Zit-face? Why some peo­ple get zits and oth­ers don't

Wellness Update - - Health Watch MD -

The bac­te­ria that cause acne live on ev­ery­one's skin, yet one in five peo­ple is lucky enough to de­velop only an oc­ca­sional pim­ple over a life­time. What's their se­cret? In a boon for teenagers every­where, a UCLA study con­ducted with re­searchers at Wash­ing­ton Univer­sity in St. Louis and the Los An­ge­les Bio­med­i­cal Re­search In­sti­tute has dis­cov­ered that acne bac­te­ria con­tain "bad" strains as­so­ci­ated with pim­ples and "good" strains that may pro­tect the skin. The find­ings, pub­lished in the Feb. 28 edi­tion of the Jour­nal of In­ves­tiga­tive Der­ma­tol­ogy, could lead to a myr­iad of new ther­a­pies to pre­vent and treat the dis­fig­ur­ing skin dis­or­der. "We learned that not all acne bac­te­ria trig­ger pim­ples — one strain ac­tu­ally may help keep skin healthy," ex­plained lead author Huiy­ing Li, an as­sis­tant pro­fes­sor of molec­u­lar and med­i­cal phar­ma­col­ogy at the David Gef­fen School of Medicine at UCLA. "We hope to ap­ply our find­ings to de­velop new strate­gies that stop blem­ishes be­fore they start, and en­able der­ma­tol­o­gists to cus­tom­ize treat­ment to each pa­tient's unique cock­tail of skin bac­te­ria." The sci­en­tists looked at a tiny mi­crobe with a big name: Pro­pi­oni­bac­terium ac­nes, bac­te­ria that

thrive in the oily depths of our pores. When the bac­te­ria ag­gra­vate the im­mune sys­tem, they cause the swollen, red bumps as­so­ci­ated with acne. Us­ing over-the-counter pore-cleans­ing strips, LA BioMed and UCLA re­searchers lifted P. ac­nes bac­te­ria from the noses of 49 pim­ply and 52 clear-skinned vol­un­teers. Af­ter ex­tract­ing the mi­cro­bial DNA from the strips, Li's lab­o­ra­tory tracked a ge­netic marker to iden­tify the bac­te­rial strains in each vol­un­teer's pores and recorded whether the per­son suf­fered from acne. Next, Li's lab cul­tured the bac­te­ria from the strips to iso­late more than 1,000 strains. Wash­ing­ton Univer­sity sci­en­tists se­quenced the genomes of 66 of the P. ac­nes strains, en­abling UCLA co-first author Shuta To­mida to zero in on genes unique to each strain. "We were in­ter­ested to learn that the bac­te­rial strains looked very dif­fer­ent when taken from dis­eased skin, com­pared to healthy skin," said co-author Dr. Noah Craft, a der­ma­tol­o­gist and di­rec­tor of the Cen­ter for Im­munother­a­peu­tics Re­search at LA BioMed at Har­bor–UCLA Med­i­cal Cen­ter. "Two unique strains of P. ac­nes ap­peared in one out of five vol­un­teers with acne but rarely oc­curred in clear-skinned peo­ple."

The big­gest dis­cov­ery was still to come. "We were ex­tremely ex­cited to un­cover a third strain of P. ac­nes that's com­mon in healthy skin yet rarely found when acne is present," said Li, who is also a mem­ber of UCLA's Crump In­sti­tute for Molec­u­lar Imag­ing. "We sus­pect that this strain con­tains a nat­u­ral de­fense mech­a­nism that en­ables it to rec­og­nize at­tack­ers and de­stroy them be­fore they in­fect the bac­te­rial cell." Of­fer­ing new hope to acne suf­fer­ers, the re­searchers be­lieve that in­creas­ing the body's friendly strain of P. ac­nes through the use of a sim­ple cream or lo­tion may help calm spotty com­plex­ions. "This P. ac­nes strain may pro­tect the skin, much like yo­gurt's live bac­te­ria help de­fend the gut from harm­ful bugs," Li said. "Our next step will be to in­ves­ti­gate whether a pro­bi­otic cream can block bad bac­te­ria from in­vad­ing the skin and pre­vent pim­ples be­fore they start." Ad­di­tional stud­ies will fo­cus on ex­plor­ing new drugs that kill bad strains of P. ac­nes while pre­serv­ing the good ones; the use of viruses to kill acne-re­lated bac­te­ria; and a sim­ple skin test to pre­dict whether a per­son will de­velop ag­gres­sive acne in the fu­ture. "Our re­search un­der­scores the im­por­tance of strain-level anal­y­sis of the world of hu­man mi­crobes to define the role of bac­te­ria in health and dis­ease," said co-author Ge­orge We­in­stock, as­so­ciate di­rec­tor of the Genome In­sti­tute and pro­fes­sor of ge­net­ics at Wash­ing­ton Univer­sity in St. Louis. "This type of anal­y­sis has a much higher res­o­lu­tion than prior stud­ies that re­lied on bac­te­rial cul­tures or only made dis­tinc­tions be­tween bac­te­rial species." Acne af­fects 80 per­cent of Amer­i­cans at some point in their lives, yet sci­en­tists know lit­tle about what causes the dis­or­der and have made limited progress in de­vel­op­ing new strate­gies for treat­ing it. Der­ma­tol­o­gists' arse­nal of anti-acne tools — ben­zoyl per­ox­ide, an­tibi­otics and Ac­cu­tane (isotretinoin) — hasn't ex­panded in decades. Most se­vere cases of acne don't re­spond to an­tibi­otics, and Ac­cu­tane can pro­duce se­ri­ous side ef­fects. -This in­for­ma­tion pro­vided courtesy of UCLA Health Sys­tems and Wash­ing­ton Univer­sity in St. Louis.

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