Propionibacterium acnes: an update on its role in the pathogenesis of acne

Abstract

In recent years, significant progress has been made in the understanding of the pathophysiological mechanisms of acne and the role of Propionibacterium acnes. With this review, the authors aim to provide an update on the current understanding of the role of P. acnes in the development of acne lesions and analysing the potential implications for future treatments. A total of 188 articles published between January 1980 and March 2013 were searched using key words such as acne, P. acnes, microbiology, Corynebacterium acnes, acne vulgaris, pathogenesis, antibiotic, vaccination and a combination of those key words. From those articles, 77 were analysed in depth. Recent data confirm that P. acnes has a strong proinflammatory activity and targets molecules involved in the innate cutaneous immunity, keratinocytes and sebaceous glands of the pilosebaceous follicle and leads to the development of comedones. Furthermore, the profile of its different strains may differ between healthy subjects and acne patients. The better understanding of the role of P. acnes may allow for new perspectives in the treatment of acne. Novel therapies should target molecules implicated in the activation of innate immunity, including toll-like receptors, protease-activated receptors and topical antimicrobial peptides; the latter may be an alternative to topical antibiotics and thus a solution for limiting bacterial resistance induced by topical macrolides. Vaccines may also be promising. However, the most appropriate candidate remains to be selected.

Antimicrobial activities of ozenoxacin against isolates of propionibacteria and staphylococci from Japanese patients with acne vulgaris

“…Especially, P. acnes is regarded as a causative bacterium involved in the pathogenesis and exacerbation of acne vulgaris (Gollnick et al, 2003;Beylot et al, 2014). Moreover, it has been reported that P. acnes was simultaneously isolated with staphylococci in severe acne patients (Nishijima et al, 2000).…”

“…The clinical picture is manifested by seborrhoea, non-inflammatory comedones (blackheads and whiteheads), inflammatory papules, pustules or nodules and scarring, which originate from the pilosebaceous units (Strauss et al, 2007;Thiboutot et al, 2009;Nast et al, 2012). The pathogenesis of acne is multifactorial and includes increased sebum production by androgen-mediated hyperactive sebaceous gland, follicular hyperkeratinization, bacterial colonization by Propionibacterium acnes, a common anaerobic Grampositive commensal of normal skin and release of inflammatory mediators (Contassot et al, 2014;Beylot et al, 2014). Multiple acne therapies are available depending on the severity, type and extent of acne lesions and topical retinoids, antimicrobials and benzoyl peroxide, oral antimicrobials and oral isotretinoin (retinoid) (Strauss et al, 2007;Thiboutot et al, 2009;Nast et al, 2012).…”

Fragility of epidermis and its consequence in dermatology

“…38 Propionibacterium acnes (P. acnes) has been identified in acne lesions and plays, together with the sebaceous gland, an important role in the pathogenesis of the condition: P. acnes, in fact, secretes lipases, chemotactic factors, metalloproteases and porphyrins, inducing an inflammatory response, with production of free radicals, and causing keratinocyte damage. 39 …”

A Derivative of the Thiopeptide GE2270A Highly Selective against Propionibacterium acnes

“…The organism catabolizes sebaceous triglycerides, using the glycerol moiety as a carbon source without catabolizing the fatty acids. While this species has been advocated to play a fundamental role in the etiogenesis of acne (5,6), a significant controversy remains as to how important a role P. acnes plays (4,7). Recent metagenomic studies have confirmed it to be the major inhabitant of pilosebaceous units (8).…”