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The Journal of Dermatological Treatment May 2021Acne vulgaris, a common and chronic disorder of the pilosebaceous unit, affects up to 85% of adolescent and young adults. While a lot is already known about acne and its... (Review)
Review
Acne vulgaris, a common and chronic disorder of the pilosebaceous unit, affects up to 85% of adolescent and young adults. While a lot is already known about acne and its treatment, still the gaps in our understanding of acne remains. This article will review the emerging evidence in the complex pathogenesis of acne and provide an overview of the potential future therapy in management of acne vulgaris.Key points targeted therapy has been the mainstay in the management of acne till now. Sebocyte activity is controlled via a range of cellular pathways and hormones in addition to androgens. This has opened an array of therapeutic options to be available for treating acne in the near future.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Antibodies, Monoclonal; Antioxidants; Biofilms; Cortodoxone; Diet; Enzyme Inhibitors; Humans; Propionibacterium acnes
PubMed: 31393195
DOI: 10.1080/09546634.2019.1654075 -
American Journal of Clinical Dermatology Sep 2020Our understanding of the role of Cutibacterium acnes in the pathophysiology of acne has recently undergone a paradigm shift: rather than C. acnes hyperproliferation, it... (Review)
Review
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 IA 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.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Anti-Inflammatory Agents; Dysbiosis; Humans; Immunity, Innate; Microbiota; Propionibacterium acnes; Skin; Symbiosis
PubMed: 32910436
DOI: 10.1007/s40257-020-00531-1 -
Boletin Medico Del Hospital Infantil de... 2022Acne is a chronic inflammatory disease of the pilosebaceous unit with multifactorial etiology. Abnormal proliferation of keratinocytes, altered sebum production,... (Review)
Review
Acne is a chronic inflammatory disease of the pilosebaceous unit with multifactorial etiology. Abnormal proliferation of keratinocytes, altered sebum production, inflammation of the sebaceous follicle, and colonization by Cutibacterium acnes have been traditionally implicated. However, the diet has also been highlighted in the pathogenesis because of its direct relation with some biochemical markers and the transcription of specific genes associated with sebaceous gland activity, inflammation, and bacterial proliferation, which together promote the development of the disease, affect the severity of the condition, and modify its response to treatment.
Topics: Acne Vulgaris; Diet; Humans; Inflammation; Propionibacterium acnes; Sebum
PubMed: 35468121
DOI: 10.24875/BMHIM.21000088 -
Future Microbiology Mar 2023protects skin homeostasis. The species has three subspecies, and associations between subsp. and acne, subsp. and prostate cancer, and subsp. and progressive... (Review)
Review
protects skin homeostasis. The species has three subspecies, and associations between subsp. and acne, subsp. and prostate cancer, and subsp. and progressive macular hypomelanosis have recently been suggested. Different phylotypes/clonal complexes may cause prosthetic joint and other infections, and virulence factors such as fimbriae, biofilms, multidrug-resistance plasmids, porphyrin, Christie-Atkins-Munch-Petersen factors and cytotoxicity contribute to infections. Isolates are subtyped by multiplex PCR or multi- or single-locus sequence typing; however, these methods could be better synchronized. Resistance of acneic strains to macrolides (25.0-73.0%), clindamycin (10.0-59.0%) and tetracyclines (up to 37.0%) is worrisome, but susceptibility testing is now facilitated by European Committee on Antimicrobial Susceptibility Testing disk diffusion breakpoints. New therapeutic approaches include sarecycline, antimicrobial peptides and bacteriophages.
