Recent advances in understanding Propionibacterium acnes (Cutibacterium acnes) in acne

Abstract

The skin commensal <i>Propionibacterium acnes</i>, recently renamed <i>Cutibacterium acnes</i>, along with the other major pathophysiological factors of increased seborrhea, hyperkeratinization of the pilosebaceous unit, and inflammation, has long been implicated in the pathogenesis of acne. Recent advances have contributed to our understanding of the role of <i>P. acnes</i> in acne. Although there are no quantitative differences in <i>P. acnes</i> of the skin of patients with acne compared with controls, the <i>P. acnes</i> phylogenic groups display distinct genetic and phenotypic characteristics, <i>P. acnes</i> biofilms are more frequent in acne, and different phylotypes may induce distinct immune responses in acne. <i>P. acnes</i> plays a further important role in the homeostasis of the skin's microbiome, interacting with other cutaneous commensal or pathogenic microorganisms such as <i>Staphylococcus epidermidis</i>, <i>Streptococcus pyogenes</i>, and <i>Pseudomonas</i> species. In the era of increasing antimicrobial resistance, the selection of acne treatment targeting <i>P. acnes</i> and the prevention of antibiotic resistance play a key role in improving outcomes in acne patients and public health.