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Wei Z, Gao M, Liu Y, Zeng R, Liu J, Sun S, Li S, Hu L, Xiang R, Mo R, Song Z, Chen Z, Bao D, Hua D, Zouboulis CC, Feng Y, Li J, Yang Y. TRPV3 promotes sebocyte inflammation via transcriptional modulating TLR2 in acne. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167195. [PMID: 38648901 DOI: 10.1016/j.bbadis.2024.167195] [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: 02/25/2024] [Revised: 04/08/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
Acne is a common chronic inflammatory disease of the pilosebaceous unit. Transient receptor potential vanilloid 3 (TRPV3) is an ion channel that is involved in inflammatory dermatosis development. However, the involvement of TRPV3 in acne-related inflammation remains unclear. Here, we used acne-like mice and human sebocytes to examine the role of TRPV3 in the development of acne. We found that TRPV3 expression increased in the skin lesions of Propionibacterium acnes (P. acnes)-injected acne-like mice and the facial sebaceous glands (SGs) of acne patients. TRPV3 promoted inflammatory cytokines and chemokines secretion in human sebocytes and led to neutrophil infiltration surrounding the SGs in acne lesions, further exacerbating sebaceous inflammation and participating in acne development. Mechanistically, TRPV3 enhanced TLR2 level by promoting transcriptional factor phosphorylated-FOS-like antigen-1 (p-FOSL1) expression and its binding to the TLR2 promoter, leading to TLR2 upregulation and downstream NF-κB signaling activation. Genetic or pharmacological inhibition of TRPV3 both alleviated acne-like skin inflammation in mice via the TLR2-NF-κB axis. Thus, our study revealed the critical role of TRPV3 in sebaceous inflammation and indicated its potential as an acne therapeutic target.
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Affiliation(s)
- Ziyu Wei
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Meng Gao
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yihe Liu
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Rong Zeng
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
| | - Juan Liu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shuya Sun
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Siyuan Li
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Linghan Hu
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ruiyu Xiang
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ran Mo
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Zhongya Song
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Zhiming Chen
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Dan Bao
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
| | - Di Hua
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Yanyan Feng
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yong Yang
- Genetic Skin Disease Center, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
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Zhang J, Liu S, Guo W, Li N. The synergistic effects of Guaiacum officinale and Rhodomyrtus tomentosa extracts in the treatment of acne vulgaris on sensitive skin. J Cosmet Dermatol 2024. [PMID: 38790116 DOI: 10.1111/jocd.16394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/09/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Acne vulgaris, a common chronic dermatological condition worldwide, is associated with inflammatory response and Cutibacterium acnes. Individuals with acne vulgaris and sensitive skin have limited suitable treatments due to the skin irritation and side effects exhibited by current hydroxy acidic medications. AIMS This study aimed to evaluate the synergistic effects of Guaiacum officinale (GO) and Rhodomyrtus Tomentosa (RT) extracts for treating acne vulgaris on sensitive skin by inhibiting inflammation. METHODS The phytochemical constituents and antioxidant activity of GO and RT extracts were determined in vitro. The anti-inflammatory effects were investigated in peptidoglycan (PGN)-induced HaCaT cells. Further, a 28-day clinical trial was conducted involving 30 subjects with both sensitive skin and acne to evaluate the efficacy and subjects' satisfaction. RESULTS Total phenolics and flavonoids were detected in GO and RT extracts, the IC50 values for DPPH radical scavenging were 6.15 wt% and 0.76 wt%, respectively. The combination of GO and RT extracts at a 1:1 (v/v) ratio significantly decreased the expression of TLR-2 and TLR-4, as well as the secretion of IL-1α, IL-8, and TNF-α in PGN-induced HaCaT cells, by 2.30-7.93 times compared to GO extract alone (p < 0.05). Moreover, the cream containing 5 wt% the combination significantly improved facial acne and redness (p < 0.05). The number of comedones decreased by 50.00% and papules by 30.65% after 28 days of application. No adverse events were reported and 96.67% of the subjects were satisfied with the treatment. CONCLUSION The efficacy of the GO and RT extracts in synergistically suppressing inflammation, improving acne vulgaris, and reducing redness. The study offers an effective and non-irritant treatment for acne vulgaris in individuals with sensitive skin.
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Affiliation(s)
- Jianhua Zhang
- N.O.D topia (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
- Simpcare (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
| | - Shichao Liu
- N.O.D topia (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
- Simpcare (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
| | - Wenjiao Guo
- N.O.D topia (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
- Simpcare (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
| | - Na Li
- N.O.D topia (GuangZhou) Biotechnology Co., Ltd., Guangzhou, China
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Ruffier d'Epenoux L, Fayoux E, Veziers J, Dagnelie MA, Khammari A, Dréno B, Corvec S. Biofilm of Cutibacterium acnes: a target of different active substances. Int J Dermatol 2024. [PMID: 38760974 DOI: 10.1111/ijd.17194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Acne vulgaris is a chronic inflammatory dermatosis. Cutibacterium acnes plays a crucial role in the acne pathophysiology. Recent works present evidence of C. acnes growing as a biofilm in cutaneous follicles. This development is currently considered one of the leading causes of C. acnes in vivo persistence and resistance to antimicrobials used to treat acne. OBJECTIVE Our objective was to evaluate the effects of various active compounds (clindamycin, erythromycin, doxycycline, and myrtle extract) on eight distinct, well-characterized strains of C. acnes following their growth in biofilm mode. METHODS/RESULTS Cutibacterium acnes isolates from phylotypes IA1 and IA2 produce more biofilm than other phylotypes. No antibiotic effect was observed either during the curative test or preventive test. Myrtle extract at 0.01% (w/v) showed significant efficacy on the biofilm for C. acnes strains (curative assays). Furthermore, it appear that myrtle extract and doxycycline together reduce the overall biomass of the biofilm. A significant dose-dependent effect was observed during the preventive test, greater than the one observed under curative conditions, with an important loss of activity of the myrtle extract observed from 0.001% (w/v) concentration onwards. Transmission electron microscopy showed that bacteria treated with myrtle extract grew biofilms much less frequently than untreated bacteria. Additionally, when the quantity of myrtle extract grew, the overall number of bacteria dropped, indicating an additional antibacterial action. CONCLUSION These findings support the hypothesis that the different C. acnes phylotypes have various aptitudes in forming biofilms. They also suggest that myrtle extract is a promising alternative as an anti-biofilm and antibacterial agent in fighting diseases caused by planktonic and biofilm C. acnes.
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Affiliation(s)
- Louise Ruffier d'Epenoux
- Service de Bactériologie et des Contrôles Microbiologiques, CHU, Nantes, France
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Erwan Fayoux
- Service de Bactériologie et des Contrôles Microbiologiques, CHU, Nantes, France
| | - Joëlle Veziers
- Inserm, UMR 1229, RMeS - Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, France
| | - Marie-Ange Dagnelie
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Amir Khammari
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Brigitte Dréno
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie et des Contrôles Microbiologiques, CHU, Nantes, France
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
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Khairnar P, Phatale V, Shukla S, Tijani AO, Hedaoo A, Strauss J, Verana G, Vambhurkar G, Puri A, Srivastava S. Nanocarrier-Integrated Microneedles: Divulging the Potential of Novel Frontiers for Fostering the Management of Skin Ailments. Mol Pharm 2024; 21:2118-2147. [PMID: 38660711 DOI: 10.1021/acs.molpharmaceut.4c00144] [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] [Indexed: 04/26/2024]
Abstract
The various kinds of nanocarriers (NCs) have been explored for the delivery of therapeutics designed for the management of skin manifestations. The NCs are considered as one of the promising approaches for the skin delivery of therapeutics attributable to sustained release and enhanced skin penetration. Despite the extensive applications of the NCs, the challenges in their delivery via skin barrier (majorly stratum corneum) have persisted. To overcome all the challenges associated with the delivery of NCs, the microneedle (MN) technology has emerged as a beacon of hope. Programmable drug release, being painless, and its minimally invasive nature make it an intriguing strategy to circumvent the multiple challenges associated with the various drug delivery systems. The integration of positive traits of NCs and MNs boosts therapeutic effectiveness by evading stratum corneum, facilitating the delivery of NCs through the skin and enhancing their targeted delivery. This review discusses the barrier function of skin, the importance of MNs, the types of MNs, and the superiority of NC-loaded MNs. We highlighted the applications of NC-integrated MNs for the management of various skin ailments, combinational drug delivery, active targeting, in vivo imaging, and as theranostics. The clinical trials, patent portfolio, and marketed products of drug/NC-integrated MNs are covered. Finally, regulatory hurdles toward benchtop-to-bedside translation, along with promising prospects needed to scale up NC-integrated MN technology, have been deliberated. The current review is anticipated to deliver thoughtful visions to researchers, clinicians, and formulation scientists for the successful development of the MN-technology-based product by carefully optimizing all the formulation variables.
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Affiliation(s)
- Pooja Khairnar
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Vivek Phatale
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Shalini Shukla
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Akeemat O Tijani
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Aachal Hedaoo
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Jordan Strauss
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Gabrielle Verana
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Ganesh Vambhurkar
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
| | - Ashana Puri
- Department of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee 37614, United States
| | - Saurabh Srivastava
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana 500037, India
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Dias da Rocha MA, Saint Aroman M, Mengeaud V, Carballido F, Doat G, Coutinho A, Bagatin E. Unveiling the Nuances of Adult Female Acne: A Comprehensive Exploration of Epidemiology, Treatment Modalities, Dermocosmetics, and the Menopausal Influence. Int J Womens Health 2024; 16:663-678. [PMID: 38650835 PMCID: PMC11034510 DOI: 10.2147/ijwh.s431523] [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] [Received: 02/01/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Previously considered a skin disease exclusively affecting adolescents, characterized by inflammatory and non-inflammatory skin lesions, acne vulgaris is now increasingly observed in adult life, including post-menopause. Today, adult female acne (AFA) is a common chronic inflammatory disease of the pilosebaceous unit, with polymorphic lesions presenting as open or closed comedones, papules, pustules, and even nodules or cysts, often with the presence of sequelae. AFA may persist from adolescence or manifest de novo in adulthood. Its etiology is multifactorial, involving genetic, hormonal, dietary, and environmental factors, yet still incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and reduced diversity of Cutibacterium acnes strains are the underlying disease mechanisms. During menopausal transition, a relative increase in androgen levels occurs, just as estrogens begin to decline, which can manifest itself as acne. Whereas most AFA exhibit few acne lesions with normo-androgenic serum levels, baseline investigations including androgen testing panel enable associated comorbidities to be eliminated, such as polycystic ovarian syndrome, congenital adrenal hyperplasia, or tumors. Another interesting feature is AFA's impact on quality of life, which is greater than in adolescents, being similar to other chronic diseases like asthma. The therapeutic approach to AFA depends on its severity and associated features. This review investigates the intricate facets of AFA, with a specific focus on incidence rates, treatment modalities, and the curious impact of menopause. Utilizing insights from contemporary literature and scientific discussions, this article seeks to advance our understanding of AFA, offering new perspectives to shape clinical practices and improve patient outcomes.
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Affiliation(s)
| | - Markéta Saint Aroman
- Corporate Medical Direction Dermocosmetics Care & Personal Care, Pierre Fabre, Toulouse, France
| | - Valérie Mengeaud
- Laboratoires Dermatologiques Ducray, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Fabienne Carballido
- Laboratoires Dermatologiques A-Derma, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Gautier Doat
- Laboratoires Dermatologiques Avène, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Ana Coutinho
- Laboratorios Pierre Fabre do Brasil LTDA, Rio de Janeiro, Brazil
| | - Edileia Bagatin
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil
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Li L, Zhang J, Cheng W, Di F, Wang C, An Q. Saponins of Paris polyphylla for the Improvement of Acne: Anti-Inflammatory, Antibacterial, Antioxidant and Immunomodulatory Effects. Molecules 2024; 29:1793. [PMID: 38675613 PMCID: PMC11052371 DOI: 10.3390/molecules29081793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Acne is a chronic inflammatory skin disease with a recurring nature that seriously impacts patients' quality of life. Currently, antibiotic resistance has made it less effective in treating acne. However, Paris polyphylla (P. polyphylla) is a valuable medicinal plant with a wide range of chemical components. Of these, P. polyphylla saponins modulate the effects in vivo and in vitro through antibacterial, anti-inflammatory, immunomodulatory, and antioxidant effects. Acne is primarily associated with inflammatory reactions, abnormal sebum function, micro-ecological disorders, hair follicle hyperkeratosis, and, in some patients, immune function. Therefore, the role of P. polyphylla saponins and their values in treating acne is worthy of investigation. Overall, this review first describes the distribution and characteristics of P. polyphylla and the pathogenesis of acne. Then, the potential mechanisms of P. polyphylla saponins in treating acne are listed in detail (reduction in the inflammatory response, antibacterial action, modulation of immune response and antioxidant effects, etc.). In addition, a brief description of the chemical composition of P. polyphylla saponins and its available extraction methods are described. We hope this review can serve as a quick and detailed reference for future studies on their potential acne treatment.
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Affiliation(s)
- Luyao Li
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Jiachan Zhang
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Wenjing Cheng
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Feiqian Di
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Changtao Wang
- College of Light Industry Science and Engineering, Beijing Technology & Business University, Beijing 100048, China; (L.L.); (W.C.); (F.D.); (C.W.)
