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The evolving role of Propionibacterium acnes in acne
1Department of Dermatology, University of Pennsylvania, Philadelphia 19104, USA.
Abstract:
Propionibacterium acnes is a member of the resident cutaneous flora. Sebaceous follicles involved in acne are characterized by the accumulation of abnormally desquamated corneocytes and excess sebum-the microcomedo. This environment provides ideal growth conditions for P acnes. Several orders of magnitude level of P acnes are found in microcomedos. P acnes produces a variety of chemotactic factors and proinflammatory molecules that are responsible for the inflammatory phase of acne. Antibiotic therapy works by reducing the viable number of P acnes as well as by reducing the production of inflammatory stimuli. Antibiotic therapy has been a mainstay of treatment for more than 30 years. In the last decade, decreased sensitivity to antibiotics has developed and clinical resistance has been described. This development threatens the usefulness of antibiotic therapy in the future.
Insights
Propionibacterium acnes (P acnes) drives acne inflammation by thriving in clogged follicles. Antibiotic resistance in P acnes now threatens this common acne treatment.
Area of Science:
- Dermatology
- Microbiology
- Cutaneous Biology
Background:
- Propionibacterium acnes (P acnes) is a common skin bacterium.
- Acne develops in sebaceous follicles with excess sebum and abnormal skin cell shedding, creating a microcomedo.
- P acnes proliferates in microcomedos, producing inflammatory molecules that cause acne lesions.
Purpose of the Study:
- To review the role of P acnes in acne pathogenesis.
- To discuss the mechanism of antibiotic therapy in treating acne.
- To highlight the emerging issue of antibiotic resistance in P acnes.
Main Methods:
- Literature review of P acnes and acne treatment.
- Analysis of P acnes' contribution to inflammation.
- Examination of antibiotic efficacy and resistance trends.
Main Results:
- P acnes accumulation in microcomedos is central to acne.
- P acnes triggers inflammation through specific factors.
- Decreased antibiotic sensitivity and clinical resistance in P acnes have emerged.
Conclusions:
- Antibiotic therapy has been a primary acne treatment for decades.
- The rise of antibiotic resistance in P acnes poses a significant challenge to future acne management.
- Alternative or adjunctive therapies may be needed to combat acne effectively.