Is Acne vulgaris a Genuine Inflammatory Disease?
Abstract
Bacterial hypercolonization of the sebaceous follicle, especially with Propionibacterium acnes, has been considered as a major causative factor for acne vulgaris [1, 2]. In addition, it is widely accepted that inflammation in acne may be mainly mediated by an immunological reaction to extracellular products of P. acnes, such as sebum free fatty acids which are proposed to be products of triglyceride metabolism induced by follicular bacteria [1–3]. However, it is by no means clear that either bacteria or their products initiate follicular inflammation. P. acnes is found both in acne and normal pilosebaceous units [4]; therefore, its role in acne cannot be explained by its presence in the follicle. In addition, the number of follicular bacteria on untreated skin of acne patients does not correlate with the grade of severity of acne [1]; high numbers of follicular bacteria have also been found in individuals without acne.
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Accumulation of lipid peroxides, specifically squalene peroxide, activates PPARs, stimulates keratinocyte proliferation and lipoxygenase activity, and overall increases the expression and secretion of proinflammatory cytokines in acne.
“Another interesting aspect of the detected changes is the accumulation of lipid peroxides, specifically squalene peroxide, which activates the Peroxisome Proliferator Activated Receptors (PPARs), stimulate keratinocyte proliferation and lipoxygenase (LOX) activity, overall increasing the expression and secretion of proinflammatory cytokines in acne.27-29”
From Sebaceous-immunobiology is orchestrated by sebum lipids (2017) · cites this paper as [28]
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New developments in our understanding of acne pathogenesis and treatment
Kurokawa, I., Danby, F. W., Ju, Q., Wang, X., Xiang, L. F., Xia, L., Chen, W., Nagy, I., Picardo, M., Suh, D. H., et al. (2009) · Experimental Dermatology · doi:10.1111/j.1600-0625.2009.00890.x · Cited by 584 · see citing works
Self-citationAcne and sebaceous gland function
Zouboulis, C. C. (2004) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2004.03.004 · Cited by 561 · see citing works
Self-citationSebaceous-immunobiology is orchestrated by sebum lipids
Lovászi, M., Szegedi, A., Zouboulis, C. C., & Törőcsik, D. (2017) · Dermato-Endocrinology · doi:10.1080/19381980.2017.1375636 · Cited by 151 · see citing works
Self-citationSebum lipids influence macrophage polarization and activation
Lovászi, M., Mattii, M., Eyerich, K., Gácsi, A., Csányi, E., Kovács, D., Rühl, R., Szegedi, A., Kemény, L., Ståhle, M., et al. (2017) · British Journal of Dermatology · doi:10.1111/bjd.15754 · Cited by 88 · see citing works
Self-citationSkin steroidogenesis in health and disease
Nikolakis, G., Stratakis, C. A., Kanaki, T., Slominski, A., & Zouboulis, C. C. (2016) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-016-9390-z · Cited by 76 · see citing works
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- Authors
- Zouboulis, C. C.
- Affiliations
- Freie Universität Berlin (DE)
- Corresponding author
- Zouboulis, Christos C.
- Venue
- Dermatology
- Publisher
- S. Karger AG
- Published
- 2001
- Volume
- 203
- Issue
- 4
- Pages
- 277-279
- ISSN
- 1018-8665 (ISSN-L)
- 1421-9832
- OpenAlex
- W2055292191
- Cited by
- 130
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 9 · 2019: 5 · 2018: 6 · 2017: 8 · 2016: 4 · 2015: 4 · 2014: 15 · 2013: 7 · 2012: 4
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Keywords
- acne, Propionibacterium acnes, sebaceous follicles, follicular inflammation, triglyceride metabolism, inflammatory diseases
- MeSH terms
- Acne Vulgaris, Anti-Inflammatory Agents, Humans, Inflammation, Interleukin-1, Leukotriene B4, Propionibacterium acnes, Sebaceous Glands, Transcription Factors, Receptors, Cytoplasmic and Nuclear
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