of "antibiotic phobia" create potential limitations on their integration in an acne treatment regimen. When prescribing oral antibiotics, dermatologists need to consider dosage, duration, and frequency, and to avoid their use as monotherapy. These considerations are important, along with the use of newer strategies and compounds, to reduce adverse-event profiles, antibiotic resistance, and to optimize outcomes. Aside from concomitant medications, allergies, and disease severity, costs and patient demographics can influence variability in prescribing plans. There are multiple published guidelines and consensus statements for the USA and Europe to promote safe antibiotic use by dermatologists. However, there is a lack of head-to-head studies and evidence for comparative superiority of any individual antibiotic, as well as any evidence to support the use of agents other than tetracyclines. Although oral antibiotics are one of the main options for moderate to severe acne, non-antibiotic therapy such as isotretinoin and hormonal therapies should be considered. As newer therapies and more outcomes data emerge, so will improved management of antibiotic therapy to foster patient safety.
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9
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Yadav AK, Bhooshan S, Johnson A, Asati DP, Nema S, Biswas D. Association of Antimicrobial Susceptibility and Treatment Outcome in Acne Vulgaris Patients: A Pilot Study. J Lab Physicians 2021; 12:233-238. [PMID: 33469248 PMCID: PMC7808859 DOI: 10.1055/s-0040-1720943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose
Cutibacterium acnes
(
C. acnes
) is an emerging pathogen that is highly resistant to antibiotics and is capable of causing persistent infections that are difficult to treat.
Methods & Materials
Acne vulgaris patients visiting dermatology OPD of our tertiary care hospital during the study period of 2 months were recruited. Skin swabs were collected, and the sample was processed on 5% sheep-blood agar for anaerobic culture by the GasPak method. Isolates were identified by the standard biochemical test. Antimicrobial susceptibility testing was performed for clinically relevant antibiotics by the E-strip method. The clinical response was evaluated after 1-month follow-up to the prescribed antibiotics.
Results
Minocycline, doxycycline, ceftriaxone, and tetracycline were the most effective antibiotics. Nonsusceptibility to clindamycin and erythromycin were observed in 11.9% and 31% isolates, respectively, with 9.5% isolates being nonsusceptible to both. For none of the antibiotics we found significant difference in the proportion of susceptible and nonsusceptible isolates between mild, moderate, and severe grades of acne vulgaris. For none of the antibiotic regimens, significant difference was observed between nonresponders and responders. Twenty-seven patients received clindamycin and among them 16 of 19 responders and 6 of 8 nonresponders yielded growth of clindamycin-susceptible isolates (
p
= 0.57).
Conclusion
We observed significant prevalence of resistant strains of
C. acnes
among patients with acne vulgaris. No association was observed between in vitro susceptibility results and treatment outcome.