- Beijing Key Laboratory of Plant Resource Research and Development, Beijing 100048, China
- Institute of Cosmetic Regulatory Science, Beijing 100048, China
| | - Quan An
- Yunnan Baiyao Group Co., Ltd., Kunming 650000, China;
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7
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Xu W, Sinaki DG, Tang Y, Chen Y, Zhang Y, Zhang Z. Acne-induced pathological scars: pathophysiology and current treatments. BURNS & TRAUMA 2024; 12:tkad060. [PMID: 38585341 PMCID: PMC10998535 DOI: 10.1093/burnst/tkad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 04/09/2024]
Abstract
Acne is a common chronic inflammatory dermatosis that can lead to pathological scars (PSs, divided into hypertrophic scars and keloids). These kinds of abnormal scars seriously reduce the quality of life of patients. However, their mechanism is still unclear, resulting in difficult clinical prevention, unstable treatment effects and a high risk of recurrence. Available evidence supports inflammatory changes caused by infection as one of the keys to abnormal proliferation of skin fibroblasts. In acne-induced PSs, increasing knowledge of the immunopathology indicates that inflammatory cells directly secrete growth factors to activate fibroblasts and release pro-inflammatory factors to promote the formation of PSs. T helper cells contribute to PSs via the secretion of interleukin (IL)-4 and IL-13, the pro-inflammatory factors; while regulatory T cells have anti-inflammatory effects, secrete IL-10 and prostaglandin E2, and suppress fibrosis production. Several treatments are available, but there is a lack of combination regimens to target different aspects of acne-induced PSs. Overall, this review indicates that the joint involvement of inflammatory response and fibrosis plays a crucial role in acne-induced PSs, and also analyzes the interaction of current treatments for acne and PS.
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Affiliation(s)
- Wanyu Xu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Dorsa Gholamali Sinaki
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Yuchen Tang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Yunsheng Chen
- Department of Burns and Plastic Surgery, Shanghai Institute of Burns Research, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Zheng Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
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8
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Lee MK, Jeong HH, Kim MJ, Seo JS, Hwang JY, Jung WK, Moon KM, Lee I, Lee B. The Beneficial Roles of Sargassum spp. in Skin Disorders. J Med Food 2024; 27:359-368. [PMID: 38526569 DOI: 10.1089/jmf.2023.k.0160] [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] [Indexed: 03/26/2024] Open
Abstract
As the body's largest organ, the skin is located at the internal and external environment interface, serving as a line of defense against various harmful stressors. Recently, marine-derived physiologically active ingredients have attracted considerable attention in the cosmeceutical industry due to their beneficial effects on skin health. Sargassum, a genus of brown macroalgae, has traditionally been consumed as food and medicine in several countries and is rich in bioactive compounds such as meroterpenoids, sulfated polysaccharides, fucoidan, fucoxanthin, flavonoids, and terpenoids. Sargassum spp. have various beneficial effects on skin disorders. They help with atopic dermatitis by improving skin barrier protection and reducing inflammation. Several species show potential in treating acne by inhibiting bacterial growth and reducing inflammation. Some species, such as Sargassum horneri, demonstrate antiallergic effects by modulating mast cell activity. Certain Sargassum species exhibit anticancer activity by inhibiting tumor growth and promoting apoptosis, and some species help with wound healing by promoting angiogenesis and reducing oxidative stress. Overall, Sargassum spp. demonstrate potential for treating and managing various skin conditions. Therefore, the bioactive compounds of Sargassum spp. may be natural ingredients with a wide range of functional properties for preventing and treating skin disorders. The present review focused on the various biological effects of Sargassum extracts and derived compounds on skin disorders.
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Affiliation(s)
- Min-Kyeong Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
- Biotechnology Research Division, National Institute of Fisheries Science, Busan, Republic of Korea
| | - Hyeon Hak Jeong
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
| | - Myeong-Jin Kim
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
| | - Jae Seong Seo
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
| | - Ji Young Hwang
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
| | - Won-Kyo Jung
- Division of Biomedical Engineering and Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, Korea
| | - Kyoung Mi Moon
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
| | - Incheol Lee
- Department of Ocean Engineering, Pukyong National University, Busan, Korea
| | - Bonggi Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan, Korea
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, Korea
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9
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Su L, Wang F, Wang Y, Qin C, Yang X, Ye J. Circulating biomarkers of oxidative stress in people with acne vulgaris: a systematic review and meta-analysis. Arch Dermatol Res 2024; 316:105. [PMID: 38489064 DOI: 10.1007/s00403-024-02840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/15/2024] [Accepted: 02/06/2024] [Indexed: 03/17/2024]
Abstract
The relationship between acne vulgaris and oxidative stress biomarkers lacks a clear consensus. This study aimed to explore the potential correlation between acne vulgaris and circulating oxidative stress biomarkers (superoxide dismutase [SOD], malondialdehyde [MDA], and total antioxidant capacity [TAC]). We searched the PubMed, Embase, and Cochrane Library databases for articles published before June 26, 2023. The literature search combined free words and the medical subject headings terms related to acne vulgaris, SOD, MDA, and TAC. Data were analyzed using Stata 15 software. Additionally, we conducted a subgroup analysis stratified by the severity of acne vulgaris. A total of 14 trials involving 1191 participants were included. Overall results revealed that acne vulgaris was associated with MDA concentrations (SMD = 1.73; 95% CI 1.05, 2.4; P < 0.001). Subgroup analyses indicated that the severity of acne vulgaris was correlated with levels of circulating biomarkers of oxidative stress. TAC concentrations were significantly lower in patients with moderate acne vulgaris compared to controls (SMD = - 1.37; 95% CI = - 2.15, - 0.58, P = 0.001). SOD concentrations were significantly lower (SMD = - 2.92; 95% CI = - 5.39, - 0.46, P = 0.02) and MDA concentrations were significantly higher (SMD = 2.26; 95% CI = 0.95, 3.57, P = 0.001) in patients with severe acne vulgaris compared to controls. Our results implied that oxidative stress may exist in acne vulgaris. Furthermore, the severity of acne vulgaris was also correlated with oxidative stress.
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Affiliation(s)
- Liang Su
- Department of Dermatology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No 120, Guanghua Street, Kunming, 650021, China
| | - Fang Wang
- The First Clinical School of Yunnan University of Chinese Medicine, Kunming, China
| | - Yuan Wang
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cheng Qin
- The First Clinical School of Yunnan University of Chinese Medicine, Kunming, China
| | - Xuesong Yang
- Department of Dermatology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No 120, Guanghua Street, Kunming, 650021, China.
| | - Jianzhou Ye
- Department of Dermatology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No 120, Guanghua Street, Kunming, 650021, China.
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10
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Wang H, Yang F, Wang H, Qin T, He J, Zhao C. Effect of CO2 fractional laser combined with recombinant human epidermal growth factor gel on skin barrier. Medicine (Baltimore) 2024; 103:e37329. [PMID: 38489702 PMCID: PMC10939677 DOI: 10.1097/md.0000000000037329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 03/17/2024] Open
Abstract
To evaluate the impact of CO2 fractional laser combined with recombinant human epidermal growth factor (rhEGF) gel on skin barrier in acne scar patients. In a retrospective analysis, we examined 105 acne scar patients admitted between July 2018 and August 2021. Of these, 51 received only CO2 fractional laser (control group), while 54 underwent a combination of CO2 fractional laser and rhEGF gel (observation group). We assessed treatment efficacy, symptom relief, skin barrier parameters, pre- and posttreatment inflammatory factors, adverse reactions, posttreatment quality of life, and patient satisfaction. The observation group exhibited a higher overall response rate, significantly shorter wound healing, scab formation, and scab detachment times. Additionally, this group showed increased stratum corneum water content, decreased pH, and transdermal water loss (TEWL), and reduced hypersensitive C-reactive protein and interleukin-6 expression posttreatment. Quality of life scores were higher, with fewer adverse reactions and greater treatment satisfaction. Combining CO2 fractional laser with rhEGF gel markedly improves acne scar treatment efficacy, enhances skin barrier function, reduces inflammation, and elevates quality of life. Its safety profile supports its broader clinical adoption.
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Affiliation(s)
- Hua Wang
- Dermatological Department (Department of Cosmetic Dermatology, Department of Surgery of Traditional Chinese Medicine), Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, China
| | - Fan Yang
- Dermatological Department (Department of Cosmetic Dermatology, Department of Surgery of Traditional Chinese Medicine), Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, China
| | - Hui Wang
- Dermatological Department (Department of Cosmetic Dermatology, Department of Surgery of Traditional Chinese Medicine), Shaanxi University of Chinese Medicine, Xixian New Area, Shaanxi Province, China
| | - Tao Qin
- Dermatological Department (Department of Cosmetic Dermatology, Department of Surgery of Traditional Chinese Medicine), Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, China
| | - Jia He
- Dermatological Department (Department of Cosmetic Dermatology, Department of Surgery of Traditional Chinese Medicine), Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, China
| | - Chan Zhao
- Dermatological Department (Department of Cosmetic Dermatology, Department of Surgery of Traditional Chinese Medicine), Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, China
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11
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Feng Y, Li J, Mo X, Ju Q. Macrophages in acne vulgaris: mediating phagocytosis, inflammation, scar formation, and therapeutic implications. Front Immunol 2024; 15:1355455. [PMID: 38550588 PMCID: PMC10972966 DOI: 10.3389/fimmu.2024.1355455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/28/2024] [Indexed: 04/02/2024] Open
Abstract
Macrophages serve as a pivotal nexus in the pathogenesis of acne vulgaris, orchestrating both the elimination of Cutibacterium acnes (C. acnes) and lipid metabolic regulation while also possessing the capacity to exacerbate inflammation and induce cutaneous scarring. Additionally, recent investigations underscore the therapeutic potential inherent in macrophage modulation and challenge current anti-inflammatory strategies for acne vulgaris. This review distills contemporary advances, specifically examining the dual roles of macrophages, underlying regulatory frameworks, and emergent therapeutic avenues. Such nuanced insights hold the promise of guiding future explorations into the molecular etiology of acne and the development of more efficacious treatment modalities.
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Affiliation(s)
| | | | - Xiaohui Mo
- Department of Dermatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Ju
- Department of Dermatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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Seiringer P, Hillig C, Schäbitz A, Jargosch M, Pilz AC, Eyerich S, Szegedi A, Sochorová M, Gruber F, Zouboulis CC, Biedermann T, Menden MP, Eyerich K, Törőcsik D. Spatial transcriptomics reveals altered lipid metabolism and inflammation-related gene expression of sebaceous glands in psoriasis and atopic dermatitis. Front Immunol 2024; 15:1334844. [PMID: 38433843 PMCID: PMC10904577 DOI: 10.3389/fimmu.2024.1334844] [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: 11/07/2023] [Accepted: 01/22/2024] [Indexed: 03/05/2024] Open
Abstract
Sebaceous glands drive acne, however, their role in other inflammatory skin diseases remains unclear. To shed light on their potential contribution to disease development, we investigated the spatial transcriptome of sebaceous glands in psoriasis and atopic dermatitis patients across lesional and non-lesional human skin samples. Both atopic dermatitis and psoriasis sebaceous glands expressed genes encoding key proteins for lipid metabolism and transport such as ALOX15B, APOC1, FABP7, FADS1/2, FASN, PPARG, and RARRES1. Also, inflammation-related SAA1 was identified as a common spatially variable gene. In atopic dermatitis, genes mainly related to lipid metabolism (e.g. ACAD8, FADS6, or EBP) as well as disease-specific genes, i.e., Th2 inflammation-related lipid-regulating HSD3B1 were differentially expressed. On the contrary, in psoriasis, more inflammation-related spatially variable genes (e.g. SERPINF1, FKBP5, IFIT1/3, DDX58) were identified. Other psoriasis-specific enriched pathways included lipid metabolism (e.g. ACOT4, S1PR3), keratinization (e.g. LCE5A, KRT5/7/16), neutrophil degranulation, and antimicrobial peptides (e.g. LTF, DEFB4A, S100A7-9). In conclusion, our results show that sebaceous glands contribute to skin homeostasis with a cell type-specific lipid metabolism, which is influenced by the inflammatory microenvironment. These findings further support that sebaceous glands are not bystanders in inflammatory skin diseases, but can actively and differentially modulate inflammation in a disease-specific manner.
