What kind of bacteria causes acne

They sequenced the genomes of 66 different P. Louis, said:. This type of analysis has a much higher resolution than prior studies that relied on bacterial cultures or only made distinctions between bacterial species.

The investigators were specifically looking for any differences in the bacterial strains of those suffering from acne versus those with healthy skin. They identified two unique strains of P. In addition, another strain of P. The finding should help in the development of future acne treatments. But not everyone's hair follicles are created equal, and that could explain why not everyone gets acne - some people might simply have hair follicles that are more suffocating than others.

This might not only explain the root causes of acne - it could also reveal a whole new pathway through which bacteria trigger inflammation, and that could help scientists understand a range of different infections. The researchers specifically looked at a type of bacterium known as Propionibacterium acnes , which - as the name suggests - can cause acne breakouts.

Most of us have P. So the team tested the bacteria under a range of conditions on the skin of mice to try and figure out what was going on. They showed that when trapped in airless environments alongside hair and skin cells, P. Usually this inflammation is switched off by enzymes called histone deacetylases , but the fatty acids produced by the bacteria deactivated that brake, so inflammation continued unchecked - going on to cause red, itchy breakouts.

As always, you should consult with your healthcare provider about your specific health needs. What kinds of bacteria cause pimples? Diana Meeks on behalf of Sigma Nursing. Family Practitioner. Continue Learning about Acne Should I talk to my doctor about my severe acne symptoms? Diana Meeks. While it remains to be determined whether certain strains of P.

This interaction was found to be the strongest with a range of type IB and II strains, consistent with previous reports that these phylogroups produce large quantities of the protein [ 30 ]. While the exact role this interaction plays in acne pathogenesis remains unclear, specifically because type IB and II strains are generally not acne-associated, it may be relevant to other types of opportunistic infections where these lineages are potentially more important. One caveat with cell-based studies, as well as different omic comparisons of P.

This makes it difficult to directly compare studies and draw definitive conclusions regarding host immunological, and other, responses to the different P. While intra-phylogroup variation may be less of a consideration for strains of types IA 2 , IB, IC and III that appear relatively conserved at the phylogenetic and accessory genome level, for type IA 1 and type II phylogroups, which display deeper phylogenetic structures, a wider range of STs should be examined.

Furthermore, in vitro models of infection provide, at best, limited insight into the true nature of the host response which is a complex and intricate interaction involving multiple cell types, biochemical pathways and immunological cascades. To understand whether the transcriptional activities of the skin microbiota contribute to acne development, Kang et al.

A core set of operational gene units expressed in all samples, and representing different metabolic pathways encoded in P.

The results showed that the transcriptional activities of P. Most interestingly, the vitamin B 12 biosynthesis pathway in P. When supplemented with vitamin B 12 , the expression of vitamin B 12 biosynthesis genes also became downregulated in healthy subjects, with one individual developing acne within a week. The mechanism driving the association of vitamin B 12 and acne is proposed to revolve around the over-production of pro-inflammatory porphyrins within the follicle as a result of repressed vitamin B 12 biosynthesis and heightened levels of the shared substrates 2-oxoglutarate and l -glutamate, with the latter shunted away from B 12 biosynthesis towards porphyrin biosynthesis.

In contrast, when vitamin B 12 levels are normal, the vitamin B 12 pathway is expressed and porphyrins are produced at low levels. The observation, however, that not all individuals develop acne after vitamin B 12 supplementation provides evidence that other host and bacterial factors regulated by vitamin B 12 may also contribute to the development of the disease.

This study revealed the presence of both human and bacterial proteins; the latter were exclusively from P. Normal casts were found to be enriched for proteins involved in protection from various stresses, including reactive oxygen species, while casts from patients with acne were enriched for proteins associated with pathways involved in host responses to bacteria, as well as tissue repair and regeneration.

Some of the most notable proteins identified included myeloperoxidase, lactotransferrin, neutrophil elastase and vimentin. Another interesting observation from this study was the much higher abundance of P. While it is unclear exactly why this was the case, it could reflect a reduction in P. Key P. Collectively, observations such as these challenge our understanding of the role P.

