Acne: role of Cutibacterium acnes and possibilities of using bacteriophages

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BACKGROUND: The role of Cutibacterium acnes in the pathogenesis of acne vulgaris and its adverse effect on follicular hyperkeratosis, inflammation and the skin microbiome have now been established. Their excessive colonization contributes to the loss of microbial diversity of the skin, activates the innate immune system, leads to the appearance of skin rash elements and chronic inflammation. Bacteriophages are considered as a new promising direction in the treatment of patients with acne, as they have an antimicrobial effect against C. acnes; contribute to the preservation of the skin microbiome; have an indirect effect on the innate and adaptive immune response.

AIM: To evaluate the effectiveness and safety of topical therapy with cosmetic gel with bacteriophages Fagoderm in the complex treatment of patients with moderate to severe acne.

MATERIALS AND METHODS: In the design of a simple open prospective study in parallel groups, the effect of cosmetic gel with bacteriophages on the number of comedones, pupules and pustules was assessed in 35 adult patients with moderate acne. During therapy, possible adverse events were simultaneously recorded.

RESULTS: During therapy, similar dynamics were noted in the form of a decrease in non-inflammatory elements of acne both in the group of people receiving a combination of adapalene and phagoderm, and in the comparison group, where monotherapy with adapalene was carried out. The number of inflammatory elements of acne decreased in both groups, but in the main group this happened at an earlier time. Compared to the initial data, already in the 2nd week the number of inflammatory elements decreased by 50% (in comparison ― by 32%); by the end of the 4th ― by 95% (respectively in the comparison group ― by 74%).

CONCLUSION: Cosmetic gel with bacteriophages with bacteriophages helps reduce the inflammatory manifestations of moderate acne.

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作者简介

Andrey Bakulev

Central State Medical Academy of Department of Presidential Affairs

编辑信件的主要联系方式.
Email: al_ba05@mail.ru
ORCID iD: 0000-0002-1450-4942
SPIN 代码: 6708-7386

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

Irina Igonina

SB Clinic Cosmetology

Email: igochka@bk.ru
ORCID iD: 0000-0003-0510-9534
SPIN 代码: 9206-6186
俄罗斯联邦, Saratov

Yulia Bocharova

SB Clinic Cosmetology

Email: juliavern@mail.ru
ORCID iD: 0009-0005-5521-5943
SPIN 代码: 7922-4120
俄罗斯联邦, Saratov

Sergey Kravchenya

Clinic of Pediatrics and Pediatric Dentistry of Dr. Truhmanov

Email: krawww@mail.ru
ORCID iD: 0000-0002-0400-7846
SPIN 代码: 3289-0591

MD, Cand. Sci. (Med.), Associate Professor

俄罗斯联邦, Engels

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2. Fig. 3. Patient A., diagnosis: “Common acne, medium severity”: а ― before treatment; b ― after treatment.

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3. Fig. 4. Patient K., diagnosis: “Common acne, medium severity”: а ― before treatment; b ― after treatment.

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4. Fig. 1. Immunopathogenesis of acne (adapted from [Farfán J, Gonzalez JM, Vives M. The immunomodulatory potential of phage therapy to treat acne: a review on bacterial lysis and immunomodulation. Peer J. 2022;10:e13553. doi: 10.7717/peerj.13553]): 1 ― triggers are recognized by sebocyte and keratinocyte receptors; 2 ― seborrhea; 3 ― production of inflammatory cytokines and metalloproteinases; 4 ― activation of dendritic cells; 5 ― production of palmetic acid; 6 ― follicular hyperkeratosis and proliferation of C. acnes; 7 ― inflammation; 8 ― Th1-immune response; 9 ― activation of phagocytosis; 10 ― decreased control role of Tregs over keratinocyte proliferation; 11 ― leukocyte infiltration. NF-κB ― nuclear factor kappa B; ROS ― reactive oxygen species; PI3 ― phosphoinositide 3-kinase; AKT ― protein kinase B; MAPK ― mitogen-activated protein kinase; mTORC1 ― mammalian target of rapamycin complex; SREBP-1 ― sterol regulatory element binding protein 1; Th ― T helper cells; Treg ― T regulatory cells; iTh ― inflammatory T helper cells; TNFα ― tumor necrosis factor α; DC ― dendritic cells.

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5. Fig. 2. Dynamics of the number of non-inflammatory and inflammatory elements of acne in the course of therapy, abs.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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