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Affiliation(s)
- Peter Seiringer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christina Hillig
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Munich, Germany
| | - Alexander Schäbitz
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manja Jargosch
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
- Zentrum für Allergie und Umwelt (ZAUM) - Center of Allergy and Environment, Technical University of Munich and Helmholtz Zentrum München, Munich, Germany
| | - Anna Caroline Pilz
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Stefanie Eyerich
- Zentrum für Allergie und Umwelt (ZAUM) - Center of Allergy and Environment, Technical University of Munich and Helmholtz Zentrum München, Munich, Germany
| | - Andrea Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Hungarian Research Network (HUN-REN DE), Allergology Research Group, Debrecen, Hungary
| | - Michaela Sochorová
- Division for Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Skin Multimodal Analytical Imaging of Aging and Senescence (SKINMAGINE), Medical University of Vienna, Vienna, Austria
| | - Florian Gruber
- Division for Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Skin Multimodal Analytical Imaging of Aging and Senescence (SKINMAGINE), Medical University of Vienna, Vienna, Austria
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Michael P Menden
- Institute of Computational Biology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Munich, Germany
- Department of Biochemistry and Pharmacology, University of Melbourne, Melbourne, VIC, Australia
| | - Kilian Eyerich
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Daniel Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Hungarian Research Network (HUN-REN DE), Allergology Research Group, Debrecen, Hungary
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Al-Momani H, Massadeh MI, Almasri M, Al Balawi D, Aolymat I, Hamed S, Albiss BA, Ibrahim L, Balawi HA, Al Haj Mahmoud S. Anti-Bacterial Activity of Green Synthesised Silver and Zinc Oxide Nanoparticles against Propionibacterium acnes. Pharmaceuticals (Basel) 2024; 17:255. [PMID: 38399471 PMCID: PMC10891609 DOI: 10.3390/ph17020255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Propionibacterium acnes plays a critical role in the development of acne vulgaris. There has been a rise in the number of patients carrying P. acnes strains that are resistant to antibiotics. Thus, alternative anti-microbial agents are required. Zinc oxide (ZnO-NPs) and silver (Ag-NPs) nanoparticles can be used against several antibiotic-resistant bacteria. The impact of Ag-NPs and ZnO-NPs against two clinical strains of P. acnes, P1 and P2, and a reference strain, NCTC747, were investigated in this research. A chemical approach for the green synthesis of Ag-NPs and ZnO-NPs from Peganum harmala was employed. The microtiter plate method was used to examine the effects of NPs on bacterial growth, biofilm development, and biofilm eradication. A broth microdilution process was performed in order to determine minimal inhibitory (MIC) concentrations. Ag-NPs and ZnO-NPs had a spherical shape and average dimensions of 10 and 50 nm, respectively. MIC values for all P. acnes strains for Ag-NPs and ZnO-NPs were 125 µg/mL and 250 µg/mL, respectively. Ag-NP and ZnO-NP concentrations of 3.9- 62.5 µg/mL and 15-62.5 µg/mL significantly inhibited the growth and biofilm formation of all P. acnes strains, respectively. ZnO-NP concentrations of 15-62.5 μg/mL significantly inhibited the growth of NCTC747 and P2 strains. The growth of P1 was impacted by concentrations of 31.25 μg/mL and 62.5 μg/mL. Biofilm formation in the NCTC747 strain was diminished by a ZnO-NP concentration of 15 μg/mL. The clinical strains of P. acnes were only affected by ZnO-NP titres of more than 31.25 μg/mL. Established P. acne biofilm biomass was significantly reduced in all strains at a Ag-NP and ZnO-NP concentration of 62.5 µg/mL. The findings demonstrated that Ag-NPs and ZnO-NPs exert an anti-bacterial effect against P. acnes. Further research is required to determine their potential utility as a treatment option for acne.
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Affiliation(s)
- Hafez Al-Momani
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
| | - Muhannad I. Massadeh
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa 13115, Jordan; (M.I.M.); (M.A.)
| | - Muna Almasri
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa 13115, Jordan; (M.I.M.); (M.A.)
| | - Dua’a Al Balawi
- Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan
| | - Iman Aolymat
- Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan;
| | - Saja Hamed
- Department of Pharmaceutical & Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa 13133, Jordan;
| | - Borhan Aldeen Albiss
- Nanotechnology Institute, Jordan University of Science & Technology, Irbid 22110, Jordan;
| | - Lugain Ibrahim
- Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan
| | - Hadeel Al Balawi
- Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan
| | - Sameer Al Haj Mahmoud
- Department of Basic Medical Science, Faculty of Medicine, Al-Balqa’ Applied University, AL-Salt 19117, Jordan;
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Jiang M, Liu T, Liu X, Liu L, Jiang X, Zhang Z, Kong M, Wu C, Zhang J. A Network Meta-analysis to Explore the Effectiveness of the Different Treatment Modalities in Acne Scars. Aesthetic Plast Surg 2024:10.1007/s00266-023-03818-w. [PMID: 38316648 DOI: 10.1007/s00266-023-03818-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/14/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Multiple treatments are used to treat acne scars, but comparing the effectiveness of these treatments have not been studied yet. This research aimed to conduct a complete analysis of the effectiveness of commonly used therapies in acne scars. METHODS PubMed, Embase, and Cochrane's Library (Cochrane Center Register of Controlled Trials) databases were searched through May 2023. We used patient satisfaction score as the primary outcome and Goodman Baron qualitative scar grading system as the secondary outcome to evaluate the effectiveness of different commonly used therapies for acne scarring, including laser, microneedling (MN), platelet-rich plasma (PRP), autologous fat grafting and combined therapies. RESULTS Herein, 495 patients from 13 studies were included. Our results showed that PRP combined with laser was the most effective among therapies in treating acne scars. Ranking of effectiveness by the surface under the cumulative ranking (SUCRA) curve for patient satisfaction score was as following: PRP + laser (96.2%) > laser (71.2%) > MN (45.5%) > MN + PRP (42.0%) > autologous fat grafting (24.5%) > PRP (20.5%). Additionally, ranking of effectiveness by the SUCRA curve for Goodman Baron qualitative scar grading system was as following: PRP + laser (86.3%) > laser (64.2%) > MN + PRP (54.2%) > MN (37.2%) > PRP (8.1%). CONCLUSION This network meta-analysis indicated that the combined therapy of PRP and laser might be the most effective. Additionally, more high-quality randomized controlled trials are needed to verify our findings. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Min Jiang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Tian Liu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiaoqiang Liu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Luojia Liu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xupin Jiang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Ze Zhang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Meng Kong
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Chao Wu
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Jiaping Zhang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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15
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Wu Y, Wang X, Wu W, Yang J. Mendelian randomization analysis reveals an independent causal relationship between four gut microbes and acne vulgaris. Front Microbiol 2024; 15:1326339. [PMID: 38371936 PMCID: PMC10869500 DOI: 10.3389/fmicb.2024.1326339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Background Numerous studies have suggested a correlation between gut microbiota and acne vulgaris; however, no specific causal link has been explored. Materials and methods To investigate the possible causal relationship between gut microbiota and acne vulgaris, this study employed a large-scale genome-wide association study (GWAS) summary statistic. Initially, a two-sample Mendelian randomization (MR) analysis was utilized to identify the specific gut microflora responsible for acne vulgaris. We used the Inverse Variance Weighted (IVW) method as the main MR analysis method. Additionally, we assessed heterogeneity and horizontal pleiotropy, while also examining the potential influence of individual single-nucleotide polymorphisms (SNPs) on the analysis results. In order to eliminate gut microbiota with reverse causal associations, we conducted reverse MR analysis. Multivariate Mendelian randomization analysis (MVMR) was then employed to verify the independence of the causal associations. Finally, we performed SNP annotation on the instrumental variables of independent gut microbiota and acne vulgaris to determine the genes where these genetic variations are located. We also explored the biological functions of these genes through enrichment analysis. Result The IVW method of forward MR identified nine gut microbes with a causal relationship with acne vulgaris (p < 0.05). The findings from the sensitivity analysis demonstrate the absence of heterogeneity or horizontal pleiotropy, and leave-one-out analysis indicates that the results are not driven by a single SNP. Additionally, the Reverse MR analysis excluded two reverse-correlated pathogenic gut microbes. And then, MVMR was used to analyze seven gut microbes, and it was found that Cyanobacterium and Family XIII were risk factors for acne vulgaris, while Ruminococcus1 and Ruminiclostridium5 were protective factors for acne vulgaris. After conducting biological annotation, we identified six genes (PLA2G4A, FADS2, TIMP17, ADAMTS9, ZC3H3, and CPSF4L) that may be associated with the pathogenic gut microbiota of acne vulgaris patients. The enrichment analysis results indicate that PLA2G4A/FADS2 is associated with fatty acid metabolism pathways. Conclusion Our study found independent causal relationships between four gut microbes and acne vulgaris, and revealed a genetic association between acne vulgaris patients and gut microbiota. Consider preventing and treating acne vulgaris by interfering with the relative content of these four gut microbes.
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Affiliation(s)
- Yujia Wu
- School of Basic Medical Sciences, Dali University, Dali, China
| | - Xiaoyun Wang
- School of Basic Medical Sciences, Dali University, Dali, China
| | - Wenjuan Wu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiankang Yang
- School of Basic Medical Sciences, Dali University, Dali, China
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Manuskiatti W, Wongdama S, Viriyaskultorn N, Li JB, Kulthanan K, Techapichetvanich T. Long-term efficacy and safety of nonablative monopolar radiofrequency in the treatment of moderate to severe acne vulgaris. Lasers Surg Med 2024; 56:133-141. [PMID: 38221810 DOI: 10.1002/lsm.23757] [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: 11/12/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Acne vulgaris (AV) is a prevalent skin condition known for its potential to cause scarring and psychological distress, often leading to diminished self-esteem. While topical and oral treatments are commonly prescribed, some patients experience treatment failure, adverse effects, or contraindications to conventional therapies. In response to these challenges, laser and energy-based device therapies have emerged as promising alternatives for individuals who fall into these categories, showing considerable potential in the treatment of AV. OBJECTIVE This study aimed to evaluate the long-term efficacy and safety of a nonablative monopolar radiofrequency (NMRF) in treatment of moderate to severe AV. METHODS Twenty-four patients with moderate to severe AV underwent a series of two NMRF treatment sessions, spaced 4 weeks apart. To evaluate treatment outcomes, live in-person lesion counts and measurements of pore size and volume, and sebum production were quantified using Antera® 3D imaging system, and Sebumeter®, respectively. Patients' self-assessment data regarding degree of improvement and facial oiliness were gathered. Dermatology life quality index (DLQI) questionnaire was utilized to assess the impact of AV on their quality of life. All objective and subjective evaluations were conducted at the baseline, 1 month after the first treatment, and during follow-up visits 1, 3, and 6 months after the last treatment sessions. Adverse effects were also recorded during each visit. RESULTS Twenty out of the 24 subjects completed the study protocol. The mean inflammatory lesion counts significantly reduced by 42.86% and 45.71% from the baseline at 3 (p = 0.027) and 6 months (p = 0.032) after the second treatment. Sebum excretion likewise significantly decreased from baseline by 11.62% (p = 0.012), 13.37% (p < 0.001), and 21.51% (p = 0.004), 1 month after the first treatment, 1 and 6 months after the second treatment, respectively. The pore volume continued to decrease by 35% (p = 0.003) and 41.5% (p < 0.001) at 1 and 6 months following the final treatment, respectively. The DLQI significantly decreased from 10.00 (interquartile range [IQR]: 6.50-15.00) to 2.00 (IQR: 1.00-4.75), corresponding to 80% improvement of the index, 1 month after the last treatment and was sustained up to the last follow-up visit. Patients' self-assessments on degree of improvement and facial oiliness also significantly improved following NMRF treatments. The treatments were well-tolerated without significant adverse effects. CONCLUSION NMRF appears to be an effective and safe treatment for inflammatory AV, with therapeutic outcomes persisting up to 6 months after two treatment sessions.
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Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supisara Wongdama
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Noldtawat Viriyaskultorn
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jayne Bernadeth Li
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanya Techapichetvanich
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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17
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Huang L, Yang S, Yu X, Fang F, Zhu L, Wang L, Zhang X, Yang C, Qian Q, Zhu T. Association of different cell types and inflammation in early acne vulgaris. Front Immunol 2024; 15:1275269. [PMID: 38357543 PMCID: PMC10864487 DOI: 10.3389/fimmu.2024.1275269] [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: 08/09/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Acne vulgaris, one of the most common skin diseases, is a chronic cutaneous inflammation of the upper pilosebaceous unit (PSU) with complex pathogenesis. Inflammation plays a central role in the pathogenesis of acne vulgaris. During the inflammatory process, the innate and adaptive immune systems are coordinately activated to induce immune responses. Understanding the infiltration and cytokine secretion of differential cells in acne lesions, especially in the early stages of inflammation, will provide an insight into the pathogenesis of acne. The purpose of this review is to synthesize the association of different cell types with inflammation in early acne vulgaris and provide a comprehensive understanding of skin inflammation and immune responses.
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Affiliation(s)
- Lei Huang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyun Yang
- Department of Dermatology, The People’s Hospital of Baoshan, Baoshan, Yunnan, China
| | - Xiuqin Yu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fumin Fang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Liping Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lu Wang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoping Zhang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Changzhi Yang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qihong Qian
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
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18
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Liang L, Qi X, Jiang X, Chen T, Dong L. Lactobacillus plantarum MH-301 as an effective adjuvant to isotretinoin in the treatment of acne vulgaris: a randomized and open-label trail. Front Med (Lausanne) 2024; 10:1340068. [PMID: 38264057 PMCID: PMC10803606 DOI: 10.3389/fmed.2023.1340068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Acne vulgaris is a common chronic inflammatory skin disease originating in the sebaceous gland units of the skin follicles. Isotretinoin is presently the primary choice for the treatment of acne vulgaris. However, it could induce several adverse reactions like diarrhea, cheilitis, headache, elevated triglyceride levels and risk of inflammatory bowel disease and depression. Hence, it is imperative to seek an alternative therapy. Methods One hundred five patients were randomly divided into 3 groups, and received a baseline treatment of oral doxycycline for the initial 4 weeks. Group I received isotretinoin oral for 12 weeks; Group P received oral Lactobacillus plantarum MH-301 treatment for 12 weeks; Group IP received combined treatment with oral probiotics and oral isotretinoin for 12 weeks. The number of skin lesions was recorded at 0, 4, 8, and 12 weeks during the treatment to compare the efficacy of each intervention, and skin and fecal samples were collected from patients at 12 weeks for high-throughput sequencing to explore the microbiota differences between various groups. Results Our results revealed that the combination of L. plantarum MH-301 with isotretinoin significantly reduced the number of skin lesions in patients compared to using L. plantarum MH-301 and isotretinoin alone (p < 0.001). Additionally, skin microbiome High-throughput analysis indicated the restorative effects of L. plantarum MH-301 on skin microbial diversity while also observing a reduction in the main microbiota of skin lesions, Propionibacterium and Corynebacterium. Meanwhile, gut microbiome High-throughput analysis showed that it could regulate disorders of the intestinal microbiota and increased the abundance of probiotics such as Lactobacillus, Bifidobacterium, Coprococcus and Bacteroides genera. Conclusion In conclusion, L. plantarum MH-301 could be used in combination with isotretinoin for optimal results in the treatment of acne vulgaris. The research conducted provides theoretical and data support for the adjuvant effect of L. plantarum in the treatment of acne vulgaris. Clinical Trial Registration [ClinicalTrials.gov], identifier (ChiCTR2200063499).
