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Eguren C, Navarro-Blasco A, Corral-Forteza M, Reolid-Pérez A, Setó-Torrent N, García-Navarro A, Prieto-Merino D, Núñez-Delegido E, Sánchez-Pellicer P, Navarro-López V. A Randomized Clinical Trial to Evaluate the Efficacy of an Oral Probiotic in Acne Vulgaris. Acta Derm Venereol 2024; 104:adv33206. [PMID: 38751177 PMCID: PMC11110809 DOI: 10.2340/actadv.v104.33206] [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: 12/01/2023] [Accepted: 04/11/2024] [Indexed: 05/24/2024] Open
Abstract
The relevance of the gut microbiota in some skin inflammatory diseases, including acne vulgaris, has been emphasized. Probiotics could play a role in the modulation of the microbiota, improving the clinical course of this disease. A 12-week randomized, double-blind, placebo-controlled, clinical trial with patients aged 12 to 30 years with acne vulgaris was conducted. The study product was a capsule composed of the probiotic Lacticaseibacillus rhamnosus (CECT 30031) and the cyanobacterium Arthrospira platensis (BEA_IDA_0074B). Patients with improvement in the Acne Global Severity Scale were 10/34 (29.41%) in the placebo group compared with 20/40 (50%) in the probiotic group (p = 0.03). A significant reduction (p = 0.03) in the number of non-inflammatory acne lesions was observed in the probiotic group (-18.60 [-24.38 to -12.82]) vs the placebo group (-10.54 [-17.43 to -3.66]). Regarding the number of total lesions, a reduction almost reaching statistical significance (p = 0.06) was observed in the probiotic group (-27.94 [-36.35 to -19.53]) compared with the placebo group (-18.31 [-28.21 to -8.41]). In addition, patients with improvement attending the Global Acne Grading System were 7/34 (20.58%) in the placebo group vs 17/40 (42.50%) in the probiotic group (p = 0.02). The number of adverse events was similar in both groups. The probiotic used in this study was effective and well tolerated, and it should be considered for acne vulgaris patients.
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Affiliation(s)
- Cristina Eguren
- Department of Dermatology, Eguren Dermatology and Aesthetics Clinic, Madrid, Spain
| | | | | | | | - Núria Setó-Torrent
- Department of Dermatology, University Hospital Sagrat Cor, Barcelona, Spain
| | | | | | - Eva Núñez-Delegido
- Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
| | | | - Vicente Navarro-López
- Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain; Department of Internal Medicine, University Hospital Vinalopó-Fisabio, Elche, Spain.
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Ryguła I, Pikiewicz W, Grabarek BO, Wójcik M, Kaminiów K. The Role of the Gut Microbiome and Microbial Dysbiosis in Common Skin Diseases. Int J Mol Sci 2024; 25:1984. [PMID: 38396663 PMCID: PMC10889245 DOI: 10.3390/ijms25041984] [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: 01/05/2024] [Revised: 01/28/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Dermatoses are an increasingly common problem, particularly in developed countries. The causes of this phenomenon include genetic factors and environmental elements. More and more scientific reports suggest that the gut microbiome, more specifically its dysbiosis, also plays an important role in the induction and progression of diseases, including dermatological diseases. The gut microbiome is recognised as the largest endocrine organ, and has a key function in maintaining human homeostasis. In this review, the authors will take a close look at the link between the gut-skin axis and the pathogenesis of dermatoses such as atopic dermatitis, psoriasis, alopecia areata, and acne. The authors will also focus on the role of probiotics in remodelling the microbiome and the alleviation of dermatoses.
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Affiliation(s)
- Izabella Ryguła
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Wojciech Pikiewicz
- Collegium Medicum—Faculty of Medicine, WSB University, 41-300 Dabrowa Gornicza, Poland; (W.P.); (B.O.G.); (M.W.)
| | - Beniamin Oskar Grabarek
- Collegium Medicum—Faculty of Medicine, WSB University, 41-300 Dabrowa Gornicza, Poland; (W.P.); (B.O.G.); (M.W.)
| | - Michał Wójcik
- Collegium Medicum—Faculty of Medicine, WSB University, 41-300 Dabrowa Gornicza, Poland; (W.P.); (B.O.G.); (M.W.)
| | - Konrad Kaminiów
- Collegium Medicum—Faculty of Medicine, WSB University, 41-300 Dabrowa Gornicza, Poland; (W.P.); (B.O.G.); (M.W.)
