Decrease in Diversity of Propionibacterium acnes Phylotypes in Patients with Severe Acne on the Back

Abstract

Propionibacterium acnes, a major member of normal skin microbiota, is subdivided into 6 phylotypes: IA1, IA2, IB, IC, II and III. This study investigated P. acnes subgroups on the face and back in patients with severe acne and in healthy controls. In 71.4% of patients with severe acne, P. acnes phylotypes were identical on the face and back, whereas this was the case in only 45.5% of healthy controls. The healthy group carried phylotypes IA1 (39.1%) and II (43.4%), whereas the acne group carried a high predominance of IA1 (84.4%), especially on the back (95.6%). In addition, the single-locus sequence typing (SLST) method revealed A1 to be the predominant type on the back of patients with acne, compared with a wide diversity in the healthy group. We report here that severity of acne on the back is associated with loss of diversity of P. acnes phylotype, with a major predominance of phylotype IA1. The change in balance of cutaneous P. acnes subgroups might be an inducing factor in the activation of P. acnes, which could trigger inflammation.

<b><i>Staphylococcus epidermidis</i></b>: A Potential New Player in the Physiopathology of Acne?

“…In the healthy group, phylotypes IA1 (39%) and II (43%) were the main phylotypes, whereas in the acne group IA1 (84%), especially on the back (96%), was the main phylotype. This may confirm the hypothesis that acne severity may be associated with a loss of diversity of C. acnes phylotypes, following a selection of phylotype IA1/clonal complex (CC) 18 present in all acne patients [28-30]. …”

“…A recent clinical study using the single-locus sequence typing method investigated C. acnes subgroups on the face and back in patients with severe acne and in healthy subjects [28]. In almost 75% of the acne patients, C. acnes phylotypes were identical on the face and back, whereas this was only the case in about 45% of the healthy subjects.…”

“…Therefore,different inflammatory profiles, depending on the phylotype (i.e., phylotype IA1, which has been mainly observed on the face and back of acne patients and clusterof C. acnes activating the innate immunity via the expression of protease-activated receptors (PARs), tumour necrosis factor-α, and the production of interferon-γ and interleukins [IL-8], have been observed [28, 31-37]. Moreover, C. acnes activates the release of lipases, matrix metalloproteinases, and hyaluronidases, leading to hyperkeratinisation of the pilosebaceous unit and finally to comedones, papules, and pustules [31-34, 38].…”

Characterisation of Cutibacterium acnes phylotypes in acne and in vivo exploratory evaluation of Myrtacine®

“…The presence of the clade IA in healthy controls and acne patients was demonstrated in several studies, [19][20][21][22] as well as its dominance in acne patients. [23][24][25] While analysing the dominant phylotypes of C. acnes in 63 patients with mild to severe acne, Paugam et al 26 also observed that phylotypes IA1 and IA2…”

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AbstractObjective Our main objective was to compare Cutibacterium acnes (C. acnes) skin colonisation in patients with mild to moderate acne versus healthy controls and secondly, to evaluate a Myrtacine â -based cream on C. acnes total population and antibioresistant Cutibacteria in patients with acne.Methods In 60 acne patients (Global Acne Severity Scale, GEA grades 2-3), of mean age 20 [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Results We first showed (i) high and similar levels of C. acnes colonisation in superficial pilosebaceous follicles and detection of EryR and ClnR strains in both acne and control groups; (ii) different repartition of phylotypes in acne patients versus healthy control, with a predominance of phylotype IA in acne patients and a link between phylotype IA and erythromycin resistance. Besides, after treatment with the Myrtacine â -based cream in acne patients, there was no change in C. acnes total load, but a significant decrease of EryR Cutibacteria, reduced porphyrin production by C. acnes, a decrease in acne severity (GEA), associated with reduced retentional and inflammatory lesions.

Conclusion Cutibacterium acnes colonisation was not significantly different in acne versus control groups.

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