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Affiliation(s)
- Lili Liang
- Department of Dermatology, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
| | - Xinyue Qi
- Institute of Life Science, Nanchang University, Nanchang, China
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institution of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xiaoke Jiang
- Department of Dermatology, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
| | - Tingtao Chen
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institution of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, China
- School of Pharmacy, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Lina Dong
- Core Laboratory, Shanxi Provincial People’s Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
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19
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Knödlseder N, Fábrega MJ, Santos-Moreno J, Manils J, Toloza L, Marín Vilar M, Fernández C, Broadbent K, Maruotti J, Lemenager H, Carolis C, Zouboulis CC, Soler C, Lood R, Brüggemann H, Güell M. Delivery of a sebum modulator by an engineered skin microbe in mice. Nat Biotechnol 2024:10.1038/s41587-023-02072-4. [PMID: 38195987 DOI: 10.1038/s41587-023-02072-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/17/2023] [Indexed: 01/11/2024]
Abstract
Microorganisms can be equipped with synthetic genetic programs for the production of targeted therapeutic molecules. Cutibacterium acnes is the most abundant commensal of the human skin, making it an attractive chassis to create skin-delivered therapeutics. Here, we report the engineering of this bacterium to produce and secrete the therapeutic molecule neutrophil gelatinase-associated lipocalin, in vivo, for the modulation of cutaneous sebum production.
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Affiliation(s)
- Nastassia Knödlseder
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - María-José Fábrega
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Javier Santos-Moreno
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Joan Manils
- Immunity, Inflammation and Cancer Group, Oncobell Program, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
- Serra Húnter Programme, Immunology Unit, Department of Pathology and Experimental Therapy, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Lorena Toloza
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Maria Marín Vilar
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Cristina Fernández
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Katrina Broadbent
- Protein Technologies Facility, Center of Genomic Regulation, Barcelona, Spain
| | | | | | - Carlo Carolis
- Protein Technologies Facility, Center of Genomic Regulation, Barcelona, Spain
| | - Christos C Zouboulis
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum; Städtisches Klinikum Dessau; and Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau-Roßlau, Germany
| | - Concepció Soler
- Immunity, Inflammation and Cancer Group, Oncobell Program, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
- Immunology Unit, Department of Pathology and Experimental Therapy, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Rolf Lood
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden
| | | | - Marc Güell
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
- ICREA, Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.
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20
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Mikrokomedonen und differenzierte Therapie bei Akne. J Dtsch Dermatol Ges 2024; 22:1-3. [PMID: 38212917 DOI: 10.1111/ddg.15351_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
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21
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Dessinioti C, Katsambas A. The Microbiome and Acne: Perspectives for Treatment. Dermatol Ther (Heidelb) 2024; 14:31-44. [PMID: 38183614 PMCID: PMC10828138 DOI: 10.1007/s13555-023-01079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024] Open
Abstract
The skin microbiome consists of the microorganisms populating the human skin. Cutibacterium acnes (C. acnes, formerly named Propionibacterium acnes) is recognized as a key factor in acne development, regulating inflammatory and immune pathways. Dysbiosis has been described as the imbalance in skin microbiome homeostasis and may play a role in acne pathogenesis. Microbial interference has been shown to be a contributor to healthy skin homeostasis and staphylococcal strains may exclude acne-associated C. acnes phylotypes. In this review we present an update on the skin microbiome in acne and discuss how current acne treatments such as benzoyl peroxide, orally administered isotretinoin, and antibiotics may affect the skin microbiome homeostasis. We highlight the collateral damage of acne antibiotics on the skin microbiome, including the risk of antimicrobial resistance and the dysregulation of the microbiome equilibrium that may occur even with short-term antibiotic courses. Consequently, the interest is shifting towards new non-antibiotic pharmacological acne treatments. Orally administered spironolactone is an emerging off-label treatment for adult female patients and topical peroxisome proliferator-activated receptor gamma (PPARγ) modulation is being studied for patients with acne. The potential application of topical or oral probiotics, bacteriotherapy, and phage therapy for acne are further promising areas of future research.
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Affiliation(s)
- Clio Dessinioti
- 1st Department of Dermatology, Andreas Sygros Hospital, University of Athens, 5, Dragoumi Str, 16 121, Athens, Greece.
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22
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Yen H, Lalor L. Non-syndromic and Syndromic Severe Acne in Adolescent Patients. Med Clin North Am 2024; 108:27-42. [PMID: 37951654 DOI: 10.1016/j.mcna.2023.05.014] [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] [Indexed: 11/14/2023]
Abstract
Acne is a common skin disorder in adolescents. However, severe acne that is persistent and refractory to conventional treatment or has other associated symptoms should raise suspicion for non-syndromic or syndromic acne.
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Affiliation(s)
- Hsi Yen
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, TBRC 2nd Floor Suite C2010, Milwaukee, WI 53226, USA
| | - Leah Lalor
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, TBRC 2nd Floor Suite C2010, Milwaukee, WI 53226, USA.
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23
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Condrò G, Sciortino R, Perugini P. Squalene Peroxidation and Biophysical Parameters in Acne-Prone Skin: A Pilot "In Vivo" Study. Pharmaceuticals (Basel) 2023; 16:1704. [PMID: 38139830 PMCID: PMC10748031 DOI: 10.3390/ph16121704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Nowadays, acne vulgaris therapies are often unsuccessful. One of the responsible factors for the formation of comedones and inflammatory lesions could be the peroxidation of squalene, a hydrocarbon representing one of the major components of human sebum. This peroxidation is increased by solar irradiation. The purpose of this work was to set up an in vivo method for the extraction and quantification of squalene from acne skin and to correlate the results with biophysical skin parameters such as sebum amount, protein content and TEWL. Healthy volunteers were used as control. The results obtained demonstrated that acne-prone skin had a major quantity of squalene, and, in the stratum corneum area, its peroxide form is present. Moreover, Spearman's rank correlation showed a positive correlation between sebum content and peroxide squalene and between porphyrin intensity and peroxide squalene.
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Affiliation(s)
- Giorgia Condrò
- Department of Drug Sciences, University of Pavia, Via Taramelli 12, 27100 Pavia, Italy; (G.C.); (R.S.)
| | - Roberta Sciortino
- Department of Drug Sciences, University of Pavia, Via Taramelli 12, 27100 Pavia, Italy; (G.C.); (R.S.)
| | - Paola Perugini
- Department of Drug Sciences, University of Pavia, Via Taramelli 12, 27100 Pavia, Italy; (G.C.); (R.S.)
- Etichub, Academic Spin-Off, University of Pavia, Via Taramelli 12, 27100 Pavia, Italy
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24
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Tanghetti EA, Zeichner JA, Gold M, Sadick N, Cook-Bolden FE, Kircik LH, Stein Gold L, Weiss J, Tyring SK, Del Rosso JQ, Guenin E. Improvements in acne and skin oiliness with tazarotene 0.045% lotion in patients with oily skin. J DERMATOL TREAT 2023; 34:2147391. [PMID: 36382987 DOI: 10.1080/09546634.2022.2147391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Excessive sebum production is a factor in acne development. Tazarotene 0.045% lotion has demonstrated reductions in acne lesions and acne-induced sequelae. OBJECTIVE Evaluate efficacy, changes in skin oiliness, and safety with tazarotene 0.045% lotion in participants with moderate-to-severe acne and oily skin. METHODS In two phase 3, double-blind, 12-week studies (NCT03168321; NCT03168334), participants aged ≥ 9 years with moderate-to-severe acne were randomized 1:1 to once-daily tazarotene 0.045% lotion or vehicle lotion (N = 1614). This pooled, post hoc analysis included only participants self-categorized with oily skin at baseline on the Acne-Specific Quality of Life questionnaire item 19 (scores: 0 [extremely oily] to 6 [not at all oily]). Inflammatory/noninflammatory lesion counts, treatment success, skin oiliness, treatment-emergent adverse events (TEAEs), and cutaneous safety/tolerability were evaluated. RESULTS In all participants with oily skin (n = 793), tazarotene provided greater reductions in inflammatory/noninflammatory lesions (p < 0.001, both) and greater treatment success rates versus vehicle (p < 0.01) at week 12. Over two-thirds of polymeric lotion-treated participants had subjective skin oiliness reductions by week 12, with around a third reporting 'low/not' oily skin. Tazarotene TEAE rates were similar to the overall population. CONCLUSIONS Once-daily treatment with tazarotene 0.045% polymeric emulsion lotion may help improve patient-perceived skin oiliness in those with moderate-to-severe acne.
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Affiliation(s)
| | - Joshua A Zeichner
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Gold
- Tennessee Clinical Research Center, Nashville, TN, USA
| | - Neil Sadick
- Department of Dermatology, Weill Cornell Medical College, New York, NY, USA.,Sadick Dermatology, New York, NY, USA
| | - Fran E Cook-Bolden
- Department of Dermatology, Weill Cornell Medical College, New York, NY, USA.,Fran E. Cook-Bolden, MD, PLLC, New York, NY, USA
| | - Leon H Kircik
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Dermatology, Indiana University Medical Center, Indianapolis, IN, USA.,Physicians Skin Care, PLLC, DermResearch, PLLC, and Skin Sciences, PLLC, Louisville, KY, USA
| | - Linda Stein Gold
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Jonathan Weiss
- Georgia Dermatology Partners, Snellville, GA, USA.,Gwinnett Clinical Research Center, Inc, Snellville, GA, USA
| | - Stephen K Tyring
- Department of Dermatology, Health Science Center, University of Texas, Houston, TX, USA
| | - James Q Del Rosso
- JDR Dermatology Research/Thomas Dermatology, Las Vegas, NV, USA.,Advanced Dermatology and Cosmetic Surgery, Maitland, FL, USA.,Department of Dermatology, Touro University Nevada, Henderson, NV, USA
| | - Eric Guenin
- Ortho Dermatologics, Division of Bausch Health US, LLC, Ortho Dermatologics, Bridgewater, NJ, USA
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25
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Melnik BC. Acne Transcriptomics: Fundamentals of Acne Pathogenesis and Isotretinoin Treatment. Cells 2023; 12:2600. [PMID: 37998335 PMCID: PMC10670572 DOI: 10.3390/cells12222600] [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: 10/07/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
This review on acne transcriptomics allows for deeper insights into the pathogenesis of acne and isotretinoin's mode of action. Puberty-induced insulin-like growth factor 1 (IGF-1), insulin and androgen signaling activate the kinase AKT and mechanistic target of rapamycin complex 1 (mTORC1). A Western diet (hyperglycemic carbohydrates and milk/dairy products) also co-stimulates AKT/mTORC1 signaling. The AKT-mediated phosphorylation of nuclear FoxO1 and FoxO3 results in their extrusion into the cytoplasm, a critical switch which enhances the transactivation of lipogenic and proinflammatory transcription factors, including androgen receptor (AR), sterol regulatory element-binding transcription factor 1 (SREBF1), peroxisome proliferator-activated receptor γ (PPARγ) and signal transducer and activator of transcription 3 (STAT3), but reduces the FoxO1-dependent expression of GATA binding protein 6 (GATA6), the key transcription factor for infundibular keratinocyte homeostasis. The AKT-mediated phosphorylation of the p53-binding protein MDM2 promotes the degradation of p53. In contrast, isotretinoin enhances the expression of p53, FoxO1 and FoxO3 in the sebaceous glands of acne patients. The overexpression of these proapoptotic transcription factors explains isotretinoin's desirable sebum-suppressive effect via the induction of sebocyte apoptosis and the depletion of BLIMP1(+) sebocyte progenitor cells; it also explains its adverse effects, including teratogenicity (neural crest cell apoptosis), a reduced ovarian reserve (granulosa cell apoptosis), the risk of depression (the apoptosis of hypothalamic neurons), VLDL hyperlipidemia, intracranial hypertension and dry skin.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, 49069 Osnabrück, Germany
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26
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Huang SL, Ye D, Xue H, Wang ZY, Yang MY, Qiao SM, Li YB, Zhu Y, Mu SZ, Yang F, Wang Z, Zeng WH. 1927nm fractional thulium fiber laser combined with 30% salicylic acid for the treatment of acne and acne scars: A prospective, randomized, and split-face study. Lasers Surg Med 2023; 55:829-837. [PMID: 37454285 DOI: 10.1002/lsm.23708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/02/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Patients with acne usually develops acne scars subsequently, early intervention of scars is crucial in acne management. 1927nm fractional thulium fiber laser (TFL) is effective in scars improvement and chemical peels with 30% supramolecular salicylic acid (SSA) can be applied for the treatment of acne. The purpose of this study is to evaluate and compare the efficacy and safety of TFL monotherapy versus the concomitant application of TFL and 30% SSA on acne and acne scars. MATERIALS AND METHODS Thirty-three patients with acne and acne scars were enrolled, and two sides of the face were randomly divided to receive either TFL and SSA chemical peeling or TFL. Four sessions of TFL treatments were applied with 4-week intervals for both sides, SSA combined treatment side received eight SSA chemical peels with 2-week intervals additionally. GAGS, ECCA score, the number of acne lesions, melanin index (MI) and erythema index (EI), transepidermal water loss (TEWL), and side effects were recorded at Weeks 0, 4, 8, 12, and 18. Satisfaction of patients was recorded on both sides at the end of the study. RESULTS Thirty patients completed the study. Both control group (TFL monotherapy) and SSA group (TFL combined with SSA chemical peeling) significantly improved GAGS and ECCA score. SSA group showed higher efficacy in terms of GAGS and ECCA score, acne lesion count, TEWL, MI, EI, and satisfaction than control group. All the side effects were temporary and tolerable, no adverse effects were observed. CONCLUSIONS Both TFL and the TFL combined with 30% SSA chemical peeling are safe and effective for the treatment and prevention of acne and acne scars, though the combined group has higher efficacy.
