“…Studies on P. acnes have shown its ability to stimulate the production of interleukin (IL)-1, IL-8, and TNF-a by PMNs, which in patients with SS are less concentrated (because of a desensitization probably linked to the chronic infection by P. acnes) (12,39). In addition, components of P. acnes have immune modulatory activity modulated by Toll-like receptor 9 (34,38). It has also been shown that P. acnes can trigger a nonspecific activation of cell-mediated immunity; the immune response that follows may be an attempt to remove the bacterium, potentially promoting continuation of the inflammation (9).…”