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Affiliation(s)
- Ashvini K Yadav
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Suneel Bhooshan
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Allen Johnson
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Dinesh P Asati
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Shashwati Nema
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Debasis Biswas
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
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10
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Sardana K, Mathachan SR, Gupta T. Antibiotic resistance in acne an emergent need to recognize resistance to azithromycin and restrict its unapproved use in acne vulgaris. J Eur Acad Dermatol Venereol 2021; 35:e347-e348. [PMID: 33351973 DOI: 10.1111/jdv.17099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/16/2020] [Indexed: 12/26/2022]
Affiliation(s)
- K Sardana
- Department of Dermatology, Venereology and Leprosy, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - S R Mathachan
- Department of Dermatology, Venereology and Leprosy, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - T Gupta
- Department of Dermatology, Venereology and Leprosy, Maulana Azad Medical College, New Delhi, India
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11
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Alnabati NA, Al-Hejin AM, Noor SO, Ahmed MMM, Abu-Zeid M, Mleeh NT. The antibacterial activity of four Saudi medicinal plants against clinical isolates of Propionibacterium acnes. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2021.1885992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Neama Ahmad Alnabati
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biological Sciences, Faculty of Science, Um Al-Qura University, Makkah, Saudi Arabia
| | - Ahmed Mahmoud Al-Hejin
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Samah Omar Noor
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed Morsi M. Ahmed
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Nucleic Acids Research Deparment, Genetic Engineering, and Biotechnology Research Institute (GEBRI), City for Scientific Research and Technological Applications, Alexandria, Egypt
| | - Mohamed Abu-Zeid
- Princess Dr. Najla Bint Saud Al-Saud Center for Excellence Research, King Abdulaziz University, Jeddah, Saudi Arabia
- Microbial Genetics Department, Genetics Engineering and Biotechnology Division, National Research Center, Giza, Egypt
| | - Nouf Talal Mleeh
- Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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12
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Abstract
Our understanding of the role of Cutibacterium acnes in the pathophysiology of acne has recently undergone a paradigm shift: rather than C. acnes hyperproliferation, it is the loss of balance between the different C. acnes phylotypes, together with a dysbiosis of the skin microbiome, which results in acne development. The loss of diversity of C. acnes phylotypes acts as a trigger for innate immune system activation, leading to cutaneous inflammation. A predominance of C. acnes phylotype IA1 has been observed, with a more virulent profile in acne than in normal skin. Other bacteria, mainly Staphylococcus epidermis, are also implicated in acne. S. epidermidis and C. acnes interact and are critical for the regulation of skin homeostasis. Recent studies also showed that the gut microbiome is involved in acne, through interactions with the skin microbiome. As commonly used topical and systemic antibiotics induce cutaneous dysbiosis, our new understanding of acne pathophysiology has prompted a change in direction for acne treatment. In the future, the development of individualized acne therapies will allow targeting of the pathogenic strains, leaving the commensal strains intact. Such alternative treatments, involving modifications of the microbiome, will form the next generation of ‘ecobiological’ anti-inflammatory treatments.
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Affiliation(s)
- Brigitte Dréno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
- CIC 1413, CRCINA, U1232, Nantes, France
| | | | - Amir Khammari
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
- CIC 1413, CRCINA, U1232, Nantes, France
| | - Stéphane Corvec
- Bacteriology and Hygiene Unit, Biology Institute, Nantes, France
- CRCINA, U1232, Nantes, France
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13
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Bonamonte D, De Marco A, Giuffrida R, Conforti C, Barlusconi C, Foti C, Romita P. Topical antibiotics in the dermatological clinical practice: Indications, efficacy, and adverse effects. Dermatol Ther 2020; 33:e13824. [PMID: 32531105 DOI: 10.1111/dth.13824] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/26/2020] [Accepted: 06/10/2020] [Indexed: 12/13/2022]
Abstract
Topical antibiotic therapy is a central component of patient management for several skin conditions, including acne, hidradenitis suppurativa, rosacea, impetigo or other superinfected dermatitis, and prevention of wound infections. Moreover, particular situations, such as skin diseases of bacterial origin in pregnancy and infants often warrant topical therapy. However, the occurrence of local delayed hypersensitivity reactions and the rising rate of antibiotic resistance are becoming great challenges faced by many dermatologists today. This narrative review provides an overview of the main topical antibiotics used in dermatology, focusing on their clinical role in the most common dermatological indications. For this purpose, a review of MEDLINE and PubMed for pertinent, scientific, and clinical publications until March 2020 was performed. Only articles published in the English language were included.