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Affiliation(s)
- Shi-Liu Huang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dan Ye
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huan Xue
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhao-Yang Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng-Yao Yang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Si-Meng Qiao
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - You-Bao Li
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yu Zhu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Sheng-Zhi Mu
- Department of Burn and Plastic Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Fan Yang
- Department of Dermatology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Zhao Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei-Hui Zeng
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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27
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Măgerușan ȘE, Hancu G, Rusu A. A Comprehensive Bibliographic Review Concerning the Efficacy of Organic Acids for Chemical Peels Treating Acne Vulgaris. Molecules 2023; 28:7219. [PMID: 37894698 PMCID: PMC10608815 DOI: 10.3390/molecules28207219] [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: 10/01/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Acne vulgaris stands out as the most prevalent skin disorder among teenagers and young adults, causing physical discomfort and considerable economic and psychological burdens on individuals and society. A wide range of topical and systemic therapies are available in acne treatment. Chemical peeling is a skin resurfacing technique designed to rebuild healthy skin using exfoliating substances, a simple and affordable process with various dermatological uses. Chemical peels, classified as superficial, medium, and deep, have been utilized for acne vulgaris and multiple other skin issues. In these chemical peels, a diverse range of chemical substances is employed, each with its unique mode of action. Among these, α-hydroxy and β-hydroxy acids have gathered attention for their efficacy in reducing acne lesions and enhancing overall skin appearance. Acids, such as salicylic acid, glycolic acid, or lactic acid, are commonly used in chemical peels due to their exfoliating and sebum-regulating properties. Despite the widespread use of these acids, there exists a lack of consensus regarding the most effective acid type and concentration for treating acne-prone skin. This review aims to bridge this knowledge gap by evaluating the effectiveness and safety of various organic acids used in chemical peels specifically for acne-prone skin. The findings of this comprehensive bibliographic review indicate that organic acid-based chemical peels represent effective and safe treatment options for individuals with acne-prone skin. Their adaptability sets these treatments apart; the choice of organic acid can be tailored to meet individual patient needs and tolerability levels. This personalized approach ensures that patients receive optimal care while minimizing the risks associated with the treatment. As research in this field progresses, it is anticipated that a more nuanced understanding of the ideal acid type and concentration will emerge, further enhancing the efficacy and safety of chemical peels for acne-prone skin.
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Affiliation(s)
| | - Gabriel Hancu
- Department of Pharmaceutical and Therapeutic Chemistry, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, 540142 Târgu Mureș, Romania; (Ș.E.M.); (A.R.)
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28
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Korkoman A, Alamri A, Al Zomia AS, Korkoman S, Qahtani SH, Alshahrani YM, Alotaibi TB, Asiri BM, Alqahtani AN, Awwadh OA, Alghamdi BA, Alshahrani A. Cross-Sectional Assessment of Dermatologists' Knowledge and Attitude Towards Isotretinoin-Related Ocular Side Effects in Aseer, Saudi Arabia. Cureus 2023; 15:e46335. [PMID: 37920642 PMCID: PMC10618121 DOI: 10.7759/cureus.46335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, which includes the hair follicle, hair shaft and sebaceous gland. The only treatment that has an effect on all the main aetiological causes of acne is isotretinoin. However, it may have a variety of negative side effects. The aim of this study was to evaluate the knowledge and attitudes of dermatologists regarding ocular effects following isotretinoin prescribing in the Aseer region, Saudi Arabia. METHODOLOGY An anonymous online cross-sectional survey was conducted in August 2022 to investigate dermatologists' knowledge and attitude regarding isotretinoin-related ocular side effects in Aseer, Saudi Arabia. Participants were recruited using convenience and snowball sampling methods. RESULTS A total of 48 dermatologists were included in this survey. The age distribution ranged from 25 to over 60 years. Sixteen (37.5%) were aged 31-40 years, 29 (60.4%) were male and 20 (41.7%) were specialists. All dermatologists reported that it can cause dry eye, 32 (66.7%) reported that it can cause contact lens intolerance, 10 (20.8%) reported that it can cause a decrease in dark adaptation and two (4.2%) thought that it can cause ectopia lentis and retinoblastoma. Regarding attitude, 43 (87.5%) thought that a course of isotretinoin is not recommended if the patient has recently undergone refractive surgery, 30 (62.5%) always inform patients about ocular side effects, 31 (72.9%) do not consider referring patients for ophthalmic examinations before initiating isotretinoin, 12 (25.0%) always prescribe lubricant eye drops, 15 (31.3%) always ask patients about recent refractive surgery, 17 (35.4%) always warn patients about avoiding refractive surgery during isotretinoin use and 19 (39.6%) always inform patients concerning discomfort with contact lenses. CONCLUSIONS The survey reveals that dermatologists in Aseer, Saudi Arabia, generally have good knowledge of isotretinoin related to some ocular side effects, especially dry eye and contact lens intolerance. However, there is some variation in their practices with regard to patient education, referrals for ophthalmic examinations, the use of lubricant eye drops and refractive surgery during isotretinoin treatment. Thus, dermatologists should receive educational training on the safety profile of isotretinoin while managing acne vulgaris.
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Affiliation(s)
| | | | - Ahmed S Al Zomia
- Medicine, College of Medicine, King Khalid University, Abha, SAU
| | | | - Saad H Qahtani
- General Medicine, College of Medicine, King Khalid University, Abha, SAU
| | | | | | | | | | - Omar A Awwadh
- Medicine, College of Medicine, King Khalid University, Abha, SAU
| | - Bader A Alghamdi
- Medicine, College of Medicine, King Khalid University, Abha, SAU
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29
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Dainichi T, Iwata M. Inflammatory loops in the epithelial-immune microenvironment of the skin and skin appendages in chronic inflammatory diseases. Front Immunol 2023; 14:1274270. [PMID: 37841246 PMCID: PMC10568311 DOI: 10.3389/fimmu.2023.1274270] [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: 08/08/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
The epithelial-immune microenvironment (EIME) of epithelial tissues has five common elements: (1) microbial flora, (2) barrier, (3) epithelial cells, (4) immune cells, and (5) peripheral nerve endings. EIME provides both constant defense and situation-specific protective responses through three-layered mechanisms comprising barriers, innate immunity, and acquired immunity. The skin is one of the largest organs in the host defense system. The interactions between the five EIME elements of the skin protect against external dangers from the environment. This dysregulation can result in the generation of inflammatory loops in chronic inflammatory skin diseases. Here, we propose an understanding of EIME in chronic skin diseases, such as atopic dermatitis, psoriasis, systemic lupus erythematosus, alopecia areata, and acne vulgaris. We discuss the current treatment strategies targeting their inflammatory loops and propose possible therapeutic targets in the future.
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Affiliation(s)
- Teruki Dainichi
- Department of Dermatology, Kagawa University Faculty of Medicine, Kagawa, Japan
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Cros MP, Mir-Pedrol J, Toloza L, Knödlseder N, Maruotti J, Zouboulis CC, Güell M, Fábrega MJ. New insights into the role of Cutibacterium acnes-derived extracellular vesicles in inflammatory skin disorders. Sci Rep 2023; 13:16058. [PMID: 37749255 PMCID: PMC10520063 DOI: 10.1038/s41598-023-43354-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023] Open
Abstract
Cutibacterium acnes (C. acnes) is one of the most prevalent bacteria that forms the human skin microbiota. Specific phylotypes of C. acnes have been associated with the development of acne vulgaris, while other phylotypes have been linked to healthy skin. In this scenario, bacterial extracellular vesicles (EVs) play a role in the interkingdom communication role with the human host. The purpose of this study was to examine the impact of EVs generated by various phylotypes of C. acnes on inflammation and sebum production using different in vitro skin cell types. The main findings of this study reveal that the proteomic profile of the cargo embodied in the EVs reflects distinct characteristics of the different C. acnes phylotypes in terms of life cycle, survival, and virulence. The in vitro skin cell types showed an extended pro-inflammatory modulation of SLST A1 EVs consistently triggering the activation of the inflammation-related factors IL-8, IL-6, TNFα and GM-CSF, in comparison to SLST H1 and SLST H2. Additionally, an acne-prone skin model utilizing PCi-SEB and arachidonic acid as a sebum inducer, was employed to investigate the impact of C. acnes EVs on sebum regulation. Our findings indicated that all three types of EVs significantly inhibited sebum production after a 24-h treatment period, with SLST H1 EVs exhibiting the most pronounced inhibitory effect when compared to the positive control. The results of this study highlight the protective nature of C. acnes SLST H1 EVs and their potential use as a natural treatment option for alleviating symptoms associated with inflammation and oily skin.
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Affiliation(s)
- Maria Pol Cros
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Júlia Mir-Pedrol
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Quantitative Biology Center, University of Tuebingen, Tuebingen, Baden-Württemberg, Germany
| | - Lorena Toloza
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Nastassia Knödlseder
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Christos C Zouboulis
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakaltät für Gesundheitswissenschaften Brandenburg, Auenweg, Germany
| | - Marc Güell
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Maria-José Fábrega
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
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Alabadallah RY, Hijazi BM, Altawalbeh SM, Oqal M, Almomani BA. Clinical pharmacist role in improving the knowledge and outcomes in patients using isotretinoin: A randomized, controlled study. Heliyon 2023; 9:e20102. [PMID: 37809575 PMCID: PMC10559846 DOI: 10.1016/j.heliyon.2023.e20102] [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] [Received: 03/23/2023] [Revised: 08/21/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Objective To evaluate the role of a clinical pharmacist in improving knowledge and outcomes among isotretinoin users. Methods Patients were randomly assigned to an intervention group (received education about isotretinoin by a clinical pharmacist in addition to the physician) and a control group (received routine education by the physician), then followed for three months. Patients' knowledge about isotretinoin optimal use, and side effects and their management and other outcomes were measured in both groups at baseline and at follow up after three months using a validated questionnaire. Results Two-hundred and three patients completed the study; 103 were in the intervention group and 100 in the control group. The knowledge improvement between baseline score and follow-up score was greater in the intervention group (mean = 2.835 ± 1.329) compared to the control group (mean = 0.530 ± 0.784) with mean differences = -2.30495, P < 0.001. Conclusion Implementing clinical pharmacy services in dermatology clinics can positively increase patients' level of knowledge about isotretinoin, which could reduce the severity of its side effects. Therefore, improving patients' quality of life, and improvement in acne. Practice implications Implementing clinical pharmacist services to patients using isotretinoin is feasible in an outpatient setting. Clinical pharmacist counseling and education improve the medication knowledge among patients who use isotretinoin.
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Affiliation(s)
- Ruba Y. Alabadallah
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Bushra M. Hijazi
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Muna Oqal
- Faculty of Pharmaceutical Sciences, Hashemite University, Zarqa, Jordan
| | - Basima A. Almomani
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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32
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Fabi SG, Beleznay K, Berson DS, Cohen JL, Lee S, Dayan SH. Treatment of acne in the aesthetic patient: A round table update. J Cosmet Dermatol 2023; 22:2391-2398. [PMID: 37403516 DOI: 10.1111/jocd.15913] [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: 05/24/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes. AIMS The goal of this work was to deliver a high-quality ethical and evidence-based educational program to physicians and adjunctive health care providers to advance patient care. METHODS This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field. RESULTS A range of topical medications, injectable products, chemical peels, and energy-based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient. CONCLUSION The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care.