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Huang Y, Huang Y, Xia D, Liu L, Xiong X, Ouyang Y, Deng Y. Lactobacillus rhamnosus ameliorates acne vulgaris in SD rats via changes in gut microbiota and associated tryptophan metabolism. Front Immunol 2024; 14:1293048. [PMID: 38250060 PMCID: PMC10796797 DOI: 10.3389/fimmu.2023.1293048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024] Open
Abstract
Background The depletion of beneficial bacteria in the gut has been found in patients with acne vulgaris, and in previous studies, the supplement of Lactobacillus rhamnosus led to the improvement of adult acne. Nevertheless, the potential mechanism of L. rhamnosus in the amelioration of acne vulgaris has not been elucidated yet. Methods To mimic the human intestinal environment, a pseudo-germ-free rat model was used, and then gut microbiota from healthy individuals and acne patients were transplanted into rats. The effects of L. rhamnosus and tryptophan (Trp) metabolites on a rat acne model were investigated by gavage. Then, 16S rRNA analysis and targeted measurement of metabolites were performed to discover the differences in gut microbiota and metabolites between groups. Finally, HaCaT cells pretreated with Cutibacterium acnes were employed to validate the effect and mechanism of Trp metabolites on acne. Results L. rhamnosus significantly improved acne-like symptoms in rats by suppressing the level of inflammatory cytokines such as IL-1β, IL-6, and TNF-α. L. rhamnosus induced an increase in the production of indole-3-acetic acid (IAA) and indole via targeted Trp metabolic analyses. Furthermore, L. rhamnosus promoted bacterial diversity and also enhanced the Firmicutes/Bacteroidota (F/B) ratio, which was positively related to both IAA and indole. Finally, the roles of IAA and indole in alleviating acne vulgaris were confirmed both in vitro and in vivo, which could be reversed by AhR inhibitors. Conclusion Our study demonstrated that L. rhamnosus could exert its therapeutic effects on acne vulgaris by modulating the gut microbiota and regulating associated Trp metabolites.
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Affiliation(s)
- Yukun Huang
- Department of Dermatology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yaxin Huang
- Department of Dermatology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Dengmei Xia
- Department of Dermatology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Lu Liu
- Department of Burn and Plastic Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan, China
| | - Xia Xiong
- Department of Dermatology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yongliang Ouyang
- Department of Health Management, Luzhou People’s Hospital, Luzhou, Sichuan, China
| | - Yongqiong Deng
- Department of Dermatology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Department of Dermatology, Chengdu First People’s Hospital, Chengdu, Sichuan, China
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El-Komy MHM, Abdo NMK, Shamma RN, Bedair NI. Topical metformin 30% gel in the treatment of acne vulgaris in women, a split face, placebo-controlled study. Exp Dermatol 2023; 32:1663-1673. [PMID: 37357907 DOI: 10.1111/exd.14868] [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: 12/04/2022] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023]
Abstract
Acne vulgaris (AV), a widely common disorder, that negatively affects the quality of life. Metformin is a relatively safe, cheap and well tolerated drug that is widely used in the treatment of Diabetes. Systemic metformin has demonstrated promising results in treating acne, while topically it was studied for melasma and recalcitrant central centrifugal cicatricial alopecia. To study the safety and efficacy of topical metformin 30% in the treatment of AV. Twenty-seven female AV patients were asked to blindly apply metformin and placebo gels to either side of the face for 12 weeks. AV lesion count was performed at baseline, at each visit and 4 weeks after end of treatment. At the end of the treatment period, the treated side showed significant improvement of comedones, papules and nodules but not pustules. Although, lesions count increased 1 month after stopping treatment, comedones and papules numbers were still significantly less on the metformin side compared to placebo. No side effects were reported. The limited number of patients studied and the limited follow-up period. The metformin effect was not studied on cellular and molecular levels. Topical metformin nanoemulsion gel can be a promising safe and effective treatment of AV.
