Objective

Present the latest biochemical and genomic data on the role of P.acnes/C.acnes and its phylotypes in acne

Methodology

Review of scientific literature

Results

Cutibacterium acnes 

Genomic and metagenomic studies have led to a better characterization of the different P. acnes families, and have shown that P. acnes present on the skin have different genetic characteristics. Thus, the name of P. acnes has been changed to Cutibacterium acnes (C. acnes)

C. acnes classification 

Genomic analyses have made it possible to characterize different families (phylotypes) of C. acnes: IA, IB, II and III. Some phylotypes are true commensals and contribute to skin health (II, III), while others may act as opportunistic pathogens (IA)

C. acnes and acne 

Acne is not linked to hyperproliferation of C. acnes. The same amount of C. acnes is found on the skin and in the pilosebaceous follicles of acne sufferers and healthy subjects 

An imbalance in the skin microbiome, with a predominance of C. acnes IA, combined with activation of innate immunity, could lead to this dermatosis

C. acnes and Porphyrins 

Porphyrins are produced by C. acnes and trigger an inflammatory reaction in the pilosebaceous follicle. C. acnes IA from acne patients produce more porphyrins than other subtypes

C. acnes and Biofilm 

C. acnes have the ability to form a biofilm, which makes the bacteria more resistant to their environment, and in particular to antibiotics, than non-biofilmed (planktonic) bacteria

Conclusion

These data pave the way for new therapeutic options for the management of acne, targeting the biofilm of C. acnes and/or its phylotypes