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Affiliation(s)
- Domenico Bonamonte
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Aurora De Marco
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Claudio Conforti
- Dermatology Clinic, Hospital Maggiore of Trieste, University of Trieste, Italy
| | - Chiara Barlusconi
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Caterina Foti
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - Paolo Romita
- Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
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14
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Lee YB, Byun EJ, Kim HS. Potential Role of the Microbiome in Acne: A Comprehensive Review. J Clin Med 2019; 8:jcm8070987. [PMID: 31284694 PMCID: PMC6678709 DOI: 10.3390/jcm8070987] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 02/06/2023] Open
Abstract
Acne is a highly prevalent inflammatory skin condition involving sebaceous sties. Although it clearly develops from an interplay of multiple factors, the exact cause of acne remains elusive. It is increasingly believed that the interaction between skin microbes and host immunity plays an important role in this disease, with perturbed microbial composition and activity found in acne patients. Cutibacterium acnes (C. acnes; formerly called Propionibacterium acnes) is commonly found in sebum-rich areas and its over-proliferation has long been thought to contribute to the disease. However, information provided by advanced metagenomic sequencing has indicated that the cutaneous microbiota in acne patients and acne-free individuals differ at the virulent-specific lineage level. Acne also has close connections with the gastrointestinal tract, and many argue that the gut microbiota could be involved in the pathogenic process of acne. The emotions of stress (e.g., depression and anxiety), for instance, have been hypothesized to aggravate acne by altering the gut microbiota and increasing intestinal permeability, potentially contributing to skin inflammation. Over the years, an expanding body of research has highlighted the presence of a gut–brain–skin axis that connects gut microbes, oral probiotics, and diet, currently an area of intense scrutiny, to acne severity. This review concentrates on the skin and gut microbes in acne, the role that the gut–brain–skin axis plays in the immunobiology of acne, and newly emerging microbiome-based therapies that can be applied to treat acne.
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Affiliation(s)
- Young Bok Lee
- Department of Dermatology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Eun Jung Byun
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea.
- Department of Biomedicine & Health Sciences, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
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15
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Abstract
Acne vulgaris is a chronic skin disorder involving hair follicles and sebaceous glands. Multiple factors contribute to the disease, including skin microbes. The skin microbiome in the follicle is composed of a diverse group of microorganisms. Among them, Propionibacterium acnes and Malassezia spp. have been linked to acne development through their influence on sebum secretion, comedone formation, and inflammatory response. Antibiotics targeting P. acnes have been the mainstay in acne treatment for the past four decades. Among them, macrolides, clindamycin, and tetracyclines are the most widely prescribed. As antibiotic resistance becomes an increasing concern in clinical practice, understanding the skin microbiome associated with acne and the effects of antibiotic use on the skin commensals is highly relevant and critical to clinicians. In this review, we summarize recent studies of the composition and dynamics of the skin microbiome in acne and the effects of antibiotic treatment on skin microbes.
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Affiliation(s)
- Haoxiang Xu
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles, 4339 CNSI, 570 Westwood Plaza, Building 114, Los Angeles, CA, 90095, USA
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles, 4339 CNSI, 570 Westwood Plaza, Building 114, Los Angeles, CA, 90095, USA.
- UCLA-DOE Institute for Genomics and Proteomics, University of California, Los Angeles, Los Angeles, CA, USA.
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16
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Yang MY, Chang KC, Chen LY, Hu A. Low-dose blue light irradiation enhances the antimicrobial activities of curcumin against Propionibacterium acnes. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 189:21-28. [PMID: 30273795 DOI: 10.1016/j.jphotobiol.2018.09.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 09/09/2018] [Accepted: 09/24/2018] [Indexed: 01/06/2023]
Abstract
Propionibacterium acnes (P. acnes) is an opportunistic infection in human skin that causes acne vulgaris. Antibiotic agents provide the effective eradication of microbes until the development of drug-resistant microbes. Photodynamic inactivation (PDI) is a non-antibiotic therapy for microbial eradication. In this study, the visible blue light (BL, λmax = 462 nm) was used to enhance the antimicrobial activities of curcumin, a natural phenolic compound. Individual exposure to curcumin or BL irradiation does not generate cytotoxicity on P. acnes. The viability of P. acnes was decreased significantly in 0.09 J/cm2 BL with 1.52 μM of curcumin. Furthermore, the low-dose blue light irradiation triggers a series of cytotoxic actions of curcumin on P. acnes. The lethal factors of photolytic curcumin were investigated based on the morphology of P. acnes by SEM and fluorescent images. The membrane disruption of microbes was observed on the PDI against P. acnes. Chromatography and mass spectrometry techniques were also used to identify the photolytic metabolites. Curcumin could be photolysed into vanillin through BL irradiation, which presents a strong linear relationship in quantitation. Because the safety of blue light in mammalian cell has been proven, the photolytic curcumin treatment could support non-antibiotic therapy to eradicate P. acnes on clinical dermatology.