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Affiliation(s)
- Mohamed H M El-Komy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Rehab Nabil Shamma
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Nermeen Ibrahim Bedair
- Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Helwan, Egypt
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Deng Y, Jiang S, Huang Y, Tan X, Huang Y, Chen L, Xu J, Xiong X, Zhou J, Xu Y. Metformin Contributes to the Therapeutic Effects of Acne Vulgaris by Modifying the Gut Microbiome. Dermatol Ther 2023. [DOI: 10.1155/2023/9336867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background. Considering the increasing side effects of the first-line treatment for acne vulgaris, metformin was developed to be an effective adjunct therapy, but its mechanism of action is poorly defined. Recent evidence shows that the gut microbiota is a site of metformin action. The aim of this study was to evaluate the effects and mechanism of action for metformin in the adjuvant treatment of acne vulgaris by regulating gut microbiota. Methods. First, untreated acne patients were randomly allocated into two treatment groups. Both groups were treated with isotretinoin, but only one was additionally treated with metformin, for three months. Sprague Dawley (SD) rats were used as acne models, and they were also separated into groups that received isotretinoin, metformin, a combination of isotretinoin and metformin, and the vehicle, respectively. Then, the fecal samples from drug-intervention rats were transferred to germ-free rats with acne. The severity of the disease was evaluated using the Global Acne Grading System (GAGS) scoring for patients, and the number of comedones and mononuclear cells in pathological sections was used for rats. The composition of the gut microbiota was detected using gene sequencing for 16S rDNA. Results. Metformin had strong effects on the composition and function of the gut microbiota, and this correlated with the reduction in the severity of acne in both humans and rats. The fecal transfer to pseudo-germ-free rats improved both the inflammatory phenotype and comedones of acne in recipients of metformin-altered microbiota. Conclusion. The results suggest that metformin improves the symptoms of acne vulgaris by modulating the gut microbiota.
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Huang Y, Liu L, Hao Z, Chen L, Yang Q, Xiong X, Deng Y. Potential roles of gut microbial tryptophan metabolites in the complex pathogenesis of acne vulgaris. Front Microbiol 2022; 13:942027. [PMID: 35966699 PMCID: PMC9363916 DOI: 10.3389/fmicb.2022.942027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Acne vulgaris is a chronic inflammatory skin disease in which the influence of gut microbiota has been implicated but without clarification of mechanisms. Gut microbiota may exert such an influence via metabolites, particularly those of tryptophan. End metabolites of tryptophan activate receptors, including aryl hydrocarbon, G protein-coupled, and pregnane X receptors to stabilize the immune microenvironment and intestinal mucosal homeostasis. Any impact on the pathogenesis of acne vulgaris remains unclear. The current review collates recent advances concerning potential roles of tryptophan metabolism in mediating skin inflammation, follicular sebaceous gland function and intestinal permeability, all of which influence the pathogenesis of acne vulgaris. The aim was to improve understanding of the pathogenesis of acne vulgaris and to expose therapeutic opportunities.
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Affiliation(s)
- Yukun Huang
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lu Liu
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhenyu Hao
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lingna Chen
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qian Yang
- School of Nursing, Chengdu Medical College, Chengdu, China
- *Correspondence: Qian Yang,
| | - Xia Xiong
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Xia Xiong,
| | - Yongqiong Deng
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Yongqiong Deng,
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Varela-Trinidad GU, Domínguez-Díaz C, Solórzano-Castanedo K, Íñiguez-Gutiérrez L, Hernández-Flores TDJ, Fafutis-Morris M. Probiotics: Protecting Our Health from the Gut. Microorganisms 2022; 10:microorganisms10071428. [PMID: 35889147 PMCID: PMC9316266 DOI: 10.3390/microorganisms10071428] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 02/07/2023] Open
Abstract
The gut microbiota (GM) comprises billions of microorganisms in the human gastrointestinal tract. This microbial community exerts numerous physiological functions. Prominent among these functions is the effect on host immunity through the uptake of nutrients that strengthen intestinal cells and cells involved in the immune response. The physiological functions of the GM are not limited to the gut, but bidirectional interactions between the gut microbiota and various extraintestinal organs have been identified. These interactions have been termed interorganic axes by several authors, among which the gut–brain, gut–skin, gut–lung, gut–heart, and gut–metabolism axes stand out. It has been shown that an organism is healthy or in homeostasis when the GM is in balance. However, altered GM or dysbiosis represents a critical factor in the pathogenesis of many local and systemic diseases. Therefore, probiotics intervene in this context, which, according to various published studies, allows balance to be maintained in the GM, leading to an individual’s good health.
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Affiliation(s)
- Gael Urait Varela-Trinidad
- Doctorado en Ciencias Biomédicas, Con Orientaciones en Inmunología y Neurociencias, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Mexico; (G.U.V.-T.); (C.D.-D.)
- Centro de Investigación en Inmunología y Dermatología (CIINDE), Calzada del Federalismo Nte 3102, Zapopan 45190, Mexico
| | - Carolina Domínguez-Díaz
- Doctorado en Ciencias Biomédicas, Con Orientaciones en Inmunología y Neurociencias, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Mexico; (G.U.V.-T.); (C.D.-D.)
