Acne vulgaris
Acne vulgaris, commonly known as acne, is a prevalent skin condition that can significantly impact an individual’s quality of life. For many years, antibiotics have been the mainstay therapy for moderate to severe acne. However, the increasing bacterial resistance to antibiotics has become a major challenge in the medical field (Dréno et al., 2018). Therefore, new approaches are needed that not only target the bacteria responsible for acne but also restore the balance of the microbiome both on the skin and in the gut.
Antibiotic Resistance in Acne Treatment
Resistance to antibiotics is increasing, particularly for those used in the treatment of acne, which has long been the standard therapy for moderate to severe cases. Research indicates that the primary purpose of antibiotic use is to kill or reduce the activity of Cutibacterium acnesResistance to antibiotics is increasing, particularly for those used in the treatment of acne, which has long been the standard therapy for moderate to severe cases. Research indicates that the primary purpose of antibiotic use is to kill or reduce the activity of Cutibacterium acnes, the main bacterium responsible for acne. However, it has now been found that several types of antibiotics, such as doxycycline, minocycline, tetracycline, gentamicin, erythromycin, and azithromycin, have become less effective because these bacteria have developed resistance (Legiawati et al., 2023)
The Role of the Microbiome in Acne Development
The microbiome, both in the gut and on the skin, plays an important role in regulating the immune system. An imbalance in the gut microbiota (gut dysbiosis) can lead to increased intestinal permeability, allowing pro-inflammatory substances such as endotoxin lipopolysaccharides to enter the bloodstream. This can trigger a systemic inflammatory response, including in the skin, which contributes to the development of acne (Dréno et al., 2020). Therefore, maintaining microbiome balance represents a potential approach in acne treatment.
Probiotics as an Adjunct Therapy for Acne
Probiotics, which contain beneficial bacteria such as Lactobacillus and Bifidobacterium, can help restore the balance of the gut microbiome and reduce inflammation that contributes to acne. Some benefits of probiotics in acne treatment include (Abdu-Allah, 2020; Goodarzi et al., 2020)
- Balancing the gut and skin microbiota
- Acts as an immunomodulator to reduce inflammation
- Inhibits the growth of pathogenic bacteria that cause acne
- Improves the integrity of the gut lining to prevent leakage of inflammatory substances
- Increases the production of metabolites such as SCFAs (short-chain fatty acids), tryptophan, and bacteriocins, which act as natural antibacterial agents
Secretome as an Anti-Inflammatory Therapy
Besides probiotics, secretome also shows great potential in managing acne, particularly in reducing inflammation and accelerating healing. Secretome works by (Arifka & Wathoni et al., 2022; Műzes et al., 2022; Marx et al., 2021):
- Inhibits inflammatory signaling pathways such as STAT3, TLR4, and NFκB
- Reduces the production of pro-inflammatory cytokines such as IL-1β, IL-6, IL-17, TNFα, and IFNγ
- Promotes the conversion of M1 macrophages to anti-inflammatory M2 macrophages
- Accelerates wound healing by enhancing keratinocyte migration
- Reduces the risk of scar formation by inhibiting the TGFβ1,2/SMAD and Wnt/β-Catenin pathways
This new approach using probiotics and secretome offers new hope for the treatment of acne vulgaris, especially for those who experience antibiotic resistance or wish to avoid the side effects of conventional therapy.
ProSTEM, together with Apt. Ida Ayu Manik Partha Sutema, S.Farm., M.Farm., conducted research to examine a new approach using probiotics and secretome in providing new hope for the treatment of acne vulgaris.
Reference
Abdu-Allah, S.N., Magtooph, M.G. and Mahmood Alubadi, A.E. (2020). Effect of cell-free supernatants (CFS) of lactobacillus acidophilus and bacillus subtilis against staphylococcus aureus isolated from acne vulgaris and biofilm formation. Biochemical and Cellular Archives, 20(1), pp. 1703–1709. Available at: https://doi.org/10.35124/bca.2020.20.1.1703
Arifka, M., Wilar, G., Elamin, K. M., & Wathoni, N. (2022). Polymeric Hydrogels as Mesenchymal Stem Cell Secretome Delivery System in Biomedical Applications. Polymers, 14(6), 1218. https://doi.org/10.3390/polym14061218
Dréno, B., Pécastaings, S., Corvec, S., Veraldi, S., Khammari, A., & Roques, C. (2018). Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a brief look at the latest updates. Journal of the European Academy of Dermatology and Venereology : JEADV, 32 Suppl 2, 5–14. https://doi.org/10.1111/jdv.15043
Dréno, B., Dagnelie, M. A., Khammari, A., & Corvec, S. (2020). The Skin Microbiome: A New Actor in Inflammatory Acne. American journal of clinical dermatology, 21(Suppl 1), 18–24. https://doi.org/10.1007/s40257-020-00531-1
Goodarzi, A., Mozafarpoor, S., Bodaghabadi, M., & Mohamadi, M. (2020). The potential of probiotics for treating acne vulgaris: A review of literature on acne and microbiota. Dermatologic therapy, 33(3), e13279. https://doi.org/10.1111/dth.13279
Legiawati, L., Halim, P. A., Fitriani, M., Hikmahrachim, H. G., & Lim, H. W. (2023). Microbiomes in Acne Vulgaris and Their Susceptibility to Antibiotics in Indonesia: A Systematic Review and Meta-Analysis. Antibiotics (Basel, Switzerland), 12(1), 145. https://doi.org/10.3390/antibiotics12010145
Marx, C., Gardner, S., Harman, R. M., Wagner, B., & Van de Walle, G. R. (2021). Mesenchymal stromal cell-secreted CCL2 promotes antibacterial defense mechanisms through increased antimicrobial peptide expression in keratinocytes. Stem cells translational medicine, 10(12), 1666–1679. https://doi.org/10.1002/sctm.21-0058
Műzes, G., & Sipos, F. (2022). Mesenchymal Stem Cell-Derived Secretome: A Potential Therapeutic Option for Autoimmune and Immune-Mediated Inflammatory Diseases. Cells, 11(15), 2300. https://doi.org/10.3390/cells11152300
