medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-8-33-38medalphabet-4354Research ArticleСтатьиВлияние системного изотретиноина на состояние микробиома кожи у больных с акнеThe effect of systemic isotretinoin on the state of the skin microbiome in patients with acnehttps://orcid.org/0000-0002-5044-5265КругловаЛ. С.KruglovaL. S.

Круглова Лариса Сергеевна, д.м.н., профессор, заведующая кафедрой дерматовенерологии и косметологии, ректор

Москва

Kruglova Larisa S., DM Sci (habil.), professor, head of Dept of Dermatovenereology and Cosmetology, rector

Moscow

kruglovals@mail.ruhttps://orcid.org/0000-0003-4920-5288ОльховскаяК. Б.OlkhovskayaK.  B.

Ольховская Кира Брониславовна, к.м.н., доцент кафедры дерматовенерологии и косметологии

Москва

Olkhovskaya Kira B., PhD Med, associate professor at Dept of Dermatovenereology and Cosmetology

Moscow

olhovskaya_kira@mail.ruФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of the Administrative Department of the President of RussiaRussian Federation20250406202508Дерматология (1)3338Copyright © Круглова Л.С., Ольховская К.Б., 20252025Круглова Л.С., Ольховская К.Б.Kruglova L.S., Olkhovskaya K.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4354

Изучение микробиома кожи прошло путь от первых микроскопических наблюдений до комплексного молекулярного анализа микробных сообществ и их функций с использованием ультрасовременных методов исследования. Установлено, что изменение микробиома при акне сопровождается снижением разнообразия Curibacterium acnes, а также повышением вирулентных свойств резидентной биоты с формированием предрасполагающих факторов колонизации кожи патогенными микроорганизмами. В проведенных исследованиях было показано, что эффективность системного изотретиноина при лечении больных с акне сопровождается повышением разнообразия филотипов C.acnes в фолликулярном микробиоме, нормализацией метаболической активности бактерий и снижением их количества на поверхности кожи в области пораженных участков.

The study of the skin microbiome has come a long way from the first microscopic observations to a comprehensive molecular analysis of microbial communities and their functions using cutting-edge research methods. It has been established that changes in the microbiome in acne are accompanied by a decrease in the diversity of Curibacterium acnes, as well as an increase in the virulence properties of the resident biota with the formation of predisposing factors for the colonization of the skin by pathogenic microorganisms. The studies have shown that the effectiveness of systemic isotretinoin in the treatment of patients with acne is accompanied by an increase in the diversity of C. acnes phylotypes in the follicular microbiome, normalization of the metabolic activity of bacteria and a decrease in their number on the skin surface in the affected areas.

