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Monday, May 1, 2017

A Vaccine to Cure Acne? by Kate Raines and Barbara Loe Fisher

Future Vaccines
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A Vaccine to Cure Acne?

girl with acne and white maskStory Highlights
  • Acne, which affects up to 50 million people in the U.S. annually, is the primary reason people seek the advice of a dermatologist.
  • The role of inflammation in the pathology of acne has been confirmed, with some scientists linking it to an inflammatory reaction to Christie-Atkins-Munch-Peterson factor, a toxic byproduct of the common skin bacterium Propionibacterium acnes.
  • Researchers at the University of California in San Diego have signed a contract with Sanofi Pasteur to develop a vaccine they say will prevent and cure acne.
Acne, one of the more universal causes of teenage angst, affects many adults as well. A chronic inflammatory disease condition,1 the role of inflammation in the pathology of acne has been confirmed but there are questions about exactly how and why some people develop severe types of acne and others do not.2

Some researchers believe the chronic inflammatory skin condition may be caused by an overactive inflammatory response to Propionibacterium acnes (P. acnes), a type of bacteria that is normally present on everyone’s skin, and that an “immunological approach to acne prevention and treatment” in the form of a vaccine can offer the cure.3
Acne may be experienced by as many as 85 percent of all people at some point in their life. Affecting up to 50 million people in the United States every year, acne is the number one condition treated by dermatologists.4 It is estimated that treating acne in the U.S. alone is a $3 billion industry. 5

All Causes and Mechanisms for Acne Not Known

Although all the causes and biological mechanisms for development of acne are not known, over the years, researchers have suggested a number of factors are associated with an increased risk of developing acne, such as heredity, hormonal changes, skin stressors like lotions or oils, and physical pressure on or irritation of the skin from things like telephones or backpacks.6 Studies also have suggested a link between a diet high in dairy and sugar and an increased risk of developing acne.7
Other studies have provided evidence that vitamin D deficiency plays a role in acne8 and that low dose vitamin A therapy can lessen its severity.9 
P. acnes is an anaerobic bacterium that feeds on the sebum at the base of hair follicles. Overgrowth of the bacteria may cause one of two immune system reactions that can lead to acne: In the first mechanism, a hypersensitive immune response floods the area with inflammatory cytokines, releasing free radicals and digestive enzymes at the source of the bacteria. The resulting inflammation often causes “collateral damage” to surrounding tissue; the second action may reflect inadequate bacterial killing abilities.10
P. acnes itself is not the culprit in acne and actually has a number of beneficial attributes to the body, including its capability for provoking a powerful nonspecific immune system reaction. In fact, it has been suggested that P. acnes might historically have contributed to natural protection against such life-threatening diseases as malaria and plague.11

Sanofi Pasteur Collaborates with University of California to Develop Acne Vaccine

In 2011, Sanofi Pasteur announced that the corporation had signed an exclusive research and development contract with the University of California to create an acne vaccine “targeting the specific neutralization of Proppionibacterium acnes factors in inflammation.”12

The group of scientists developing the acne vaccine at the University of California, San Diego are led by Professor Eric Huang. They believe that the inflammatory response responsible for the chain of events leading to acne are triggered when the bacterium releases a toxin known as the secretory Christie-Atkins-Munch-Peterson (CAMP) factor, which the body is not able to neutralize by itself.

An Acne Vaccine for School Kids

These researchers have developed two types of vaccines designed to neutralize the CAMP factor, which drives the overgrowth process leading to acne, without killing the bacteria itself.13 14 The first vaccine is a traditional preventive vaccine and is planned for injection at the elementary school level. The second is a so-called “therapeutic vaccine,” designed for topical application in someone who has already developed acne.
In a recent article in Business Insider, Professor Huang talked about how his team was creating a vaccine that blocks the ability of the bacteria to cause acne without killing the bacteria:
Acne is caused, in part, by P. acnes bacteria that are with you your whole life—and we couldn’t create a vaccine for the bacteria because, in some ways, P. acnes are good for you. But we found an antibody to a toxic protein that P. acnes bacteria secrete on skin—the protein is associated with the inflammation that leads to acne.15
According to Huang, the experimental vaccine has been tested on skin biopsies taken from patients with acne and human clinical trials will be underway soon and could take one to two years.15


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