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Affiliation(s)
- Ming-Yeh Yang
- Institute of Medical Sciences, Tzu-Chi University, Hualien 970, Taiwan
| | - Kai-Chih Chang
- Department of Laboratory Medicine and Biotechnology, Tzu-Chi University, Hualien 970, Taiwan; Department of Laboratory Medicine, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan
| | - Liang-Yü Chen
- Department of Biotechnology, Ming-Chuan University, Taoyuan City 333, Taiwan.
| | - Anren Hu
- Department of Laboratory Medicine and Biotechnology, Tzu-Chi University, Hualien 970, Taiwan.
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17
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Pécastaings S, Roques C, Nocera T, Peraud C, Mengeaud V, Khammari A, Dréno B. Characterisation ofCutibacterium acnesphylotypes in acne andin vivoexploratory evaluation of Myrtacine®. J Eur Acad Dermatol Venereol 2018; 32 Suppl 2:15-23. [DOI: 10.1111/jdv.15042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/24/2018] [Indexed: 12/29/2022]
Affiliation(s)
- S. Pécastaings
- Laboratoire de Génie Chimique; UMR 5503; Université de Toulouse, Université Paul Sabatier; CNRS; INPT; Toulouse Cedex 9 France
| | - C. Roques
- Laboratoire de Génie Chimique; UMR 5503; Université de Toulouse, Université Paul Sabatier; CNRS; INPT; Toulouse Cedex 9 France
- Fonderephar; Faculty of Pharmacy; Toulouse Cedex 9 France
- CHU Toulouse; Hôpital Purpan, Service de Bactériologie-Hygiène; Toulouse France
| | - Th. Nocera
- Clinical Skin Research Center; Pierre Fabre Dermo-Cosmetique; Toulouse France
| | - C. Peraud
- Clinical Skin Research Center; Pierre Fabre Dermo-Cosmetique; Toulouse France
| | - V. Mengeaud
- Laboratoires Dermatologiques Ducray; Pierre Fabre Dermo-Cosmétique; Cauquillous Lavaur France
| | - A. Khammari
- Department of Dermatology; CHU Nantes; CIC 1413; CRCINA; University Nantes; Nantes France
| | - B. Dréno
- Department of Dermatology; CHU Nantes; CIC 1413; CRCINA; University Nantes; Nantes France
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18
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Gupta T, Sardana K, Kumar B, Gautam HK. Letter to the editor submitted in response to “the extinction of topical erythromycin therapy for acne vulgaris and concern for the future of topical clindamycin”. J DERMATOL TREAT 2018; 29:105-106. [DOI: 10.1080/09546634.2017.1335852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Tanvi Gupta
- Department of Dermatology & VD, Maulana Azad Medical College, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology & VD, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Bipul Kumar
- Department of Microbial Biotechnology, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Hemant K. Gautam
- Department of Microbial Biotechnology, CSIR-Institute of Genomics and Integrative Biology, Delhi, India
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19
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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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20
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Nair SS, Zolotarskaya OY, Beckwith MJ, Ohman DE, Wynne KJ. A Polycation Antimicrobial Peptide Mimic without Resistance Buildup against Propionibacterium Acnes. Macromol Biosci 2017; 17. [PMID: 28605136 DOI: 10.1002/mabi.201700090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/08/2017] [Indexed: 11/09/2022]
Abstract
A preliminary study is reported for a polycation antimicrobial peptide (AMP) mimic against Propionibacterium acnes, which is associated with acne vulgaris, a common skin condition. Antibiotics are commonly used against P. acnes but buildup of resistance is well-known. Worse, antibiotic regimens build up resistance for more sensitive bacteria such as Staphylococcus epidermidis. The polycation AMP mimic C12-50, 1, is chosen for the present study as it has been previously shown to have high antimicrobial effectiveness. This study reports that C12-50 is active against P. acnes (strain ATCC 6919) with a minimum inhibitory concentration (MIC) of 6.3 µg mL-1 . To monitor resistance build-up ten passages are conducted with C12-50 against P. acnes. The MIC remains constant with no resistance buildup. Parallel studies with erythromycin confirm previously reported resistance buildup. The results point to a promising pathway to applications for polycation AMP mimics against P. acnes.