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Affiliation(s)
| | - Katie Beleznay
- Humphrey & Beleznay Cosmetic Dermatology, Vancouver, British Columbia, Canada
| | - Diane S Berson
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, USA
| | - Joel L Cohen
- AboutSkin Dermatology and DermSurgery, PC, Greenwood Village, Colorado, USA
| | - Sandra Lee
- Skin Physicians & Surgeons, Upland, California, USA
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Almoughrabie S, Cau L, Cavagnero K, O’Neill AM, Li F, Roso-Mares A, Mainzer C, Closs B, Kolar MJ, Williams KJ, Bensinger SJ, Gallo RL. Commensal Cutibacterium acnes induce epidermal lipid synthesis important for skin barrier function. SCIENCE ADVANCES 2023; 9:eadg6262. [PMID: 37595033 PMCID: PMC10438445 DOI: 10.1126/sciadv.adg6262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/20/2023] [Indexed: 08/20/2023]
Abstract
Lipid synthesis is necessary for formation of epithelial barriers and homeostasis with external microbes. An analysis of the response of human keratinocytes to several different commensal bacteria on the skin revealed that Cutibacterium acnes induced a large increase in essential lipids including triglycerides, ceramides, cholesterol, and free fatty acids. A similar response occurred in mouse epidermis and in human skin affected with acne. Further analysis showed that this increase in lipids was mediated by short-chain fatty acids produced by Cutibacterium acnes and was dependent on increased expression of several lipid synthesis genes including glycerol-3-phosphate-acyltransferase-3. Inhibition or RNA silencing of peroxisome proliferator-activated receptor-α (PPARα), but not PPARβ and PPARγ, blocked this response. The increase in keratinocyte lipid content improved innate barrier functions including antimicrobial activity, paracellular diffusion, and transepidermal water loss. These results reveal that metabolites from a common commensal bacterium have a previously unappreciated influence on the composition of epidermal lipids.
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Affiliation(s)
- Samia Almoughrabie
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
- SILAB, Brive, France
| | | | - Kellen Cavagnero
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
| | - Alan M. O’Neill
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
| | - Fengwu Li
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
| | - Andrea Roso-Mares
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
| | | | | | - Matthew J. Kolar
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
| | - Kevin J. Williams
- Department of Biological Chemistry, UCLA, Los Angeles, CA, USA
- UCLA Lipidomics Lab, UCLA, Los Angeles, CA, USA
| | - Steven J. Bensinger
- UCLA Lipidomics Lab, UCLA, Los Angeles, CA, USA
- Department of Microbiology, Immunology, and Molecular Genetics, UCLA, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA, USA
| | - Richard L. Gallo
- Department of Dermatology, University of California San Diego, La Jolla CA, USA
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Daoud M, Suppa M, Heudens S, Daxhelet M, Njimi H, Nobile L, Tannous J, Van Damme C, Karama J, White JM, Revuz J, Benhadou F, Del Marmol V. Treatment of Acne with Isotretinoin Should Be Avoided in Patients with Hidradenitis Suppurativa "Conglobata Phenotype". Dermatology 2023; 239:738-745. [PMID: 37490871 DOI: 10.1159/000530664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/31/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Acne conglobata (AC) and nodulocystic acne have long been confused clinically, despite the presentation and the response to treatment being different. AC and hidradenitis suppurativa (HS) resemble each other; a subtype of HS called "conglobata phenotype" has recently been reported in a large Dutch cohort. Acne vulgaris and HS are often associated. Isotretinoin is typically ineffective in treating HS and may even aggravate it, but it is often indispensable in treating acne vulgaris. OBJECTIVE The aim of the study was to assess whether isotretinoin may be used safely in adults with both HS and acne vulgaris and when it might be contraindicated. MATERIALS AND METHODS Belgian HS patients from the European Registry for Hidradenitis Suppurativa Registry (ERHS) reporting a history of severe acne of the face and/or the back, and who have ever used isotretinoin for their acne, were all selected. Patients whose acne worsened on isotretinoin were compared to patients whose acne did not worsen (improvement or no change). RESULTS Among the 82 selected patients, 10 (12.2%) report that their acne was aggravated while taking isotretinoin, while 72 (87.8%) report that their acne was not aggravated on isotretinoin. Of the 10 HS patients whose acne worsened with isotretinoin, 9 (90%) were men (p = 0.04) and 8 (80%) were HS "conglobata phenotype" (p < 0.001). In contrast, 47 (65.3%) of the 72 patients whose acne did not worsen on isotretinoin belonged to the HS "regular phenotype" (p = 0.01). On multivariate analysis, the item most strongly associated with poor response to isotretinoin was the HS "conglobata phenotype," followed by body mass index (BMI) (worse response to isotretinoin if BMI >25 kg/m2). Additionally, of 26 patients who received isotretinoin while their HS had already started, only 6 (23.1%) reported isotretinoin effectiveness on their HS. CONCLUSION Subject to confirmation by larger studies, our study suggests that isotretinoin should be avoided in the treatment of acne in HS patients with the HS "conglobata phenotype," as it may worsen the acne, likewise being male or having a BMI above 25 seems to increase this risk of a bad therapeutic outcome. Patients with an HS "regular phenotype" appear to be at a reduced risk of isotretinoin treatment worsening their acne.
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Affiliation(s)
- Mathieu Daoud
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Brussels, Belgium
| | - Stephanie Heudens
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Mathilde Daxhelet
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Hassane Njimi
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Laura Nobile
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Julio Tannous
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Claire Van Damme
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Jalila Karama
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Jonathan M White
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | | | - Farida Benhadou
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Veronique Del Marmol
- Department of Dermatology, Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
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Kim JE, Han H, Xu Y, Lee MH, Lee HJ. Efficacy of FRO on Acne Vulgaris Pathogenesis. Pharmaceutics 2023; 15:1885. [PMID: 37514071 PMCID: PMC10384752 DOI: 10.3390/pharmaceutics15071885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Acne vulgaris is a common skin disease characterized by increased sebum production, inflammation, and Cutibacterium acnes (CA: formerly Propionibacterium acnes) hyperproliferation in pilosebaceous follicles. This study evaluated the efficacy of FRO, a formula composed of fermented Rhus verniciflua Stokes and Orostachys japonicus, against acne pathogenesis via antimicrobial assessment and an in vitro analysis. Stimulated model cells treated with hormones, CA, or lipopolysaccharide (LPS) were designed based on the characteristics of acne pathogenesis, including inflammation and sebum hypersecretion. High-performance liquid chromatography, disc diffusion, MTS, and western blotting assays were used to examine potential anti-acne effects. FRO was determined to contain phenolics such as gallic acid, fisetin, quercetin, and kaempferol. FRO exerted antimicrobial activity against CA and inhibited reactive oxygen species production that was otherwise increased by LPS or CA in HaCaT cells. Additionally, FRO exerted anti-inflammatory effects by inhibiting iNOS, TNF-α, IL-6, p-STAT-3, and p-NF-κB, which were previously upregulated by LPS or CA in THP-1 and HaCaT cells. FRO inhibited lipogenesis induced by steroid hormones and CA by decreasing FAS and SREBP-1 levels in sebocytes. Additionally, FRO down-regulated the androgen receptor, 5α-reductase, SREBP-1, and FAS levels, which were upregulated by steroid hormone in LNCaP cells. Taken together, our findings suggest that FRO alleviates acne by inhibiting the growth of CA, inflammation, and excess sebum and could be used for functional cosmetics or acne treatments.
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Affiliation(s)
- Jung-Eun Kim
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Hengmin Han
- Department of Cancer Preventive Material Development, College of Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdamun-gu, Seoul 02447, Republic of Korea
| | - Yinzhu Xu
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Min-Ho Lee
- Department of Food Science & Services, Eulji University, Seongnam 13135, Republic of Korea
| | - Hyo-Jeong Lee
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
- Department of Cancer Preventive Material Development, College of Korean Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdamun-gu, Seoul 02447, Republic of Korea
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Agamia NF, El Mulla KF, Alsayed NM, Ghazala RM, El Maksoud REA, Abdelmeniem IM, Talaat IM, Zaki II, Sabah RM, Melnik BC. Isotretinoin treatment upregulates the expression of p53 in the skin and sebaceous glands of patients with acne vulgaris. Arch Dermatol Res 2023; 315:1355-1365. [PMID: 36585988 PMCID: PMC10205870 DOI: 10.1007/s00403-022-02508-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 01/01/2023]
Abstract
The transcriptomic regulation induced by isotretinoin (13-cis retinoic acid) is still a matter of debate as short-term exposures of immortalized sebocytes with isotretinoin produced conflicting results. Based on translational evidence, it has been hypothesized that oral isotretinoin treatment upregulates the expression of the transcription factor p53. Twenty-five patients suffering from acne vulgaris were treated with isotretinoin (0.6 mg/kg body weight) for 6 weeks. Biopsies from back skin were taken before and after isotretinoin treatment for the determination of p53 expression by immunohistochemical staining, quantification of p53 protein concentration by enzyme-linked immunosorbent assay and TP53 gene expression by quantitative reverse transcription real time PCR. Fifteen socio-demographically cross-matched healthy volunteers served as controls. Isotretinoin treatment significantly increased the nuclear expression of p53 in sebaceous glands of treated patients compared to pre-treatment levels and p53 levels of untreated controls. Furthermore, the p53 protein and gene expression significantly increased in the skin after treatment. The magnitude of p53 expression showed an inverse correlation to acne severity score and body mass index. Under clinical conditions, isotretinoin induced the expression of p53, which controls multiple transcription factors involved in the pathogenesis of acne vulgaris including FoxO1, androgen receptor and critical genes involved in the induction of autophagy and apoptosis. Increased p53-FoxO1 signalling enhanced by systemic isotretinoin treatment explains the underlying transcriptomic changes causing sebum suppression but also the adverse effects associated with systemic isotretinoin therapy.
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Affiliation(s)
- Naglaa Fathi Agamia
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
| | - Khalid Fawzi El Mulla
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Naglaa Mohamed Alsayed
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Rasha Mohamed Ghazala
- Department of Medical Biochemistry, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | | | - Iman Mohamed Abdelmeniem
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Iman Mamdouh Talaat
- Department of Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Inass Ibrahim Zaki
- Department of Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Rana Mohamed Sabah
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Bodo Clemens Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, 49076, Osnabrück, Germany
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Liu L, Xue Y, Chen Y, Chen T, Zhong J, Shao X, Chen J. Prevalence and risk factors of acne scars in patients with acne vulgaris. Skin Res Technol 2023; 29:e13386. [PMID: 37357642 PMCID: PMC10240192 DOI: 10.1111/srt.13386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/25/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Acne scar is a persistent complication of acne vulgaris. However, the prevalence and risk factors are still unclear. This study aimed to assess the global prevalence and risk factors of acne scars in patients with acne. MATERIALS AND METHODS A systematic search of published studies in three databases was performed and the meta-analyses were conducted. RESULTS Finally, we included 37 studies involving 24 649 acne patients. And, the pooled prevalence of acne scars in these patients was 47% (95% confidence interval [CI]: 38-56%). Besides, the differences in prevalence were observed based on the subgroup analysis for age, gender, acne severity, source of patients, and so on. Subsequently, we quantified the relationship of three risk factors with acne scars: male gender (odds ratio [OR]: 1.58, 95% CI: 1.19-2.09), positive family history of acne (OR: 2.73, 95% CI: 1.26-5.91), and acne severity (OR for moderate acne: 2.34, 95% CI: 1.54-3.57; OR for severe acne: 5.51, 95% CI: 2.45-12.41). CONCLUSION Herein, we found that 47% of acne patients suffered from acne scars and identified three risk factors: male gender, positive family history of acne, and acne severity. In order to reduce acne scarring, attention and effective therapy early in the course of acne is important.
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Affiliation(s)
- Lin Liu
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yuzhou Xue
- Department of Cardiology and Institute of Vascular MedicinePeking University Third HospitalBeijingChina
| | - Yangmei Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Tingqiao Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Judan Zhong
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Xinyi Shao
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jin Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Wang S, Zhao M, Yan Y, Li P, Huang W. Flexible Monitoring, Diagnosis, and Therapy by Microneedles with Versatile Materials and Devices toward Multifunction Scope. RESEARCH (WASHINGTON, D.C.) 2023; 6:0128. [PMID: 37223469 PMCID: PMC10202386 DOI: 10.34133/research.0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/02/2023] [Indexed: 05/25/2023]
Abstract
Microneedles (MNs) have drawn rising attention owing to their merits of convenience, noninvasiveness, flexible applicability, painless microchannels with boosted metabolism, and precisely tailored multifunction control. MNs can be modified to serve as novel transdermal drug delivery, which conventionally confront with the penetration barrier caused by skin stratum corneum. The micrometer-sized needles create channels through stratum corneum, enabling efficient drug delivery to the dermis for gratifying efficacy. Then, incorporating photosensitizer or photothermal agents into MNs can conduct photodynamic or photothermal therapy, respectively. Besides, health monitoring and medical detection by MN sensors can extract information from skin interstitial fluid and other biochemical/electronic signals. Here, this review discloses a novel monitoring, diagnostic, and therapeutic pattern by MNs, with elaborate discussion about the classified formation of MNs together with various applications and inherent mechanism. Hereby, multifunction development and outlook from biomedical/nanotechnology/photoelectric/devices/informatics to multidisciplinary applications are provided. Programmable intelligent MNs enable logic encoding of diverse monitoring and treatment pathways to extract signals, optimize the therapy efficacy, real-time monitoring, remote control, and drug screening, and take instant treatment.
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Affiliation(s)
| | | | - Yibo Yan
- Address correspondence to: (Y.Y.); (P.L.); (W.H.)
| | - Peng Li
- Address correspondence to: (Y.Y.); (P.L.); (W.H.)
| | - Wei Huang
- Address correspondence to: (Y.Y.); (P.L.); (W.H.)