In addition to the fact that patients had previously been treated with antibiotics and other antimicrobials that may have impacted on their microbiota composition, other limitations of this study which may have affected the results were the nature of the sampling sites which varied between the control and acne cohorts; controls were sampled from the nose while acne patients were sampled from the face and back skin areas.

Also, extracted follicular casts are heterogeneous in respect to size, composition and their state of health and disease. The observation that specific acneic- and skin health-associated lineages of P. Furthermore, such knowledge will enable us to examine and, where necessary, challenge new treatment strategies currently in development and their possible effects on commensal or beneficial lineages of P.

In patients with acne, rates of P. Such observations therefore highlight the potential of phage-based antimicrobial treatment to alter or shift the P. For further detail on the biology and genetic diversity of P.

As indicated, one consideration when developing a treatment that targets skin microbiota is the specificity of action and effect on health-associated lineages. It has been known for a long time that type I strains of P. Recent studies based on our improved understanding of the population genetic structure of P. Of particular interest from the study of Liu et al.

In contrast, Brown et al. As previous studies have found that type IB and III strains are not associated with acne, and strains from the type II phylogroup appear positively associated with skin health see Section 3.

Other issues of concern are transduction of pathogenicity genes, the presence of phage genes of currently unknown function, and the possibility that phage-resistant P. The idea or concept of using topical probiotics masks, cleansers or creams consisting of various bacterial formulations that will restore skin microbiome balance and selectively suppress pathogenic organisms and inflammation is a growing area of research for the treatment of acne and atopic dermatitis [ , ].

In particular, interspecies interactions and antagonism between P. While studies to date have centred on species-level competition as the basis of probiotic therapies for acne, there is currently little information on the use of commensal or health-associated lineages of P. These should be areas of research which are actively pursued in the future given our newly improved understanding of P. Furthermore, probiotic approaches to the treatment of acne may not prove straightforward since stable colonisation of donor bacteria is likely to be influenced by host genetics and other biological factors so that personalised probiotic therapies are likely to be required.

The development of an acne vaccine based on targeting of P. Vaccine development has, however, been hindered by the absence of a suitable acne animal model, as well as the potential detrimental effect such a treatment may have on health-associated or beneficial strains. Under such circumstances, targeting the mechanism of virulence transition while maintaining colonisation and, therefore, commensal benefit is the ideal approach.

Recently, there has been significant interest in the development of an acne vaccine based on targeting of the CAMP factor 2 protein of P. Studies with a mouse model of bacterial induced inflammation have shown that CAMP factor 2 vaccination reduces P.

Caution is, however, advised in over-interpreting such results since mice are not naturally colonized with P. The cytotoxic effects of CAMP factor 2 may partly reflect interactions of the protein with host cell sphingomyelinase [ ].

As all phylogroups and strains of P. Other lines of evidence that support the idea that CAMP factor 2 is more than just a virulence factor are the observation that it may have been purged from other cutaneous propionibacteria where it was not essential for survival on the human host, alongside the demonstration that the CAMP factor 2 gene appears to be evolving under functional constraints similar to that seen with housekeeping genes [ 27 ].

Its presence in hair follicles and sebaceous glands of non-lesional skin is also consistent with a role in commensal existence, albeit at lower levels than found in acne lesions where some bacterial overgrowth may have occurred [ ]; against this latter observation, Bek-Thompson et al. Furthermore, knockout mutants for the CAMP factor show significantly reduced bacterial growth compared to wild type within an in vivo context mouse ear , compared to growth in broth culture [ ].

Further studies are clearly required to determine what effect CAMP factor 2 vaccination would have on health-associated lineages of P.

It may be that local passive immunoprotection with therapeutic anti-CAMP factor antibodies is a safer and more appropriate approach than pre-pubertal immunization [ ]. In conclusion, the last number of years has seen some very significant developments in our understanding of P.