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Affiliation(s)
- Sithara S Nair
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23219, USA
| | - Olga Y Zolotarskaya
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23219, USA
| | - Matthew J Beckwith
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23219, USA
| | - Dennis E Ohman
- Department of Microbiology and Immunology, VCU School of Medicine, 1101 East Marshall Street, Richmond, VA, 23298, USA.,McGuire Veterans Affairs Medical Center, Richmond, VA, 23249, USA
| | - Kenneth J Wynne
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, 23219, USA
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21
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Takoudju EM, Guillouzouic A, Kambarev S, Pecorari F, Corvec S. In vitro emergence of fluoroquinolone resistance in Cutibacterium (formerly Propionibacterium) acnes and molecular characterization of mutations in the gyrA gene. Anaerobe 2017; 47:194-200. [PMID: 28602804 DOI: 10.1016/j.anaerobe.2017.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
In vitro occurrence of levofloxacin (LVX) resistance in C. acnes and characterization of its molecular background were investigated. The mutation frequency was determined by inoculation of 108 cfu of C. acnes ATCC 11827 (LVX MIC = 0.25 mg/L) on LVX-containing agar plates. The progressive emergence of resistance was studied by a second exposure to increasing LVX concentrations. For mutants, the QRDR regions including the gyrA and parC genes were sequenced and compared to both C. acnes ATCC 11827 and C. acnes KPA171202 reference sequences (NC006085). The importance of the efflux pump system in resistance was investigated by using inhibitors on selected resistant mutants with no mutation in the QRDR. C. acnes growth was observed on LVX-containing plates with mutation frequencies of 3. 8 cfu × 10-8 (8 × MIC) and 1.6 cfu × 10-7 (4 × MIC). LVX resistance emerged progressively after one-step or two-step assays. In LVX-resistant isolates, the MIC ranged from 0.75 to >32 mg/L. Mutations were detected exclusively in the gyrA gene. Ten genotypes were identified: G99 C, G99 D, D100N, D100 H, D100 G, S101L, S101W, A102 P, D105 H and A105 G. Mutants S101L and S101W were always associated with a high level of resistance. Mutants with no mutation in the QRDR were more susceptible when incubated with an efflux pump inhibitor (phenyl-arginine β-naphthylamide) only, suggesting, for the first time, the expression of such a system in C. acnes LVX-resistant mutants.
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Affiliation(s)
- Eve-Marie Takoudju
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France
| | | | - Stanimir Kambarev
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Frédéric Pecorari
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France; Nantes Study Group Member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.