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Chen Y, Yi S, Wang Q, Xiong H, Yuan J, Zhang Y, Yang L, Zhong G, Li X, Zhu T. Lutein attenuates Propionibacterium acnes-induced inflammation by inhibiting pyroptosis of human keratinocyte cells via TLR4/NLRP3/Caspase-1 pathway. Int Immunopharmacol 2023; 117:109937. [PMID: 37012890 DOI: 10.1016/j.intimp.2023.109937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Previous studies found Propionibacterium acnes (P. acnes) has a strong association with acne inflammation and cell pyroptosis. Because of the various side effects of current acne medicines, it is important to explore alternative drugs with anti-inflammatory activity against P. acnes. we explored the effect of Lutein on P. acnes-induced cell pyroptosis and accelerated the recovery of acne inflammation in vitro and vivo. METHODS Lutein was utilized to expose HaCaT keratinocytes, then we reassessed the effect of Lutein on the cell apoptosis, pyroptotic-associated inflammatory factors and catabolic enzymes in heat-killed P. acnes-treated HaCaT cells. Next, living P. acnes was intradermally injected into the right ears of ICR mice to induce mice with acne inflammation, and the effect of Lutein on living P. acnes-induced inflammation was investigated. Moreover, we explored the mechanism of Lutein on TLR4/NLRP3/Caspase-1 pathways by ELISA, immunofluorescence microscopy, and western blot assay. RESULTS Heat-killed P. acnes triggered remarkable cell pyroptosis, pyroptotic inflammatory factors and catabolic enzymes in HaCaT cells, including up-regulating interleukin (IL)-1β, IL-18, TNF-α, MMP3, MMP13, ADAMTS4, and ADAMTS5, TLR4, NLRP3, caspase-1, and the ratio of gasdermin D to cleaved gasdermin D, whereas these effects were suppressed by Lutein. In addition, Lutein effectively improved ear redness, swelling, and the expression of TLR4, IL-1β and TNF-α in vivo. Finally, NLRP3 activator (nigericin) increased caspase-1, IL-1β and IL-18 level, while TLR4 inhibitor (TAK-242) significantly blocked this effect in heat-killed P. acnes-treated cells. CONCLUSIONS Lutein attenuated P. acnes-caused pyroptosis of HaCaTs and the subsequent acne inflammation via the TLR4/NLRP3/Caspase-1 pathway.
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Affiliation(s)
- Yan Chen
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Sha Yi
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Qing Wang
- Department of Dermatology, Dazhou Central Hospital, Dazhou 635000, China
| | - Haojun Xiong
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Jingyi Yuan
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Yuting Zhang
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Lin Yang
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Guishu Zhong
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Xiang Li
- Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Southwest Medical University, Luzhou, China.
| | - Tingting Zhu
- Department of Dermatology, The first affiliated hospital of Soochow University, No.188, Shizi Street, Suzhou 215006, China.
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Kozłowski M, Niedzielska M, Lorenz A, Brodowska A, Malanowska E, Przepiera A, Cymbaluk-Płoska A, Sowińska-Przepiera E. Metabolic and Dietary Factors in Acne Vulgaris and Evaluation of the Acne Vulgaris Treatment with Oral Contraceptive-Based Therapies in Young Adult Women. Nutrients 2023; 15:nu15061488. [PMID: 36986218 PMCID: PMC10057923 DOI: 10.3390/nu15061488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/05/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
The etiopathogenesis of acne is complex, as several endo- and exogenous factors that affect the sebaceous-hair unit are involved in the development of acne lesions. The main aim of the study was to evaluate selected metabolic parameters before treatment. Another goal of the study was to determine the correlation between selected metabolic and dietary parameters and the severity of acne before treatment. The third objective was to assess the severity of acne before and after treatment, considering the type of treatment used. The final objective was to assess the relationship between the difference in acne severity before and after treatment, considering the type of treatment used and factors of dairy or sweets intake. 168 women participated in the study. The patients belonged to two groups: the study group (99 patients with acne vulgaris) and the control group (69 patients without skin lesions). The study group was divided into subgroups according to the treatment used: contraceptive preparation, contraceptive preparation and cyproterone acetate, and contraceptive preparation and isotretinoin preparation. We found that LDL levels and consumption of sweets correlated with acne severity. The mainstay of acne treatment is contraceptive treatment (ethinylestradiol and drospirenone). The effectiveness of the three contraceptive-based treatments was confirmed by observing the severity of acne. There were no significant correlations between the difference in acne severity before and after treatment with the three treatments and factors of dairy or sweet consumption.
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Affiliation(s)
- Mateusz Kozłowski
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Mirela Niedzielska
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Anna Lorenz
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Agnieszka Brodowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Ewelina Malanowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Adam Przepiera
- Department of Urology and Urologic Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Elżbieta Sowińska-Przepiera
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
- Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
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41
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Ramata-Stunda A, Boroduskis M, Kaktina E, Patetko L, Kalnenieks U, Lasa Z, Rubina M, Strazdina I, Kalnins G, Rutkis R. Comparative Evaluation of Existing and Rationally Designed Novel Antimicrobial Peptides for Treatment of Skin and Soft Tissue Infections. Antibiotics (Basel) 2023; 12:antibiotics12030551. [PMID: 36978418 PMCID: PMC10044245 DOI: 10.3390/antibiotics12030551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Skin and soft tissue infections (SSTIs) and acne are among the most common skin conditions in primary care. SSTIs caused by ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter sp.) can range in severity, and treating them is becoming increasingly challenging due to the growing number of antibiotic-resistant pathogens. There is also a rise in antibiotic-resistant strains of Cutibacterium acne, which plays a role in the development of acne. Antimicrobial peptides (AMPs) are considered to be a promising solution to the challenges posed by antibiotic resistance. In this study, six new AMPs were rationally designed and compared to five existing peptides. The MIC values against E. coli, P. aeruginosa, K. pneumoniae, E. faecium, S. aureus, and C. acnes were determined, and the peptides were evaluated for cytotoxicity using Balb/c 3T3 cells and dermal fibroblasts, as well as for hemolytic activity. The interaction with bacterial membranes and the effect on TNF-α and IL-10 secretion were also evaluated for selected peptides. Of the tested peptides, RP556 showed high broad-spectrum antibacterial activity without inducing cytotoxicity or hemolysis, and it stimulated the production of IL-10 in LPS-stimulated peripheral blood mononuclear cells. Four of the novel AMPs showed pronounced specificity against C. acnes, with MIC values (0.3–0.5 μg/mL) below the concentrations that were cytotoxic or hemolytic.
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Affiliation(s)
- Anna Ramata-Stunda
- Alternative Plants Ltd., 2 Podraga Str., LV-1007 Riga, Latvia
- Correspondence:
| | | | - Elza Kaktina
- Alternative Plants Ltd., 2 Podraga Str., LV-1007 Riga, Latvia
| | - Liene Patetko
- Laboratory of Bioanalytical and Biodosimetry Methods, Faculty of Biology, University of Latvia, 3 Jelgavas Str., LV-1004 Riga, Latvia
| | - Uldis Kalnenieks
- Alternative Plants Ltd., 2 Podraga Str., LV-1007 Riga, Latvia
- Institute of Microbiology and Biotechnology, University of Latvia, 1 Jelgavas Str., LV-1004 Riga, Latvia
| | - Zane Lasa
- Institute of Microbiology and Biotechnology, University of Latvia, 1 Jelgavas Str., LV-1004 Riga, Latvia
| | - Marta Rubina
- Institute of Microbiology and Biotechnology, University of Latvia, 1 Jelgavas Str., LV-1004 Riga, Latvia
| | - Inese Strazdina
- Institute of Microbiology and Biotechnology, University of Latvia, 1 Jelgavas Str., LV-1004 Riga, Latvia
| | - Gints Kalnins
- Latvian Biomedical Research and Study Centre, 1 Ratsupites Str., LV-1067 Riga, Latvia
| | - Reinis Rutkis
- Institute of Microbiology and Biotechnology, University of Latvia, 1 Jelgavas Str., LV-1004 Riga, Latvia
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42
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Truncal Acne and Scarring: A Comprehensive Review of Current Medical and Cosmetic Approaches to Treatment and Patient Management. Am J Clin Dermatol 2023; 24:199-223. [PMID: 36539678 DOI: 10.1007/s40257-022-00746-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
Acne vulgaris is one of the most common skin disorders worldwide. It typically affects skin areas with a high density of sebaceous glands such as the face, upper arms, chest, and/or back. Historically, the majority of research efforts have focused on facial acne vulgaris, even though approximately half of patients with facial lesions demonstrate truncal involvement. Truncal acne vulgaris is challenging to treat and poses a significant psychosocial burden on patients. Despite these characteristics, studies specifically examining truncal acne vulgaris are limited, with treatment guidelines largely derived from facial protocols. Therefore, truncal acne remains an understudied clinical problem. Here, we provide a clinically focused review on the epidemiology, evaluation, and available treatment options for truncal acne vulgaris. In doing so, we highlight knowledge gaps with the goal of spurring further investigation into the management of truncal acne vulgaris.
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Flori E, Mastrofrancesco A, Ottaviani M, Maiellaro M, Zouboulis CC, Camera E. Desaturation of sebaceous-type saturated fatty acids through the SCD1 and the FADS2 pathways impacts lipid neosynthesis and inflammatory response in sebocytes in culture. Exp Dermatol 2023. [PMID: 36843338 DOI: 10.1111/exd.14780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/12/2022] [Accepted: 02/23/2023] [Indexed: 02/28/2023]
Abstract
Sebum is a lipid-rich mixture secreted by the sebaceous gland (SG) onto the skin surface. By penetrating through the epidermis, sebum may be involved in the regulation of epidermal and dermal cells in both healthy and diseased skin conditions. Saturated and monounsaturated fatty acids (FAs), found as free FAs (FFAs) and in bound form in neutral lipids, are essential constituents of sebum and key players of the inflammatory processes occurring in the pilosebaceous unit in acne-prone skin. Little is known on the interplay among uptake of saturated FFAs, their biotransformation, and induction of proinflammatory cytokines in sebocytes. In the human SG, palmitate (C16:0) is the precursor of sapienate (C16:1n-10) formed by insertion of a double bond (DB) at the Δ6 position catalysed by the fatty acid desaturase 2 (FADS2) enzyme. Conversely, palmitoleate (C16:1n-7) is formed by insertion of a DB at the Δ9 position catalysed by the stearoyl coenzyme A desaturase 1 (SCD1) enzyme. Other FFAs processed in the SG, also undergo these main desaturation pathways. We investigated lipogenesis and release of IL-6 and IL-8 pro-inflammatory cytokines in SZ95 sebocytes in vitro after treatment with saturated FFAs, that is, C16:0, margarate (C17:0), and stearate (C18:0) with or without specific inhibitors of SCD1 and FADS2 desaturase enzymes, and a drug with mixed inhibitory effects on FADS1 and FADS2 activities. C16:0 underwent extended desaturation through both SCD1 and FADS2 catalysed pathways and displayed the strongest lipoinflammatory effects. Inhibition of desaturation pathways proved to enhance lipoinflammation induced by SFAs in SZ95 sebocytes. Palmitate (C16:0), margarate (C17:0), and stearate (C18:0) are saturated fatty acids that induce different arrays of neutral lipids (triglycerides) and dissimilar grades of inflammation in sebocytes.
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Affiliation(s)
- Enrica Flori
- Cutaneous Physiopathology and Integrated Centre for Metabolomic Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Arianna Mastrofrancesco
- Cutaneous Physiopathology and Integrated Centre for Metabolomic Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Monica Ottaviani
- Cutaneous Physiopathology and Integrated Centre for Metabolomic Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Miriam Maiellaro
- Cutaneous Physiopathology and Integrated Centre for Metabolomic Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Emanuela Camera
- Cutaneous Physiopathology and Integrated Centre for Metabolomic Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
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Topical Administration of Lactiplantibacillus plantarum (SkinDuo TM) Serum Improves Anti-Acne Properties. Microorganisms 2023; 11:microorganisms11020417. [PMID: 36838382 PMCID: PMC9967017 DOI: 10.3390/microorganisms11020417] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
The tailoring of the skin microbiome is challenging and is a research hotspot in the pathogenesis of immune-mediated inflammatory skin diseases such as acne. Commonly encountered preservatives used as functional ingredients have an impact on the skin microbiota and are known to inhibit the survival of skin commensal bacteria. The selected species is Lactiplantibacillus plantarum, formulated with natural enhancers for topical use (SkinDuoTM). Ex vivo human skin models were used as a test system to assess the strain viability which was then validated on healthy volunteers. SkinDuoTM showed increased viability over time for in vitro skin models and a stable viability of over 50% on healthy skin. The strain was tested on human primary sebocytes obtained from sebaceous gland rich areas of facial skin and inoculated with the most abundant bacteria from the skin microbiota. Results on human ex vivo sebaceous gland models with the virulent phylotype of Cutibacterium acnes and Staphylococcus epidermidis present a significant reduction in viability, lipid production, and anti-inflammatory markers. We have developed an innovative anti-acne serum with L. plantarum that mimics the over-production of lipids, anti-inflammatory properties, and improves acne-disease skin models. Based on these results, we suggest that SkinDuoTM may be introduced as an acne-mitigating agent.
