Linking diet to acne metabolomics, inflammation, and comedogenesis: an update
Open accessAbstract
Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Diet-induced insulin/insulin-like growth factor (IGF-1)-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs), glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1). Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1), the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ), liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c), crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea) and composition (dysseborrhea) promote Propionibacterium acnes overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a "danger signal," stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte proliferation. Oleate stimulates P. acnes adhesion, keratinocyte proliferation, and comedogenesis via interleukin-1α release. Thus, diet-induced metabolomic alterations promote the visible sebofollicular inflammasomopathy acne vulgaris. Nutrition therapy of acne has to increase FoxO1 and to attenuate mTORC1/SREBP-1c signaling. Patients should balance total calorie uptake and restrict refined carbohydrates, milk, dairy protein supplements, saturated fats, and trans-fats. A paleolithic-like diet enriched in vegetables and fish is recommended. Plant-derived mTORC1 inhibitors and ω-3-PUFAs are promising dietary supplements supporting nutrition therapy of acne vulgaris.
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P. acnes is an anaerobic bacterium capable of metabolizing sebaceous triglycerides into free fatty acids on the surface of the skin via its lipases and peroxidases.
“One of the most studied colonizing member is P. acnes, an anaerobic bacterium, which is capable of metabolizing sebaceous triglycerides into FFA on the surface of the skin via its lipases and peroxidases.56,57”
From Sebaceous-immunobiology is orchestrated by sebum lipids (2017) · cites this paper as [57]
The “Western diet promotes NRLP3 inflammasome activation” section (page not provided) says P. acnes triglyceride lipase increases free palmitate and oleate in sebum. It does not attribute that conversion to peroxidases or locate it specifically on the skin surface; it describes follicular activity instead. (LLM, conf=0.88)
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- [236]Melnik BC Western-diet mediated mTORC1 signaling in acne, psoriasis, atopic dermatitis, and related disorders of civilization: therapeutic role of plant-derived natural mTORC1 inhibitors Watson RR Zibadi S Biocative Dietary Factors and Plant Extracts in Dermatology New York, NY Springer Science + Business Media 2013 397 419
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Nutritional and Microbial Strategies for Treating Acne, Alopecia, and Atopic Dermatitis
Borrego-Ruiz, A., & Borrego, J. J. (2024) · Nutrients · doi:10.3390/nu16203559 · Cited by 26 · see citing works
Melnik, B. C. (2015) · Experimental Dermatology · doi:10.1111/exd.12917 · Cited by 20 · see citing works
Self-citationHao, T., Chen, H., Wu, S., & Tian, H. (2019) · Molecular Medicine Reports · doi:10.3892/mmr.2019.10304 · Cited by 20 · see citing works
Significance of host antimicrobial peptides in the pathogenesis and treatment of acne vulgaris
Lesiak, A., Paprocka, P., Wnorowska, U., Mańkowska, A., Król, G., Głuszek, K., Piktel, E., Spałek, J., Okła, S., Fiedoruk, K., et al. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1502242 · Cited by 21 · see citing works
Synchronizing pharmacotherapy in acne with review of clinical care
Sacchidanand, S., Lahiri, K., Godse, K. V., Patwardhan, N. G., Ganjoo, A., Kharkar, R., Narayanan, V., Borade, D., & D'souza, L. L. (2017) · Indian Journal of Dermatology · doi:10.4103/ijd.ijd_41_17 · Cited by 19 · see citing works
Adibi, N., & ROBATI, R. M. (2021) · Journal of Research in Medical Sciences · doi:10.4103/jrms.jrms_585_20 · Cited by 18 · see citing works
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Endocrine disorders and hormonal therapy for adolescent acne
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Alpha- and gamma-mangostins exhibit anti-acne activities via multiple mechanisms
Xu, N., Deng, W., He, G., Gan, X., Gao, S., Chen, Y., Gao, Y., Xu, K., Qi, J., Lin, H., et al. (2018) · Immunopharmacology and Immunotoxicology · doi:10.1080/08923973.2018.1519831 · Cited by 18 · see citing works
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Melnik, B. C. (2017) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2017.01.026 · Cited by 16 · see citing works
Self-citationDall’Oglio, F., Milani, M., & Micali, G. (2018) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s179627 · Cited by 16 · see citing works
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Agamia, N., Mulla, K. F. E., Alsayed, N. M., Ghazala, R. A., Abdelmaksoud, R., Abdelmeniem, I. M., Talaat, I. M., Zaki, I. I., Sabah, R. M., & Melnik, B. C. (2022) · Archives of Dermatological Research · doi:10.1007/s00403-022-02508-y · Cited by 18 · see citing works
Self-citation
- Authors
- Melnik, B.
- Affiliations
- Osnabrück University (DE)
- Corresponding author
- Melnik, Bodo
- ORCID
- Melnik, Bodo
- Venue
- Clinical, Cosmetic and Investigational Dermatology
- Publisher
- Informa UK Limited
- Published
- 2015-07
- Volume
- 8
- Pages
- 371
- ISSN
- 1178-7015 (ISSN-L)
- PMC
- PMC4507494
- OpenAlex
- W1652147305
- Cited by
- 259
- References
- 299
- Citations by year
- 2026: 24 · 2025: 26 · 2024: 31 · 2023: 21 · 2022: 22 · 2021: 23 · 2020: 21 · 2019: 19 · 2018: 24 · 2017: 26 · 2016: 16 · 2015: 5
- FWCI
- 3.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Cosmetic and Investigational Dermatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- osnaDocs (Osnabrück University) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Lipid metabolism and biosynthesis
- Keywords
- acne, Western diet, FOXO1, mTORC1, SREBP-1c, PPARγ, insulin/IGF-1 signaling, branched-chain amino acids, glutamine, palmitate, oleate, Propionibacterium acnes, comedogenesis, inflammation, metabolomics, nutrigenomics, triacylglycerol lipase
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