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22
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Enhanced antimicrobial activity of amphiphilic cationic polymers against a broad range of bacterial strains and skin microbes. Colloid Polym Sci 2017. [DOI: 10.1007/s00396-017-4106-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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23
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Dreno B, Martin R, Moyal D, Henley JB, Khammari A, Seité S. Skin microbiome and acne vulgaris: Staphylococcus, a new actor in acne. Exp Dermatol 2017; 26:798-803. [PMID: 28094874 DOI: 10.1111/exd.13296] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 12/13/2022]
Abstract
Propionibacterium acnes (P. acnes), the sebaceous gland and follicular keratinocytes are considered the three actors involved in the development of acne. This exploratory study investigated the characteristics of the skin microbiota in subjects with acne and determined microbiota changes after 28 days of application of erythromycin 4% or a dermocosmetic. Skin microbiota were collected under axenic conditions from comedones, papulo-pustular lesions and non-lesional skin areas from subjects with mild to moderate acne according to the GEA grading using swabs. Samples were characterized using a high-throughput sequencing approach that targets a portion of the bacterial 16S rRNA gene. Overall, microbiota samples from 26 subjects showed an overabundance of Proteobacteria and Firmicutes and an under-representation of Actinobacteria. Staphylococci were more abundant on the surface of comedones, papules and pustules (P=.004 and P=.003 respectively) than on non-lesional skin. Their proportions increased significantly with acne severity (P<.05 between GEA-2 and GEA-3). Propionibacteria represented less than 2% of the bacteria on the skin surface. At Day 28, only the number of Actinobacteria had decreased with erythromycin while the dermocosmetic decreased also the number of Staphylococci. A significant reduction (P<.05) from Day 0 of comedones, papules and pustules with no significant difference between the products was observed. The bacterial diversity on all sampling areas was similar. The dermocosmetic decreased the number of Actinobacteria and Staphylococcus spp. after 28 days. Staphylococcus remained the predominant genus of the superficial skin microbiota. No significant reduction in Staphylococcus spp. was observed with the topical antibiotic.
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Affiliation(s)
- Brigitte Dreno
- Department of Dermatology, Nantes University Hospital, Nantes, France.,CIC, Inserm U892-CNRS 6299, Nantes, France
| | | | - Dominique Moyal
- La Roche-Posay Dermatological Laboratories, Asnières, France
| | - Jessica B Henley
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - Amir Khammari
- Department of Dermatology, Nantes University Hospital, Nantes, France.,CIC, Inserm U892-CNRS 6299, Nantes, France
| | - Sophie Seité
- La Roche-Posay Dermatological Laboratories, Asnières, France
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24
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Jończyk-Matysiak E, Weber-Dąbrowska B, Żaczek M, Międzybrodzki R, Letkiewicz S, Łusiak-Szelchowska M, Górski A. Prospects of Phage Application in the Treatment of Acne Caused by Propionibacterium acnes. Front Microbiol 2017; 8:164. [PMID: 28228751 PMCID: PMC5296327 DOI: 10.3389/fmicb.2017.00164] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/23/2017] [Indexed: 12/11/2022] Open
Abstract
Propionibacterium acnes is associated with purulent skin infections, and it poses a global problem for both patients and doctors. Acne vulgaris (acne) remains a problem due to its chronic character and difficulty of treatment, as well as its large impact on patients' quality of life. Due to the chronic course of the disease, treatment is long lasting, and often ineffective. Currently there are data regarding isolation of P. acnes phages, and there have been numerous studies on phage killing of P. acnes, but no data are available on phage application specifically in acne treatment. In this review, we have summarized the current knowledge on the phages active against P. acnes described so far and their potential application in the treatment of acne associated with P. acnes. The treatment of acne with phages may be important in order to reduce the overuse of antibiotics, which are currently the main acne treatment. However, more detailed studies are first needed to understand phage functioning in the skin microbiome and the possibility to use phages to combat P. acnes.