Topics: Male; Humans; Propionibacterium acnes; Acne Vulgaris; Skin; Biofilms; Plasmids
PubMed: 37042433
DOI: 10.2217/fmb-2022-0191 -
European Journal of Dermatology : EJD Jul 2022The principal actors in acne are the sebaceous gland, keratinocytes of the follicle and skin microbiome/innate immunity. Current acne treatments are frequently... (Review)
Review
The principal actors in acne are the sebaceous gland, keratinocytes of the follicle and skin microbiome/innate immunity. Current acne treatments are frequently accompanied by side effects or may cause antibacterial resistance. New formulations and emerging treatments with novel mechanisms of action and improved formulations have recently been made available or are currently under development. This review provides an update on the most recent advances in topical or systemic acne therapy related to recent data on the pathophysiology of acne. A review of the most recent literature about new and emerging acne treatments since 2016 listed in the PubMed and Clinicaltrials.gov database was performed by a group of dermatologists interested in acne (GEA). Several novel treatments have been made available or are currently under development, including Clascosterone, Trifarotene and Sarecy-cline, as well as more effective and better tolerated formulations of existing compounds, such as Minocycline, Tretinoin, Tazarotene and Lidose-isotretinoin, and emerging acne therapies (including hyaluronic acid, cannabidiol, modulators of the skin microbiota, insulin-like growth factor, vaccines, bacteriophages, probiotics and antimicrobial peptides), targeting the sebaceous gland and its activity, inflammation or keratinocytes of the follicle and skin microbiome including Cutibacterium acnes. Recently, in addition to other fixed combinations, a fixed combination of adapalene and benzoyl peroxide that targets acne scars has been made available for the first time. The newly available products and other potentially emerging treatment options will increase the armamentarium of acne therapies and potentially reduce its prevalence worldwide.
Topics: Humans; Anti-Bacterial Agents; Acne Vulgaris; Benzoyl Peroxide; Adapalene; Propionibacterium acnes; Dermatologic Agents
PubMed: 36301760
DOI: 10.1684/ejd.2022.4306 -
Dermatologic Therapy May 2020Acne is known as a chronic inflammatory skin disease with sever adverse effects on quality of life in the patients. The increasing resistance to antibiotics has... (Review)
Review
Acne is known as a chronic inflammatory skin disease with sever adverse effects on quality of life in the patients. The increasing resistance to antibiotics has decreased their effectiveness in treating acne. As viable microbial dietary supplements, probiotics provide health benefits through fighting pathogens and maintaining the homeostasis of the gut and skin microbiome. The present article reviewed the potential of probiotics as beneficial microorganisms for treating acne vulgaris. This review of literature was conducted through a bibliographic search of popular databases, including Science Direct, PubMed, Scielo and Medline, using keywords such as probiotics, prebiotics, synbiotics, microbiome, and acne vulgaris to determine potential applications of these beneficial microbiomes in treating acne vulgaris. Acne lesions are associated with increases in proportion of Propionibacterium acnes as a skin commensal bacterium. The environmental studies showed inhibitory effects of probiotics on P. acnes, mediating by antibacterial proteins and bacteriocin-like inhibitory substances, and their immunomodulatory effects onkeratinocytes and epithelial cells. Probiotics were also found to inhibit cytokine IL-8 in epithelial cells and keratinocytes, suggesting immunomodulatory activities. Moreover, glycerol fermentation by Staphylococcus epidermidis was found to be a natural skin defense against acne and an overgrowth inhibitor of P. acnes. As an antimicrobial agent in lotions and cosmetic formulations, Lactococcus sp. can decrease the inflammatory mediators that are produced by P. acnes and cause vasodilation, edema, mast cell degranulation and TNF-alpha release. Oral administration of probiotics was found to constitute an adjuvant therapy to conventional modalities for treating mild-to-moderate acne vulgaris.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Microbiota; Probiotics; Propionibacterium acnes; Quality of Life
PubMed: 32266790
DOI: 10.1111/dth.13279 -
Folia Microbiologica Dec 2022Acne is a frequently presented dermatological condition brought about by an interplay among inflammation, increased sebum production, hyperkeratinisation, and... (Review)
Review
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.
Topics: Humans; Gastrointestinal Microbiome; Acne Vulgaris; Propionibacterium acnes; Skin; Microbiota
PubMed: 35711021
DOI: 10.1007/s12223-022-00982-5 -
The Yale Journal of Biology and Medicine Dec 2022Antimicrobial resistance is an increasing public health problem worldwide. The interest of a focus on antimicrobial resistance in acne lies on the facts that acne... (Review)
Review
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 (, formerly ) 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.
