Engineering selectivity of Cutibacterium acnes phages by epigenetic imprinting

Antibacterial activity and impact on keratinocyte cell growth of Cutibacterium acnes bacteriophages in a Cutibacterium acnes IA1- colonized keratinocyte model

Acne is an inflammatory disease in which microbial disbalance is represented by an augmented population of phylotype IA1 of Cutibacterium acnes. Various treatments for acne can cause side effects, and it has been reported that C. acnes is resistant to prescribed antibiotics. Phage therapy has been proposed as an alternative treatment for acne, given its species-specificity to kill bacteria, its relative innocuity, and its potential to manage antibiotic-resistant pathogens. Moreover, bacteriophages (phages) may modulate the microbiota and immune responses. Some studies have shown the potential use of phages in the treatment of acne. Nevertheless, the capacity to specifically reduce phylotype IA1 and the effect of phage treatment on skin cells are poorly understood. We assessed the capacity of phages to clear C. acnes IA1 and their effects on cell cytotoxicity and growth in HEKa cells- C. acnes IA1 co-culture. Phylotypes IA1 and IB had similar effects on HEKa cells, causing cytotoxicity and diminishing cell growth. Nevertheless, IA1 caused a higher impact on cell doubling time by increasing it 1.8 times more than cell growth control group. Even though there are no phages IA1-specific, we found phages that have a diminished effect on other phylotypes not related to acne. Phage treatment in general reduced IA1-caused cytotoxicity, with differences in efficacy among phages. In addition, phage purification was necessary to restore metabolic activity and growth of HEKa. Overall, phage evaluation as a therapeutic alternative should include phage-bacteria interactions and their impact on skin cells because of the differences that each phage can exhibit.

Cutibacterium acnes bacteriophage therapy: exploring a new frontier in acne vulgaris treatment

The skin microbiome, encompassing a variety of microorganisms, plays a critical role in skin health and function. Acne vulgaris, affecting approximately 9.4% of the global population, is a prevalent skin condition primarily targeting pilosebaceous units rich in sebaceous glands. The condition is influenced by factors such as hormonal changes, sebaceous gland dysfunction, and the activity of Cutibacterium acnes, a gram-positive bacterium linked to acne development. The skin's immune system, particularly keratinocytes with pattern recognition receptors like Toll-like receptors (TLRs), plays a crucial role in recognizing and responding to bacterial presence. The onset of acne is often linked to adolescence, marked by significant hormonal fluctuations. Genetics also plays a role, with family history being a notable risk factor. Acne is characterized by distinct alterations in the C. acnes composition, with specific phylotypes associated with either commensal or pathogenic behavior. Traditional treatments include antibiotics, but the rise of antibiotic resistance has led to exploring alternative therapies, such as bacteriophage therapy. Bacteriophages offer a targeted approach to treating acne by targeting C. acnes strains, potentially reducing antibiotic resistance and enhancing treatment efficacy. Phage therapy shows promise, but further research is needed to fully understand its effectiveness and potential in clinical applications. Additionally, combining phages with antibiotics may offer a synergistic approach to overcoming antibiotic resistance and managing acne.

Delivery of a sebum modulator by an engineered skin microbe in mice

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.

Putative pseudolysogeny-dependent phage gene implicated in the superinfection resistance of Cutibacterium acnes

Objectives: Cutibacterium acnes, formerly Propionibacterium acnes, is a bacterial species characterized by tenacious acne-contributing pathogenic strains. Therefore, bacteriophage therapy has become an attractive treatment route to circumvent issues such as evolved bacterial antibiotic resistance. However, medical and commercial use of phage therapy for C. acnes has been elusive, necessitating ongoing exploration of phage characteristics that confer bactericidal capacity. Methods: A novel phage (Aquarius) was isolated and analyzed. Testing included genomic sequencing and annotation, electron microscopy, patch testing, reinfection assays, and qPCR to confirm pseudolysogeny and putative superinfection exclusion (SIE) protein expression. Results: Given a superinfection-resistant phenotype was observed, reinfection assays and patch tests were performed, which confirmed the re-cultured bacteria were resistant to superinfection. Subsequent qPCR indicated pseudolysogeny was a concomitantly present phenomenon. Phage genomic analysis identified the presence of a conserved gene (gp41) with a product containing Ltp family-like protein signatures which may contribute to phage-mediated bacterial superinfection resistance (SIR) in a pseudolysogeny-dependent manner. qPCR was performed to analyze and roughly quantify gp41 activity, and mRNA expression was high during infection, implicating a role for the protein during the phage life cycle. Conclusions: This study confirms that C. acnes bacteria are capable of harboring phage pseudolysogens and suggests that this phenomenon plays a role in bacterial SIR. This mechanism may be conferred by the expression of phage proteins while the phage persists within the host in the pseudolysogenic state. This parameter must be considered in future endeavors for efficacious application of C. acnes phage-based therapeutics.