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Affiliation(s)
- Ewa Jończyk-Matysiak
- Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences Wroclaw, Poland
| | - Beata Weber-Dąbrowska
- Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland; Phage Therapy Unit, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland
| | - Maciej Żaczek
- Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences Wroclaw, Poland
| | - Ryszard Międzybrodzki
- Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland; Phage Therapy Unit, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland; Department of Clinical Immunology, Transplantation Institute, Medical University of WarsawWarsaw, Poland
| | - Sławomir Letkiewicz
- Phage Therapy Unit, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland; Medical Sciences Institute, Katowice School of EconomicsKatowice, Poland
| | - Marzanna Łusiak-Szelchowska
- Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences Wroclaw, Poland
| | - Andrzej Górski
- Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland; Phage Therapy Unit, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of SciencesWroclaw, Poland; Department of Clinical Immunology, Transplantation Institute, Medical University of WarsawWarsaw, Poland
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25
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Sardana K, Verma G. Propionibacterium acnes and the Th1/Th17 Axis, Implications in Acne Pathogenesis and Treatment. Indian J Dermatol 2017; 62:392-394. [PMID: 28794550 PMCID: PMC5527720 DOI: 10.4103/ijd.ijd_483_16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Acne vulgaris is one of the most commonly seen conditions and the immunological link is a topic of active research. Recently, the Th17 pathway has been found to play a pivotal role in acne. The adaptive immune response toward Propionibacterium acnes leads to activation of Th17 axis. Consequently, the Th17 cytokines (IL-17, IL-1 β, IL-6, and tumor growth factor, in turn, activate the various pathogenic steps in acne. Drugs such as Vitamin D3 and isotretinoin which target the Th17 pathway may offer an additional pathway for their therapeutic response.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology & STD, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Gunjan Verma
- Department of Dermatology & STD, PGIMER and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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26
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Kim SY, Ochsendorf FR. New developments in acne treatment: role of combination adapalene-benzoylperoxide. Ther Clin Risk Manag 2016; 12:1497-1506. [PMID: 27757036 PMCID: PMC5055040 DOI: 10.2147/tcrm.s94062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The fixed-dose combination adapalene 0.1%/benzoylperoxide 2.5% (A/BPO) was introduced as an acne vulgaris therapeutic in 2007. It combines anti-inflammatory, keratolytic, comedolytic, and antibacterial properties. Thus, it addresses several pathophysiological factors involved in the pathophysiology of acne. This review highlights the rationale for the use of this fixed-dose combination product, its therapeutic efficacy including effects on adherence and quality of life, its use for different forms of acne, and the side-effect profile. In summary, the fixed-dose combination of A/BPO gel can be regarded as a highly effective and safe formulation. It is not associated with antibiotic resistance. It reduces factors that cause nonadherence and has positive effects on the quality of life of affected patients. The tolerance is good. The initial mild irritation potential can be addressed by adequate counseling. A/BPO can be used for all forms of inflammatory acne, including severe forms, as part of a combination with systemic antibiotics. Finally, it can also be used for the long-term treatment of chronic acne. Thus, it is a very valuable therapeutic option in daily practice, which is reflected by its strong recommendation in the “European S3-guidelines”.
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Affiliation(s)
- Su Youn Kim
- Clinic for Dermatology, Venereology, and Allergology, University Hospital, Frankfurt/M, Germany
| | - Falk R Ochsendorf
- Clinic for Dermatology, Venereology, and Allergology, University Hospital, Frankfurt/M, Germany
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27
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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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28
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Abstract
Cross-sectional study design is a type of observational study design. In a cross-sectional study, the investigator measures the outcome and the exposures in the study participants at the same time. Unlike in case-control studies (participants selected based on the outcome status) or cohort studies (participants selected based on the exposure status), the participants in a cross-sectional study are just selected based on the inclusion and exclusion criteria set for the study. Once the participants have been selected for the study, the investigator follows the study to assess the exposure and the outcomes. Cross-sectional designs are used for population-based surveys and to assess the prevalence of diseases in clinic-based samples. These studies can usually be conducted relatively faster and are inexpensive. They may be conducted either before planning a cohort study or a baseline in a cohort study. These types of designs will give us information about the prevalence of outcomes or exposures; this information will be useful for designing the cohort study. However, since this is a 1-time measurement of exposure and outcome, it is difficult to derive causal relationships from cross-sectional analysis. We can estimate the prevalence of disease in cross-sectional studies. Furthermore, we will also be able to estimate the odds ratios to study the association between exposure and the outcomes in this design.
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Affiliation(s)
- Maninder Singh Setia
- Department of Epidemiologist, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
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