акнемикробиомC.acnesдисбиозсистемный изотретиноинСотретacnemicrobiomeC. acnesdysbiosissystemic isotretinoinSotretReferencesKutschera U. Antonie van Leeuwenhoek (1632– 1723): Master of Fleas and Father of Microbiology. Microorganisms. 2023; 11(8): 1994. https://doi.org/10.3390/microorganisms11081994Kutschera U. Antonie van Leeuwenhoek (1632– 1723): Master of Fleas and Father of Microbiology. Microorganisms. 2023; 11(8): 1994. https://doi.org/10.3390/microorganisms11081994Smith K.A. Louis pasteur, the father of immunology? Front Immunol. 2012; 3: 68. https://doi.org/10.3389/fimmu.2012.00068Smith K.A. Louis pasteur, the father of immunology? Front Immunol. 2012; 3: 68. https://doi.org/10.3389/fimmu.2012.00068Kong H.H., Andersson B., Clavel T., et al. Performing Skin Microbiome Research: A Method to the Madness. J Invest Dermatol. 2017; 137 (3): 561–568. https://doi.org/10.1016/j.jid.2016.10.033Kong H.H., Andersson B., Clavel T., et al. Performing Skin Microbiome Research: A Method to the Madness. J Invest Dermatol. 2017; 137 (3): 561–568. https://doi.org/10.1016/j.jid.2016.10.033Lederberg J. Infectious history. Science. 2000; 288(5464): 287–293. https://doi.org/10.1126/science.288.5464.287.Lederberg J. Infectious history. Science. 2000; 288(5464): 287–293. https://doi.org/10.1126/science.288.5464.287.Николаева М.Ю., Монахов К.Н., Соколовский Е.В. Нарушения микробиома кожи при атопическом дерматите и псориазе. Вестник дерматологии и венерологии. 2021; 97 (6): 33–43. https://doi.org/10.25208/vdv1282Nikolaeva M. Yu., Monakhov K. N., Sokolovsky E. V. Skin microbiome disturbances in atopic dermatitis and psoriasis. Bulletin of Dermatology and Venereology. 2021; 97 (6): 33–43. (In Russ.). https://doi.org/10.25208/vdv1282Хушпульян Д.М., Никулин С.В., Захарянц А.А., и др. Микробиом и in vitro модели кишечника. Биотехнология. 2023; 39 (5): 82–96. https://doi.org/10.56304/S0234275823050071Khushpulyan D.M., Nikulin S.V., Zakharyants A.A., et al. Microbiome and in vitro models of the intestine. Biotechnology. 2023; 39 (5): 82–96. (In Russ.). https://doi.org/10.56304/S0234275823050071Ильина Е.Н., Майорова Е.М., Манолов А. И., и др. Микробиом кишечника и метаболизм лекарственных соединений. Biomedical Chemistry: Research and Methods. 2021; 4 (1). (In Russ.). e00146. https://doi. org/10.18097/bmcrm00146Ilyina E.N., Mayorova E.M., Manolov A.I., et al. Gut microbiome and metabolism of drug compounds. Biomedical Chemistry: Research and Methods. 2021; 4 (1): e00146. https://doi.org/10.18097/bmcrm00146Schommer N.N., Gallo R. L. Structure and function of the human skin microbiome. Trends Microbiol. 2013; 21(12): 660–668. https://doi.org/10.1016/j.tim.2013.10.001.Schommer N.N., Gallo R. L. Structure and function of the human skin microbiome. Trends Microbiol. 2013; 21(12): 660–668. https://doi.org/10.1016/j.tim.2013.10.001.Grice E.A., Kong H.H., Conlan S., et al. Topographical and temporal diversity of the human skin microbiome. Science. 2009; 324 (5931): 1190–1192. https://doi.org/10.1126/science.1171700Grice E.A., Kong H.H., Conlan S., et al. Topographical and temporal diversity of the human skin microbiome. Science. 2009; 324 (5931): 1190–1192. https://doi.org/10.1126/science.1171700Findley K., Oh J., Yang J., et al. Topographic diversity of fungal and bacterial communities in human skin. Nature. 2013; 498 (7454): 367–370. https://doi.org/10.1038/nature12171Findley K., Oh J., Yang J., et al. Topographic diversity of fungal and bacterial communities in human skin. Nature. 