Mohammadi Mehrdad
Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, 8715973449, Iran.
Arch Dermatol Res. 2024 Dec 7;317(1):84. doi: 10.1007/s00403-024-03585-x.
The skin microbiome, encompassing a variety of microorganisms, plays a critical role in skin health and function. Acne vulgaris, affecting approximately 9.4% of the global population, is a prevalent skin condition primarily targeting pilosebaceous units rich in sebaceous glands. The condition is influenced by factors such as hormonal changes, sebaceous gland dysfunction, and the activity of Cutibacterium acnes, a gram-positive bacterium linked to acne development. The skin's immune system, particularly keratinocytes with pattern recognition receptors like Toll-like receptors (TLRs), plays a crucial role in recognizing and responding to bacterial presence. The onset of acne is often linked to adolescence, marked by significant hormonal fluctuations. Genetics also plays a role, with family history being a notable risk factor. Acne is characterized by distinct alterations in the C. acnes composition, with specific phylotypes associated with either commensal or pathogenic behavior. Traditional treatments include antibiotics, but the rise of antibiotic resistance has led to exploring alternative therapies, such as bacteriophage therapy. Bacteriophages offer a targeted approach to treating acne by targeting C. acnes strains, potentially reducing antibiotic resistance and enhancing treatment efficacy. Phage therapy shows promise, but further research is needed to fully understand its effectiveness and potential in clinical applications. Additionally, combining phages with antibiotics may offer a synergistic approach to overcoming antibiotic resistance and managing acne.
皮肤微生物群包含多种微生物，在皮肤健康和功能中起着关键作用。寻常痤疮影响着全球约9.4%的人口，是一种常见的皮肤疾病，主要针对富含皮脂腺的毛囊皮脂腺单位。这种疾病受激素变化、皮脂腺功能障碍以及痤疮丙酸杆菌（一种与痤疮发展相关的革兰氏阳性细菌）的活性等因素影响。皮肤免疫系统，特别是具有Toll样受体（TLRs）等模式识别受体的角质形成细胞，在识别和应对细菌存在方面起着关键作用。痤疮的发病通常与青春期有关，其特点是激素大幅波动。遗传因素也起作用，家族病史是一个显著的风险因素。痤疮的特征在于痤疮丙酸杆菌组成的明显改变，特定的系统发育型与共生或致病行为相关。传统治疗方法包括使用抗生素，但抗生素耐药性的增加促使人们探索替代疗法，如噬菌体疗法。噬菌体通过靶向痤疮丙酸杆菌菌株提供了一种治疗痤疮的靶向方法，有可能降低抗生素耐药性并提高治疗效果。噬菌体疗法显示出前景，但需要进一步研究以充分了解其在临床应用中的有效性和潜力。此外，将噬菌体与抗生素联合使用可能提供一种协同方法来克服抗生素耐药性并治疗痤疮。
