Lymphocyte transformation in subjects with nodulo-cystic acne

Abstract

Patients with severe nodulo-cystic acne are known to have elevated serum antibody levels and increased immediate hypersensitivity reactions to Propionibacterium acnes. This organism is the predominant bacterium in normal pilosebaceous follicles of human skin, and can be consistently isolated from pustular lesions in acne. Previously it had been observed that delayed cutaneous hypersensitivity reactions to P. acnes were negative in patients with acne. The present study investigated the proliferative response of lymphocytes from patients with nodulo-cystic acne to phytohaemagglutinin (PHA) and P. acnes antigen stimulation. The response to PHA stimulation was within normal limits. The response to P. acnes antigen showed a significant increase over control values obtained by testing lymphocytes from acne-free subjects. Thus cell mediated immunity to P. acnes may be present in subjects with severe inflammatory acne. These findings raise the possibility that reactions to P. acnes may contribute to intensifying the inflammatory response in acne lesions.

Delayed Hypersensitivity to <i>Propionibacterium acnes</i> in Patients with Severe Nodular Acne and Acne fulminans

“…However, the lymphocyte responses obtained with the two P. acnes anti gens (1 and 2) correlated well with each other, and the skin tests with the antigens 2 and 3 also yielded parallel results. It seems therefore that the present results with these differ ent P. acnes antigens are comparable to the previous in vitro and in vivo findings [12,13,18], Some subjects with severe acne probably exhibit an im mune response different from that seen in ordinary acne. Patients with AF have shown decreased or lacking skin test reactivity to common bacterial antigens [14][15][16].…”

“…Circulating antibodies against P. acnes have been demonstrated, and their levels seem to correlate with the severity of the acne [10, 11J. Fur ther evidence was presented by Puhvel et al [18], who showed that lymphocyte stimulation to P. acnes was signif icantly increased in 18 patients with nodulocystic acne when compared to acne-free subjects. In the present study, we investigated lymphocyte responses to P. acnes in the active and inactive phases of severe acne.…”

Diseases of cutaneous appendages

“…Outside the inner root sheath is the outer (external) root sheath. 24 In a small proportion, it produces considerable disfigurement. It is only one cell thick at the level of the bulb; it is thickest at the isthmus, where it starts to keratinize, forming a narrow zone of tricholemmal keratinization.…”

The Role of Innate Immunity in the Pathogenesis of Acne

“…Ashbee et al [21]reported that patients with severe acne have significantly higher levels of complement fixing antibodies to P. acnes. Puhvel et al [22]showed that lymphocyte stimulation by P. acnes is significantly increased in patients with nodulocystic acne. Kersey et al [23]demonstrated that delayed skin test reactivity to P. acnes correlates with the severity of the disease.…”