2013; 498 (7454): 367–370. https://doi.org/10.1038/nature12171Lacey N., Ní Raghallaigh S., Powell F. C. Demodex mites – commensals, parasites or mutualistic organisms? Dermatology. 2011; 222 (2): 128–130. https://doi.org/10.1159/000323009Lacey N., Ní Raghallaigh S., Powell F. C. Demodex mites – commensals, parasites or mutualistic organisms? Dermatology. 2011; 222 (2): 128–130. https://doi.org/10.1159/000323009Cogen A.L., Nizet V., Gallo R.L. Skin microbiota: a source of disease or defence? Br J Dermatol. 2008; 158 (3): 442–455. https://doi.org/10.1111/j.1365–2133.2008.08437.xCogen A.L., Nizet V., Gallo R.L. Skin microbiota: a source of disease or defence? Br J Dermatol. 2008; 158 (3): 442–455. https://doi.org/10.1111/j.1365–2133.2008.08437.xPanda S., Guarner F., Manichanh C. Structure and functions of the gut microbiome. Endocr Metab Immune Disord Drug Targets. 2014; 14 (4): 290–299. https://doi.org/10.2174/1871530314666140714120744Panda S., Guarner F., Manichanh C. Structure and functions of the gut microbiome. Endocr Metab Immune Disord Drug Targets. 2014; 14 (4): 290–299. https://doi.org/10.2174/1871530314666140714120744Pimentel M., Mathur R., Chang C. Gas and the microbiome. Curr Gastroenterol Rep. 2013; 15 (12): 356. https://doi.org/10.1007/s11894–013–0356-y22Pimentel M., Mathur R., Chang C. Gas and the microbiome. Curr Gastroenterol Rep. 2013; 15 (12): 356. https://doi.org/10.1007/s11894–013–0356-y22Giles K., Pluvinage B., Boraston A.B. Structure of a glycoside hydrolase family 50 enzyme from a subfamily that is enriched in human gut microbiome bacteroidetes. Proteins. 2017; 85 (1): 182–187. https://doi.org/10.1002/prot.25189Giles K., Pluvinage B., Boraston A.B. Structure of a glycoside hydrolase family 50 enzyme from a subfamily that is enriched in human gut microbiome bacteroidetes. Proteins. 2017; 85 (1): 182–187. https://doi.org/10.1002/prot.25189Gloux K., Leclerc M., Iliozer H., et al. Development of high-throughput phenotyping of metagenomic clones from the human gut microbiome for modulation of eukaryotic cell growth. Appl Environ Microbiol. 2007; 73 (11): 3734–3737. https://doi.org/10.1128/AEM.02204–06Gloux K., Leclerc M., Iliozer H., et al. Development of high-throughput phenotyping of metagenomic clones from the human gut microbiome for modulation of eukaryotic cell growth. Appl Environ Microbiol. 2007; 73 (11): 3734–3737. https://doi.org/10.1128/AEM.02204–06Sudo N. Microbiome, HPA axis and production of endocrine hormones in the gut. Adv Exp Med Biol. 2014; 817: 177–194. https://doi.org/10.1007/978 1 4939 0897 4_8Sudo N. Microbiome, HPA axis and production of endocrine hormones in the gut. Adv Exp Med Biol. 2014; 817: 177–194. https://doi.org/10.1007/978 1 4939 0897 4_8Wolf A., Moissl-Eichinger C., Perras A., et al. The salivary microbiome as an indicator of car cinogenesis in patients with oropharyngeal squamous cell carcinoma: A pilot study. Sci Rep. 2017; 7(1): 5867. https://doi.org/10.1038/s41598 017 06361 2.Wolf A., Moissl-Eichinger C., Perras A., et al. The salivary microbiome as an indicator of car cinogenesis in patients with oropharyngeal squamous cell carcinoma: A pilot study. Sci Rep. 2017; 7(1): 5867. https://doi.org/10.1038/s41598 017 06361 2.Аравийская Е.Р., Соколовский Е.В. Микробиом: новая эра в изучении здоровой и патологически измененной кожи. Вестник дерматологии и венерологии. 