Propionibacterium acnes and Acne Vulgaris: New Insights from the Integration of Population Genetic, Multi-Omic, Biochemical and Host-Microbe Studies

Abstract

The anaerobic bacterium Propionibacterium acnes is believed to play an important role in the pathophysiology of the common skin disease acne vulgaris. Over the last 10 years our understanding of the taxonomic and intraspecies diversity of this bacterium has increased tremendously, and with it the realisation that particular strains are associated with skin health while others appear related to disease. This extensive review will cover our current knowledge regarding the association of P. acnes phylogroups, clonal complexes and sequence types with acne vulgaris based on multilocus sequence typing of isolates, and direct ribotyping of the P. acnes strain population in skin microbiome samples based on 16S rDNA metagenomic data. We will also consider how multi-omic and biochemical studies have facilitated our understanding of P. acnes pathogenicity and interactions with the host, thus providing insights into why certain lineages appear to have a heightened capacity to contribute to acne vulgaris development, while others are positively associated with skin health. We conclude with a discussion of new therapeutic strategies that are currently under investigation for acne vulgaris, including vaccination, and consider the potential of these treatments to also perturb beneficial lineages of P. acnes on the skin.

Skin Cutibacterium acnes Mediates Fermentation to Suppress the Calcium Phosphate-Induced Itching: A Butyric Acid Derivative with Potential for Uremic Pruritus

“…On the other hand, a higher percentage of genus Staphylococcus in the majority of itchy skin of CKD patients, supporting the previous findings that members of the genus Staphylococcus frequently colonize itchy skin [87,88]. Results using multilocus sequence typing (MLST) and ribotyping analysis have shown that C. acnes with phylotype IA1/IC and III was globally associated with the severity of acne vulgaris, while phylotype II mostly colonizes healthy skin [89,90]. The constructed phylogenetic tree in Supplemental Figure S6 demonstrates that C. acnes we isolated from human skin shares the same branch and branch length with C. acnes phylotype II.…”

“…Future works will include evaluation of pharmacokinetics and stability of BA-NH-NH-BA in skin. Certain subtypes of opportunistic skin C. acnes bacteria are predominantly present in lesions of skin disorders such as acne vulgaris [89,90]. However, it has been illustrated that the abundance of C. acnes declined in dry and/or aged skin [63,64,95].…”

Cutibacterium acnes Phylotype I and II Strains Interact Differently With Human Skin Cells

“…Altered follicular keratinization, increased and altered sebum production, C. acnes colonization, and inflammation are traditionally described as the key factors in the pathogenesis of acne. Nevertheless, the specific role of the skin commensal C. acnes in the whole disease process remains unclear ( McLaughlin et al., 2019 ). To this end, we studied the interaction process of C. acnes with its host, hereby focusing on potential differential interactions of C. acnes strains typically associated with acneic skin (type I) or with healthy skin (type II).…”

Acne in the 21st century

“…While recent evidence suggests that crosstalk between the host and its microbiome can be partly mediated by the sebaceous gland, the extent to which C. acnes contributes to acne remains to be unequivocally determined . After all, it is a commensal that also exerts beneficial effects …”

“…7 After all, it is a commensal that also exerts beneficial effects. 8 Regardless of what will eventually supplant our current therapeutics, its development will require proper clinical outcome measures. 'Proper' in this context means quantitative, validated, including quality of life and internationally agreed upon.…”