- Centro de Investigación en Inmunología y Dermatología (CIINDE), Calzada del Federalismo Nte 3102, Zapopan 45190, Mexico
| | - Karla Solórzano-Castanedo
- Doctorado en Ciencias de la Nutrición Traslacional, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Mexico;
| | - Liliana Íñiguez-Gutiérrez
- Instituto de Investigación de Inmunodeficiencias y VIH, Hospital Civil de Guadalajara, Coronel Calderón 777, Guadalajara 44280, Mexico; (L.Í.-G.); (T.d.J.H.-F.)
| | - Teresita de Jesús Hernández-Flores
- Instituto de Investigación de Inmunodeficiencias y VIH, Hospital Civil de Guadalajara, Coronel Calderón 777, Guadalajara 44280, Mexico; (L.Í.-G.); (T.d.J.H.-F.)
- Departamento de Disciplinas Filosóficas Metodológicas e Intrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Mexico
| | - Mary Fafutis-Morris
- Centro de Investigación en Inmunología y Dermatología (CIINDE), Calzada del Federalismo Nte 3102, Zapopan 45190, Mexico
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Mexico
- Correspondence: ; Tel.: +52-33-1411-4590
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Acne, Microbiome, and Probiotics: The Gut–Skin Axis. Microorganisms 2022; 10:microorganisms10071303. [PMID: 35889022 PMCID: PMC9318165 DOI: 10.3390/microorganisms10071303] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of this narrative review was to check the influence of the human microbiota in the pathogenesis of acne and how the treatment with probiotics as adjuvant or alternative therapy affects the evolution of acne vulgaris. Acne is a chronic inflammatory skin disease involving the pilosebaceous units. The pathogenesis of acne is complex and multifactorial involving genetic, metabolic, and hormonal factors in which both skin and gut microbiota are implicated. Numerous studies have shown the bidirectionality between the intestinal microbiota and skin homeostasis, a communication mainly established by modifying the immune system. Increased data on the mechanisms of action regarding the relevance of Cutibacterium acnes, as well as the importance of the gut–skin axis, are becoming known. Diverse and varied in vitro studies have shown the potential beneficial effects of probiotics in this context. Clinical trials with both topical and oral probiotics are scarce, although they have shown positive results, especially with oral probiotics through the modulation of the intestinal microbiota, generating an anti-inflammatory response and restoring intestinal integrity, or through metabolic pathways involving insulin-like growth factor I (IGF-1). Given the aggressiveness of some standard acne treatments, probiotics should continue to be investigated as an alternative or adjuvant therapy.
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Truncal Acne: An Overview. J Clin Med 2022; 11:jcm11133660. [PMID: 35806952 PMCID: PMC9267677 DOI: 10.3390/jcm11133660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
Acne is a relatively common disease of the pilosebaceous units. Many aspects of facial acne have been studied. However, there is limited evidence regarding truncal acne. Truncal acne is also observed in a significant number of patients, but it is often ignored by patients and clinicians. Although the pathogenesis of facial and trunk acne is considered to be similar, the characteristics of the skin on the trunk and face are thought to be different. As truncal acne can cause scars on large areas of the body and adversely affect the quality of life of patients, more attention should be given to patients with truncal acne. Although only a few studies have been published to date, the epidemiology, etiology, severity assessment tool, assessments of the quality of life, and new treatments targeting truncal acne are currently being studied. Therefore, in this review, the latest knowledge on truncal acne will be discussed.
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The increasing importance of the gut microbiome in acne vulgaris. Folia Microbiol (Praha) 2022; 67:825-835. [PMID: 35711021 DOI: 10.1007/s12223-022-00982-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/26/2022] [Indexed: 11/04/2022]
Abstract
Acne is a frequently presented dermatological condition brought about by an interplay among inflammation, increased sebum production, hyperkeratinisation, and predominantly Propionibacterium acnes (renamed as Cutibacterium acnes) proliferation, leading to debilitating psychological scars. However, it has been shown that it is the loss of microbial diversity in the skin and the imbalance among C. acnes phylotypes that brings about acne rather than the C. acnes species as a whole. Interestingly, recent evidence suggests that other microorganisms may be implicated, such as the fungi Malassezia and the bacteria Cutibacterium granulosum. A plethora of scientific evidence suggests that the gut microbiome is implicated in the overall health and physiology of the host; studies show that the gut microbiome of acne patients is distinct and depicts less microbial diversity compared to individuals without acne. Herein, using the key terms: acne, C. acnes, IGF-1, sebum, and gut microbiome, we carried out a review of the literature, using Google Scholar and PubMed, and discussed the role of the gut and skin microbiome in relation to acne, as a narrative review. The role of hormones, diet, sebum, and stress in relation to the gut microbiome was also investigated. Therapeutic implications and the use of pre-/postbiotics are also deliberated upon. In this light, future research should investigate the relationship between the gut microbiome and the agreed upon factors of acne pathology, potentially leading to the discovery of novel acne treatments with milder side effects.
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