2016; 92 (3): 102–109. https://doi.org/10.25208/0042 4609 2016 92 3 102 109Araviyskaya E.R., Sokolovsky E.V. Microbiome: a new era in the study of healthy and pathologically altered skin. Bulletin of Dermatology and Venereology. 2016; 92 (3): 102–109. https://doi.org/10.25208/0042 4609 2016 92 3 102 109 (In Russ.). https://doi.org/10.25208/0042 4609 2016 92 3 102 109Орлова Е.В., Зыбарева А.С., Смирнова Л.М., и др. Современное представление о структуре микробиоты кожи при различных дерматозах. Российский журнал кожных и венерических болезней. 2019; 22 (3–4): 97–103.Orlova E.V., Zybareva A.S., Smirnova L.M., et al. Modern understanding of the structure of skin microbiota in various dermatoses. Russian Journal of Skin and Venereal Diseases. 2019; 22 (3–4): 97–103. (In Russ.).Kim H., Lee K., Lee J.Y., et al. Distinct Cutibacterium acnes subspecies defendens strains classified by multi-omics dissection alleviate inflammatory skin lesions of a rosacea-like mouse model. Front Microbiomes. 2024; 3: 1362408. https://doi.org/10.3389/frmbi.2024.1362408Kim H., Lee K., Lee J.Y., et al. Distinct Cutibacterium acnes subspecies defendens strains classified by multi-omics dissection alleviate inflammatory skin lesions of a rosacea-like mouse model. Front Microbiomes. 2024; 3: 1362408. https://doi.org/10.3389/frmbi.2024.1362408Boyanova L. Cutibacterium Acnes (Formerly Propionibacterium Acnes): Friend or Foe? Future Microbiol. 2023; 18 (4): 235–244. https://doi.org/10.2217/fmb 2022–0191Boyanova L. Cutibacterium Acnes (Formerly Propionibacterium Acnes): Friend or Foe? Future Microbiol. 2023; 18 (4): 235–244. https://doi.org/10.2217/fmb 2022–0191Dréno B., Dagnelie M.A., Khammari A., Corvec S. The Skin Microbiome: A New Actor in Inflammatory Acne. American Journal of Clinical Dermatology. 2020; 21 (S1): 18–24. https://doi.org/10.1007/s40257 020 00531 1Dréno B., Dagnelie M.A., Khammari A., Corvec S. The Skin Microbiome: A New Actor in Inflammatory Acne. American Journal of Clinical Dermatology. 2020; 21 (S1): 18–24. https://doi.org/10.1007/s40257 020 00531 1Christensen G. J., Scholz C. F., Enghild J., et al. Antagonism between Staphylococcus epidermidis and Propionibacterium acnes and its genomic basis. BMC Genom. 2016; 29 (17): 152. https://doi.org/10.1186/s12864 016 2489 5Christensen G. J., Scholz C. F., Enghild J., et al. Antagonism between Staphylococcus epidermidis and Propionibacterium acnes and its genomic basis. BMC Genom. 2016; 29 (17): 152. https://doi.org/10.1186/s12864 016 2489 5Claudel J.P., Auffret N., Leccia M.T., et al. Staphylococcus epidermidis: a potential new player in the physiopathology of acne? Dermatology. 2019; 235 (4): 287–294. https://doi.org/10.1159/000499858Claudel J.P., Auffret N., Leccia M.T., et al. Staphylococcus epidermidis: a potential new player in the physiopathology of acne? Dermatology. 2019; 235 (4): 287–294. https://doi.org/10.1159/000499858Nied´zwiedzka A., Micallef M.P., Biazzo M., Podrini C. The Role of the Skin Microbiome in Acne: Challenges and Future Therapeutic Opportunities. Int J Mol Sci. 2024; 25 (21): 11422. https://doi.org/10.3390/ijms252111422Nied´zwiedzka A., Micallef M.P., Biazzo M., Podrini C. The Role of the Skin Microbiome in Acne: Challenges and Future Therapeutic Opportunities. Int J Mol Sci. 2024; 25 (21): 11422. https://doi.org/10.3390/ijms252111422Böni R., Nehrhoff B. Treatment of Gram-Negative Folliculitis in Patients with Acne. Am J. Clin Dermatol. 