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45
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Ayaki S, Mii T, Matsuno K, Tokuyama T, Tokuyama T, Tokuyama T, Uyama T, Ueda N. β-1,4-Galactan suppresses lipid synthesis in sebaceous gland cells via TLR4. J Biochem 2023; 173:85-94. [PMID: 36288613 DOI: 10.1093/jb/mvac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/28/2022] [Accepted: 10/15/2022] [Indexed: 02/07/2023] Open
Abstract
Sebum is a lipid mixture secreted from sebaceous glands of the skin. The excessive secretion of sebum causes acne vulgaris and seborrheic dermatitis, while its deficiency causes xerosis. Therefore, the appropriate control of sebum secretion is crucially important to keep the skin healthy. In the present study, we evaluated the effects of naturally occurring polysaccharides on lipid biosynthesis in hamster sebaceous gland cells. Among the tested polysaccharides, β-1,4-galactan, the main chain of type I arabinogalactan, most potently suppressed lipid synthesis in the sebaceous gland cells as analysed by oil red O staining. Toll-like receptor (TLR)4 inhibitors counteracted this suppressive effect and lipopolysaccharide, a TLR4 ligand, mimicked this effect, suggesting the involvement of the TLR4 signalling pathway. In the cells β-1,4-galactan significantly decreased mRNA levels of lipogenesis-related transcription factors (peroxisomeGraphical Abstract$\includegraphics{\bwartpath }$ proliferator-activated receptor γ and sterol regulatory element-binding protein 1) and enzymes (acetyl-CoA carboxylase and fatty acid synthase) as well as the glucose transporter GLUT4. Furthermore, β-1,4-galactan increased the production of lactic acid serving as a natural moisturizing factor and enhanced the proliferation of sebaceous gland cells. These results suggest potential of β-1,4-galactan as a material with therapeutic and cosmetic values for the skin.
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Affiliation(s)
- Satomi Ayaki
- Department of Biochemistry, Kagawa University School of Medicine, Miki, Kagawa 761-0793, Japan.,Yushin Brewer Co., Ltd., Ayagawa, Kagawa 761-2307, Japan
| | - Tomohiro Mii
- Yushin Brewer Co., Ltd., Ayagawa, Kagawa 761-2307, Japan
| | - Kosuke Matsuno
- Yushin Brewer Co., Ltd., Ayagawa, Kagawa 761-2307, Japan
| | | | | | | | - Toru Uyama
- Department of Biochemistry, Kagawa University School of Medicine, Miki, Kagawa 761-0793, Japan
| | - Natsuo Ueda
- Department of Biochemistry, Kagawa University School of Medicine, Miki, Kagawa 761-0793, Japan
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46
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Bromfield JI, Hugenholtz P, Frazer IH, Khosrotehrani K, Chandra J. Targeting Staphylococcus aureus dominated skin dysbiosis in actinic keratosis to prevent the onset of cutaneous squamous cell carcinoma: Outlook for future therapies? Front Oncol 2023; 13:1091379. [PMID: 36816953 PMCID: PMC9933124 DOI: 10.3389/fonc.2023.1091379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) and its premalignant precursor, actinic keratosis (AK), present a global health burden that is continuously increasing despite extensive efforts to promote sun safety. Chronic UV exposure is a recognized risk factor for the development of AK and cSCC. However, increasing evidence suggests that AK and cSCC is also associated with skin microbiome dysbiosis and, in particular, an overabundance of the bacterium Staphylococcus aureus (S. aureus). Studies have shown that S. aureus-derived toxins can contribute to DNA damage and lead to chronic upregulation of proinflammatory cytokines that may affect carcinogenesis. Eradication of S. aureus from AK lesions and restoration of a healthy microbiome may therefore represent a therapeutic opportunity to alter disease progression. Whilst antibiotics can reduce the S. aureus load, antibiotic resistant S. aureus pose an increasing global public health threat. The use of specific topically delivered probiotics has been used experimentally in other skin conditions to restore eubiosis, and could therefore also present a non-invasive treatment approach to decrease S. aureus colonization and restore a healthy skin microbiome on AK lesions. This article reviews mechanisms by which S. aureus may contribute to cutaneous carcinogenesis, and discusses hypotheses and theories that explore the therapeutic potential of specific bacterial species which compete with S. aureus in an attempt to restore microbial eubiosis in skin.
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Affiliation(s)
| | - Philip Hugenholtz
- Australian Centre for Ecogenomics, The University of Queensland, St. Lucia, QLD, Australia,School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Ian Hector Frazer
- Frazer Institute, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
| | - Kiarash Khosrotehrani
- Frazer Institute, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia,Department of Dermatology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Janin Chandra
- Frazer Institute, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia,*Correspondence: Janin Chandra,
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47
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Md Jaffri J. Reactive Oxygen Species and Antioxidant System in Selected Skin Disorders. Malays J Med Sci 2023; 30:7-20. [PMID: 36875194 PMCID: PMC9984103 DOI: 10.21315/mjms2023.30.1.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/07/2021] [Indexed: 03/06/2023] Open
Abstract
The skin has a solid protective system that includes the stratum corneum as the primary barrier and a complete antioxidant defence system to maintain the skin's normal redox homeostasis. The epidermal and dermal cells are continuously exposed to physiological levels of reactive oxygen species (ROS) originating from cellular metabolic activities. Environmental insults, such as ultraviolet (UV) rays and air pollutants, also generate ROS that can contribute to structural damage of the skin. The antioxidant defence system ensures that the ROS level remains within the safe limit. In certain skin disorders, oxidative stress plays an important role, and there is an established interplay between oxidative stress and inflammation in the development of the condition. Lower levels of skin antioxidants indicate that oxidative stress may mediate the pathogenesis of the disorder. Accordingly, the total antioxidant level was also found to be lower in individuals with skin disorders in individuals with normal skin conditions. This review attempts to summarise the skin oxidant sources and antioxidant system. In addition, both skin and total antioxidant status of individuals with psoriasis, acne vulgaris, vitiligo and atopic dermatitis (AD), as well as their associations with the progression of these disorders will be reviewed.
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Affiliation(s)
- Juliana Md Jaffri
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Pahang, Malaysia
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48
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Layton AM, Dias da Rocha MA. Real-World Case Studies Showing the Effective Use of Azelaic Acid in the Treatment, and During the Maintenance Phase, of Adult Female Acne Patients. Clin Cosmet Investig Dermatol 2023; 16:515-527. [PMID: 36873659 PMCID: PMC9975535 DOI: 10.2147/ccid.s396023] [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] [Received: 11/29/2022] [Accepted: 02/01/2023] [Indexed: 02/25/2023]
Abstract
Acne Vulgaris is a chronic inflammatory skin disease, and one of the most prevalent inflammatory dermatoses among teenagers, affecting more than >95% of boys and 85% of girls. Adult female acne (AFA) is a subtype of acne, pragmatically defined as affecting women over the age of 25. The clinical presentation of AFA may be distinguished from adolescent acne according to some key clinical and psychosocial characteristics. The etiopathogenic factors and the chronic clinical course that are implicated in AFA make management complex and challenging. A frequent tendency to relapse makes the requirement for maintenance therapy highly likely. Therefore, AFA typically requires a specific, tailored therapeutic approach. This paper presents six challenging case studies that demonstrate the efficacy of azelaic acid gel (AZA) in adult female acne. The six cases use AZA as monotherapy, as part of a combination regimen at treatment initiation, or as maintenance treatment (which is frequently required in this adult population). The positive outcomes achieved in this case series demonstrate that AZA can be efficacious, result in excellent patient satisfaction in mild to moderate adult female acne, and can be effective as a maintenance therapy.
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Affiliation(s)
- Alison M Layton
- Skin Research Centre, Hull York Medical School, University of Hull, Hull, UK
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49
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Liu W, Jie L, Liu D, Makino ET, Krutmann J, Mehta RC. Protective effects of a day/night dual-antioxidant serum on skin: A randomized, regimen-controlled study in Chinese women exposed to air pollution. J Cosmet Dermatol 2023; 22:245-254. [PMID: 35150184 PMCID: PMC10078722 DOI: 10.1111/jocd.14839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/09/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Chronic exposure to air pollution can negatively affect skin health. AIMS To assess the efficacy of the LUMIVIVE® System (LVS), a skincare system consisting of individual day and night serums, in Chinese women exposed to air pollution. PATIENTS/METHODS In this single-center, vehicle-controlled study, eligible females (mean age, 49.02 years) were randomized 1:1 to treatment group (LVS plus basic moisturizer) or control group (basic moisturizer). Skin color, sebum content, barrier function, elasticity, and texture were measured at baseline and at each follow-up visit (days 28, 56, and 84). Air pollution parameters were collected throughout the study. RESULTS Air pollution levels, including PM2.5 and NO2 , were consistently high during the study. The treatment group showed significantly higher skin color L* (p ≤ 0.0001) and lower a* values (p ≤ 0.05) at all follow-up visits compared with the control group, indicating lower skin pigmentation and redness, respectively. Skin color L* and a* values remained unchanged over time for the control group but were significantly different at all follow-up visits compared to baseline (p ≤ 0.0001 and p ≤ 0.05, respectively) for the treatment group. There was an increasing trend for sebum content in the control group, which was not observed in the treatment group. Both groups showed improvements over time in other skin physiology parameters. CONCLUSIONS The current analysis demonstrates the efficacy of LVS plus basic moisturizer compared with basic moisturizer alone to reduce skin pigmentation and redness, as well as to mitigate sebum production, in Chinese women exposed to air pollution.
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Affiliation(s)
- Wei Liu
- Department of Dermatology, General Hospital of Air Force, Beijing, China
| | - Liyun Jie
- Department of Dermatology, The First People's Hospital of Bijie, Guizhou, China
| | - Dan Liu
- Air Force Medical Center, Beijing, China
| | | | - Jean Krutmann
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Rahul C Mehta
- Allergan Aesthetics, an AbbVie Company, Irvine, CA, USA
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50
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Wang P, Wang B, Zhang L, Liu X, Shi L, Kang X, Lei X, Chen K, Chen Z, Li C, Zhang C, Tu P, Pan M, Ju Q, Man X, Lu Y, Yu N, Li Y, Zhu H, Zhang R, Su J, Tao S, Qiao J, Mu Q, Zeng W, Li Z, Gao Y, Gu H, Wang X. Clinical practice Guidelines for 5-Aminolevulinic acid photodynamic therapy for acne vulgaris in China. Photodiagnosis Photodyn Ther 2022; 41:103261. [PMID: 36587863 DOI: 10.1016/j.pdpdt.2022.103261] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/16/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
A variety of evidence suggest that 5-Aminolevulinic acid-based photodynamic therapy (ALA-PDT) is clinically effective in management of acne vulgaris. Several clinical guidelines for acne recommend PDT as an alternative treatment modality for severe acne. However, there is a lack of detailed clinical guideline for PDT in acne treatment. To propose up-to-date, evidence-based and practical recommendations on application of ALA-PDT for acne vulgaris, dermatologists and PDT experts from the Photodynamic Therapy Research Center of the CMA and Photodynamic Therapy Rehabilitation Training Center of CARD achieved consensus and guidelines based on careful evaluation of published literature, expert opinions and experience. ALA-PDT plays a therapeutic role in all four major pathogenesis of acne, and is suitable for moderate to severe acne and scar-prone acne, especially for patients who cannot tolerate or refused systemic antibiotics and isotretinoin. The efficacy and adverse reactions of ALA-PDT are closely related to therapeutic parameters including ALA concentration, incubation time, light source and dosage. Proper pretreatment helps to improve transdermal absorption of ALA and enhances its efficacy. We reviewed and proposed recommended protocols for four PDT procedures including conventional PDT (C-PDT), modified painless PDT (M-PDT), intense pulsed light PDT (IPL-PDT) and daylight PDT (DL-PDT). M-PDT with lower ALA concentration (3-5%), shorter incubation time (30 mins), and lower dose but prolonged illumination (630nm, 40-60 mW/cm2, 150 J/cm2) can improve lesions of moderate to severe acne vulgaris effectively with minimal pain and easier manipulation, and thus was recommended by Chinese dermatologists. Lastly, management of adverse reactions were addressed.
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Affiliation(s)
- Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, United States
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaojing Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Shi
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Xiaojing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, The Army Medical University, Chongqing, China
| | - Kun Chen
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Zhou Chen
- Department of Dermatology, Peking University People's Hospital, Beijing, China
| | - Chengxin Li
- Department of Dermatology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chunlei Zhang
- Department of Dermatology, Peking University Third Hospital, Beijing, China
| | - Ping Tu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China
| | - Meng Pan
- Department of Dermatology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Ju
- Department of Dermatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Shanghai, China
| | - Xiaoyong Man
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang China
| | - Yan Lu
- Dermatology Department, 1st Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Nan Yu
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Yuzhen Li
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huilan Zhu
- Guangzhou Institute of Dermatology, Guangzhou, China
| | - Ruzhi Zhang
- Department of Dermatology, The Third Affiliated Hospital of Suzhou University, Suzhou, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Shiqin Tao
- Department of Dermatology, Wuxi No.2 People's Hospital, Wuxi Jiangsu, China
| | - Jianjun Qiao
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiri Mu
- Department of Dermatology, International Mongolian Hospital of Inner Mongolia, Inner Mongolia, China
| | - Weihui Zeng
- Department of Dermatology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an , China
| | - Zhiming Li
- Department of Dermatology and Venereology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ying Gao
- Department of Dermatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Heng Gu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
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