Characterization of a live Cutibacterium acnes subspecies defendens strain XYCM42 and clinical assessment as a topical regimen for general skin health and cosmesis

Abstract

Background When formulating topical products to treat skin diseases and addressing general skin health and cosmesis, most of the focus has traditionally been placed on how any given ingredient may impact the structure, function, and health of human skin elements. However, recent research is beginning to highlight the importance of the skin microbiome in relation to certain skin conditions and general cosmesis. Cutibacterium acnes is one of the most prolific skin‐specific bacterial species. Research has shown that the species is divided into subspecies, some of which are thought to be beneficial to the skin. This paper aims to determine the efficacy of strainXYCM42, a C. acnes subspecies defendens derived strain designed to improve the health and appearance of the skin. Methods In vitro studies were performed on human keratinocyte and fibroblast monolayers, human peripheral blood mononuclear cells (PBMC), and skin explants to elucidate the effects of live XYCM42 cells and their ferment on human skin cells and tissues. Subsequently, clinical studies were performed using XYCM42‐based topical regimens designed to deliver and support the engraftment of live XYCM42 cells onto subjects' skin. Two studies were performed, a 3‐week pilot study (n = 10) and a 8‐week pivotal study (n = 121). In the latter, 32 subjects were enrolled for an in‐clinic portion for efficacy evaluation, with clinic visits occurring at Baseline, Week 1, Week 4, and Week 8. Results In vitro data suggest that XYCM42 and its ferment filtrate have potential to provide benefits to the skin via antioxidant, anti‐inflammatory, and select antimicrobial activities. Clinical observation demonstrated that a XYCM42‐containing regimen supports a healthy skin environment, promotes increased skin hydration, decreases erythema, calms the skin, and regulates sebum production. Conclusion These studies provide further evidence that specific strains of C. acnes, such as XYCM42, have a more beneficial function regarding skin health and appearance than was previously thought. Appropriate use of formulations derived from symbiotic strains within the skin microbiome can support the development of novel, beneficial topicals.

Study to determine the safety and efficacy of microneedling as an effective treatment for acne vulgaris

“…Despite there being no definitive evidence that acne is in any way communicable via microbial transference or that microbial over-proliferation is connected to developing acne or the severity of the disease state, these ideas seem to persist. 7,[25][26][27][28][29] The common misperception that C. acnes is solely responsible for acne or that microneedling could spread C. acnes across the face has likely hindered research into investigating such as a potential treatment for acne. However, as acne is a multi-factorial disease state involving the hyperkeratinization of the stratum corneum, which blocks the normal flow of sebum from the follicle, it makes sense that initiation of local skin remodeling via transdermal microneedling (involving rapid turnover of the epidermis and stratum corneum) would allow for relief of acneic symptoms during the remodeling process.…”

“…Additionally, recent research has shown that certain strains of C . acnes are healthy for skin and can contribute to benefits such as antioxidant activity, anti‐inflammatory activity, and upregulation of genes involved in skin barrier homeostasis 7 …”

“…acnes bacterium from acneic lesions to other areas of the face. Despite there being no definitive evidence that acne is in any way communicable via microbial transference or that microbial over‐proliferation is connected to developing acne or the severity of the disease state, these ideas seem to persist 7,25–29 . The common misperception that C. acnes is solely responsible for acne or that microneedling could spread C .…”

“…15,16 These methodologies again assume that the overall reduction of the C. acnes species will reduce pathology but do not consider the long-term effects of deprivation of the skin biome of potential protective benefits conferred by healthy strains of the species. 7,17 Additionally, acne vulgaris treatment modalities can be over-the-counter or prescription strength in topical or oral therapies that include benzoyl peroxide, azelaic acid, salicylic acid, and oral isotretinoin or as procedures using a medical device that delivers thermal energy to sebaceous glands. 18,19 These standard treatments to target acne may not be effective for everyone, and some patients do not qualify to take What is already known about this topic?…”

“…6 Additionally, recent research has shown that certain strains of C. acnes are healthy for skin and can contribute to benefits such as antioxidant activity, antiinflammatory activity, and upregulation of genes involved in skin barrier homeostasis. 7 Despite the emerging evidence to the contrary and the ubiquity of C. acnes on healthy skin, many still refer to acne specifically as a C. acnes-related infection of the pilosebaceous unit. 3,[8][9][10] Because of this, first line prescriptive treatments for acne have traditionally included antibiotics.…”