2003; 4 (4): 273–276. https://doi.org/10.2165/00128071 200304040 00005Böni R., Nehrhoff B. Treatment of Gram-Negative Folliculitis in Patients with Acne. Am J. Clin Dermatol. 2003; 4 (4): 273–276. https://doi.org/10.2165/00128071 200304040 00005Semba R.D. On the ‘discovery’ of vitamin A. Ann Nutr Metab. 2012; 61 (3): 192–198. https://doi.org/10.1159/000343124Semba R.D. On the ‘discovery’ of vitamin A. Ann Nutr Metab. 2012; 61 (3): 192–198. https://doi.org/10.1159/000343124Reynolds R.V., Yeung H., Cheng C.E., et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024; 90 (5): 1006.e1–1006.e30. https://doi.org/10.1016/j.jaad.2023.12.017Reynolds R.V., Yeung H., Cheng C.E., et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024; 90 (5): 1006.e1–1006.e30. https://doi.org/10.1016/j.jaad.2023.12.017Thiboutot D.M., Dréno B., Abanmi A., et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018; 78 (2 Suppl 1): S1–S23.e1. https://doi.org/10.1016/j.jaad.2017.09.078Thiboutot D.M., Dréno B., Abanmi A., et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018; 78 (2 Suppl 1): S1–S23.e1. https://doi.org/10.1016/j.jaad.2017.09.078Ryan-Kewley A.E., Williams D.R., Hepburn N., Dixon R.A. Non-antibiotic Isotretinoin Treatment Differentially Controls Propionibacterium acnes on Skin of Acne Patients. Front Microbiol. 2017; 8: 1381. https://doi.org/10.3389/fmicb.2017.01381Ryan-Kewley A.E., Williams D.R., Hepburn N., Dixon R.A. Non-antibiotic Isotretinoin Treatment Differentially Controls Propionibacterium acnes on Skin of Acne Patients. Front Microbiol. 2017; 8: 1381. https://doi.org/10.3389/fmicb.2017.01381Kelhala H.L., Aho V. T.E., Fyhrquist N., et al. Isotretinoin and lymecycline treatments modify the skin microbiota in acne. Exp Dermatol. 2018; 27 (1): 30–36. https://doi.org/10.1111/exd.13397Kelhala H.L., Aho V. T.E., Fyhrquist N., et al. Isotretinoin and lymecycline treatments modify the skin microbiota in acne. Exp Dermatol. 2018; 27 (1): 30–36. https://doi.org/10.1111/exd.13397McCoy W.H. 4th, Otchere E., Rosa B.A., et al. Skin ecology during sebaceous drought-how skin microbes respond to Isotretinoin. J Invest Dermatol. 2019; 139 (3): 732–735. https://doi.org/10.1016/j.jid.2018.09.023McCoy W.H. 4th, Otchere E., Rosa B.A., et al. Skin ecology during sebaceous drought-how skin microbes respond to Isotretinoin. J Invest Dermatol. 2019; 139 (3): 732–735. https://doi.org/10.1016/j.jid.2018.09.023Nolan Z. T., Banerjee K., Cong Z., et al. Treatment response to isotretinoin correlates with specific shifts in Cutibacterium acnes strain composition within the follicular microbiome. Exp Dermatol. 2023; 32 (7): 955–964. https://doi.org/10.1111/exd.14798Nolan Z. T., Banerjee K., Cong Z., et al. Treatment response to isotretinoin correlates with specific shifts in Cutibacterium acnes strain composition within the follicular microbiome. Exp Dermatol. 2023; 32 (7): 955–964. https://doi.org/10.1111/exd.14798Перламутров Ю.Н., Ольховская К.Б. Клиническая эффективность и профиль безопасности системного изотретиноина в терапии акне. Клиническая дерматология и венерология. 2020; 19 (5): 730–736. https://doi.org/10.17116/ klinderma202019051730.Perlamutrov Yu.N., Olkhovskaya K.B. Clinical efficacy and safety profile of systemic isotretinoin in acne therapy. Clinical dermatology and venereology. 2020; 19 (5): 730–736. https://doi.org/10.17116/klinderma202019051730 (In Russ.). https://doi.org/10.17116/klinderma202019051730.

The authors declare that there are no conflicts of interest present.