Topics: Humans; Anti-Bacterial Agents; Drug Resistance, Bacterial; Acne Vulgaris; Skin; Propionibacterium acnes
PubMed: 36568833
DOI: No ID Found -
Archives of Dermatological Research Jul 2019Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. Four factors play vital roles in acne pathophysiology: hyperseborrhea and... (Review)
Review
Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. Four factors play vital roles in acne pathophysiology: hyperseborrhea and dysseborrhea, altered keratinization of the pilosebaceous duct, Cutibacterium acnes (C. acnes) and inflammation. The main hormones responsible for the development of acne vulgaris include androgens, insulin and insulin-like growth factor-1. Other factors involved in this process are corticotropin-releasing hormone, α-melanocyte-stimulating hormone and substance P. Wnt/β-catenin signaling pathway, phosphoinositide 3-kinase (PI3K)/Akt pathway, mitogen-activated protein kinase pathway, adenosine 5'-monophosphate-activated protein kinase pathway and nuclear factor kappa B pathway participate in the modulation of sebocyte, keratinocyte and inflammatory cell (e.g. lymphocytes, monocytes, macrophages, neutrophils) activity. Among all the triggers and pathways mentioned above, IGF-1-induced PI3K/Akt/Forkhead box protein O1/mammalian target of rapamycin (mTOR) C1 pathway is the most important signaling responsible for acne pathogenesis. Commonly used anti-acne agents include retinoids, benzoyl peroxide, antibiotics and hormonal agents (e.g. spironolactone, combination oral contraceptive and flutamide). New approaches including peroxisome proliferator-activated receptor γ modifier, melanocortin receptor antagonists, epigallocatechin-3-gallate, metformin, olumacostat glasaretil, stearoyl-CoA desaturase inhibitor omiganan pentahydrochloride, KPT, afamelanotide, apremilast and biologics have been developed as promising treatments for acne vulgaris. Although these anti-acne agents have various pharmacological effects against the diverse pathogenesis of acne, all of them have a synergistic mode of action, the attenuation of Akt/mTORC1 signaling and enhancement of p53 signal transduction. In addition to drug therapy, diet with no hyperglycemic carbohydrates, no milk and dairy products is also beneficial for treatment of acne.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Dairy Products; Dermatologic Agents; Dietary Carbohydrates; Drug Synergism; Humans; Propionibacterium acnes; Sebaceous Glands; Sebum; Signal Transduction
PubMed: 30859308
DOI: 10.1007/s00403-019-01908-x -
Experimental Dermatology Jul 2019Acne vulgaris is a prevalent cutaneous disease characterized by a multifactorial pathogenic process including hyperseborrhea, inflammation, over-keratinization of...
Acne vulgaris is a prevalent cutaneous disease characterized by a multifactorial pathogenic process including hyperseborrhea, inflammation, over-keratinization of follicular keratinocytes and Propionibacterium acnes (P acnes) overgrowth. Salicylic acid (SA), a beta-hydroxy acid, is frequently used in the treatment of acne. SA has been found to decrease skin lipids and to possess anti-inflammatory properties. However, few studies have elucidated the mechanisms and pathways involved in such treatment of acne. In this study, we initially investigated the anti-acne properties of SA in human SEB-1 sebocytes. Treatment with SA decreased sebocyte lipogenesis by downregulating the adenosine monophosphate-activated protein kinase (AMPK)/sterol response element-binding protein-1 (SREBP-1) pathway and reduced inflammation by suppressing the NF-κB pathway in these cells. Salicylic acid also decreased the cell viability of SEB-1 by increasing apoptosis via the death signal receptor pathway. Subsequently, histopathological analysis of a rabbit ear acne model after application of SA for three weeks confirmed that SA suppressed the levels of cytokines and major pathogenic proteins around acne lesions, which supports the mechanisms suggested by our in vitro experiments. These results initially clarified that therapeutic activities of SA in acne vulgaris treatment could be associated with the regulation of SREBP-1 pathway and NF-κB pathway in human SEB-1 sebocytes.
Topics: AMP-Activated Protein Kinases; Acne Vulgaris; Apoptosis; Cell Line; Computational Biology; Down-Regulation; Humans; Keratinocytes; Lipid Metabolism; Propionibacterium acnes; Salicylic Acid; Sebaceous Glands; Sebum; Signal Transduction; Sterol Regulatory Element Binding Protein 1
PubMed: 30972839
DOI: 10.1111/exd.13934