The observation that certain lineages are acne-associated, while other appear to promote skin health, has breathed new life into the study of acne pathogenesis. The integration of data from phylogenetics, multi-omic, biochemical and host-microbe studies has also provided a more holistic understanding of the mechanisms driving the pathogenicity of certain strains, thus creating opportunities for the future development of new therapeutics.

As lineages of P. The development of this site was funded by the Wellcome Trust. Conceptualization, A. Grant Project No. National Center for Biotechnology Information , U. Journal List Microorganisms v. Published online May Layton , 2 Anthony J. Find articles by Joseph McLaughlin. Find articles by Steven Watterson.

Alison M. Anthony J. Find articles by Anthony J. Find articles by Andrew McDowell. Author information Article notes Copyright and License information Disclaimer. Received Apr 1; Accepted May 9. This article has been cited by other articles in PMC. Abstract The anaerobic bacterium Propionibacterium acnes is believed to play an important role in the pathophysiology of the common skin disease acne vulgaris. Keywords: Propionibacterium acnes , Cutibacterium , phylogroups, MLST, clonal complex, sequence types, multi-omic analyses, virulence factors, host-microbe interactions, novel therapeutics, vaccination.

Introduction The human skin, which is the largest organ of the body, is composed of a variety of key microbial genera associated with skin health, including Staphylococcus , Propionibacterium , Streptococcus , Corynebacterium and Malassezia [ 1 ]. Open in a separate window. Figure 1. Taxonomy and Intraspecies Diversity of Propionibacterium acnes The last ten years have seen a fast-moving shift in our understanding of the population genetic structure of P.

Figure 2. What is the Evidence that P. Figure 3. Inflammatory Responses in Acne: How does P. Insights into the Role of P. Culture-Based Analysis Over the last decade, the development of various molecular typing methods for P. Figure 4. Figure 5. Figure 6. Table 1 Skin strain differences between acne and healthy subjects based on the study and data of Fitz-Gibbon et al.

Shotgun Metagenomic Analysis In a follow-up study from the same group, Barnard et al. Antibiotic Resistance The widespread use of oral and topical antibiotics to treat acne, and other chronic skin conditions like rosacea where P. Figure 7. Figure 8. Table 2 Key P. Figure 9.

Figure Transcriptome While inspection of the genome provides some insight into potential functional differences between phylogroups in the context of health and disease, it provides no information regarding variation at the transcriptional and translational levels. Proteome Whole cell proteomic profiling of P.

New Therapeutic Strategies The observation that specific acneic- and skin health-associated lineages of P. Bacteriophage Therapy In patients with acne, rates of P. Skin Probiotics The idea or concept of using topical probiotics masks, cleansers or creams consisting of various bacterial formulations that will restore skin microbiome balance and selectively suppress pathogenic organisms and inflammation is a growing area of research for the treatment of acne and atopic dermatitis [ , ].

Vaccine Development The development of an acne vaccine based on targeting of P. Conclusions In conclusion, the last number of years has seen some very significant developments in our understanding of P. Author Contributions Conceptualization, A. Funding J. Conflicts of Interest The authors declare no conflict of interest. References 1. Barnard E. Shaping of cutaneous function by encounters with commensals.

Shu M. Fermentation of Propionibacterium acnes , a commensal bacterium in the human skin microbiome, as skin probiotics against methicillin-resistant Staphylococcus aureus. Christensen G. Antagonism between Staphylococcus epidermidis and Propionibacterium acnes and its genomic basis. BMC Genom. Fujimura S. Purification and properties of a bacteriocin-like substance acnecin of oral Propionibacterium acnes. Agents Chemother. Perry A. Propionibacterium acnes : Infection beyond the skin.

Expert Rev. McGinley K. Regional variations of cutaneous propionibacteria. Chang H. Alteration of the cutaneous microbiome in psoriasis and potential role in Th17 polarization.

Kong H. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. Beylot C. Propionibacterium acnes : An update on its role in the pathogenesis of acne. Strains of the Propionibacterium acnes type III lineage are associated with the skin condition progressive macular hypomelanosis.