Rola Propionibacterium acnes ( P. acnes) w patogenezie trądziku pospolitego

*Anna Michalak-Stoma, Grażyna Chodorowska, Maria Juszkiewicz-Borowiec, Agnieszka Gerkowicz, Joanna Bartosińska

Summary
Acne vulgaris is a disease of the pilosebaceous follicle. The pathogenesis of acne is multifactorial and not fully elucidated. The most important factors are: increased serum, ductal epidermal hyperproliferation, Propionibacterium acnes ( P. acnes) colonization, inflammation, hormonal and genetic disturbances. Immune abnormalities, hyperreactivity of pilosebaceous follicle, psychological, physical and iatrogenic factors can also take part in acne pathogenesis. Although P. acnes has been implicated in acne pathogenesis, the exact mechanism of action in the acne lesion formation is not well known. The recognition of P. acnes genome and Toll-like receptor (TLR) function had a great impact. This microorganism can be involved in inflammation as well as in comedogenesis. An acute inflammatory reaction in acne can be the result of an innate immune response, in which TLRs are involved, and Th1 adaptive immune response for specific antigens of P. acnes. These bacteria take part in the complement activation, release proinflammatory factors and they are mitogenic for T cells. Further studies concerning the role of P. acnes, TLR and the interaction of the skin microflora on the immune response can help develop innovative therapies for acne vulgaris. The knowledge about the biofilm of P. acnes is also very important to develop new medications which can reduce the bacteria adhesion to the epithelium and decrease extracellular matrix production by changes of the pilosebaceous follicle microenvironment.

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