Skin dysbiosis and Cutibacterium acnes biofilm in inflammatory acne lesions of adolescents

Abstract

Acne vulgaris is a common inflammatory disorder affecting more than 80% of young adolescents. Cutibacterium acnes plays a role in the pathogenesis of acne lesions, although the mechanisms are poorly understood. The study aimed to explore the microbiome at different skin sites in adolescent acne and the role of biofilm production in promoting the growth and persistence of C. acnes isolates. Microbiota analysis showed a significantly lower alpha diversity in inflammatory lesions (LA) than in non-inflammatory (NI) lesions of acne patients and healthy subjects (HS). Differences at the species level were driven by the overabundance of C. acnes on LA than NI and HS. The phylotype IA1 was more represented in the skin of acne patients than in HS. Genes involved in lipids transport and metabolism, as well as potential virulence factors associated with host-tissue colonization, were detected in all IA1 strains independently from the site of isolation. Additionally, the IA1 isolates were more efficient in early adhesion and biomass production than other phylotypes showing a significant increase in antibiotic tolerance. Overall, our data indicate that the site-specific dysbiosis in LA and colonization by virulent and highly tolerant C. acnes phylotypes may contribute to acne development in a part of the population, despite the universal carriage of the microorganism. Moreover, new antimicrobial agents, specifically targeting biofilm-forming C. acnes, may represent potential treatments to modulate the skin microbiota in acne.

A cross‐sectional cohort study on the skin microbiota in patients with different acne durations

“…Since the patients in the 4–6 years group did not use any antibiotics in the past 6 months, the decrease we observed is less likely due to the medication. Changes in alpha diversity between acne and normal groups were not consistent in the previous research 32–34 . Variations in these studies may be explained by the disease time of recruited individuals.…”

“…Changes in alpha diversity between acne and normal groups were not consistent in the previous research. [32][33][34] Variations in these studies may be explained by the disease time of recruited individuals. In the present study, we also found that the alpha diversity of microbial communities increased in the skin pore.…”

New insights into the characteristic skin microorganisms in different grades of acne and different acne sites

“…There were two reports investigating Chinese acne patients’ skin microbiota suggested that the alpha diversity of skin microbiota in the acne group is greater than that in the healthy control group, while beta diversity also showed differences ( Li et al, 2019 ; Shi et al, 2021 ). However, there were reports found that the diversity of skin microbiota in the acne group is no different from that in the healthy group, and even reports suggested that the diversity of skin microbiota in acne patients is significantly reduced ( Cavallo et al, 2022 ). Recently, a report from Korea revealed that there was no difference in the diversity between acne and healthy group ( Kim et al, 2021 ), which was consistent with this study that only a slight difference was found in the beta diversity of fungal flora between the different grade acne group and the health group ( Table 2 ; Figure 2 ; Supplementary Figures S1 – S4 ).…”

Acne microbiome: From phyla to phylotypes

“…47,48 The formation of biofilm and secretion of virulence factors (CAMP haemolysis, lipase, RoxP enzyme) by C. acnes phylotype IA 1 stimulates production of interleukin-17 by Th17 lymphocytes. 47,49 Thus, the various C. acnes phylotypes can modulate T-cell responses leading to either acne development or homeostasis. 47…”