Unraveling the Complexities of Acne: A Microbiome and Endobolome Perspective
Acne vulgaris, a dermatological condition that has perplexed physicians and researchers for decades, is undergoing a radical reconsideration in light of emerging evidence pointing to the interconnected role of the gut microbiome, endobolome, and skin microecology. The pathophysiology of acne, initially attributed to factors such as genetics, hormonal fluctuations, and the bacterium Cutibacterium acnes, is now being reevaluated through the lens of microbial dysbiosis and its systemic impacts.
The gut-skin axis represents a bidirectional communication pathway whereby the gut microbiota influences skin homeostasis through its modulatory effect on systemic immunity. Lee, Byun, and Kim (2019) elaborated on this interaction, highlighting how gut dysbiosis can lead to the translocation of microbiota and their metabolites into the bloodstream, ultimately accumulating in the skin and disrupting its equilibrium. This process underscores the intricate relationship between internal microbial populations and skin health, suggesting a direct influence of the gut microbiota on the cutaneous microbial landscape, particularly through the production of short-chain fatty acids (SCFAs).
The elucidation of the mechanism behind acne's manifestation further converges on the gut microbiota's potential involvement via the mechanistic target of rapamycin (mTOR) pathway, a crucial regulator of cell growth, lipid metabolism, and inflammation. Dréno et al. (2020) observed that gut dysbiosis might establish a feedback loop exacerbating host metabolism disruptions and inflammation, a condition conducive to acne proliferation. The interaction between mTOR signaling and gut microbiota delineates a fascinating avenue, suggesting that the modulation of intestinal flora could influence acne severity and occurrence.
Adding another layer to the complexity, the correlation between stress, gut dysbiosis, and acne development posits an intriguing perspective on acne's exacerbation in response to psychological stressors. The alteration of gut microflora composition, particularly the reduction of Lactobacillus and Bifidobacterium species, reveals the profound influence of stress on the gut-skin axis. This interaction exemplifies the systemic nature of acne, where neurotransmitters produced by distressed gut microbes can incite systemic inflammation, thereby aggravating cutaneous conditions.
The endobolome, defined by Aguilera, Gálvez-Ontiveros, and Rivas (2020) as the metabolic interface orchestrated by the gut microbiota in relation to endocrine-disrupting chemicals (EDCs) and endogenous steroids, introduces a novel dimension to acne's etiology. The bi-directional interaction between hormones, EDCs, and gut microbiota illuminates the multifaceted role of the microbial environment in modulating hormone balance and, consequently, skin health. The concept of "microbiota disrupting chemicals" (MDCs) emerges as a pivotal point of consideration, advocating for a holistic approach in evaluating the risk of hormonal dysregulation and its repercussions on disorders like acne.
The intricate dance between the gut microbiome, endobolome, and skin microbiota reshapes our understanding of acne from a condition rooted in bacterial overgrowth to a systemic issue influenced by microbial dysbiosis and hormonal interplays. This paradigm shift underscores the need for acne treatments that extend beyond conventional antibiotic therapy, which may exacerbate cutaneous dysbiosis. Instead, the future of acne management may lie in therapeutic approaches aimed at restoring microbial harmony and hormonal balance, casting a spotlight on probiotics, prebiotics, and diet modifications as potential avenues for intervention.
Our comprehension of acne's pathophysiology is on the cusp of a significant transform, propelled by the growing acknowledgment of the gut-skin axis, the critical role of the endobolome, and the importance of microbial diversity in maintaining cutaneous harmony. The promising avenue of research that integrates these multifaceted interactions offers hope for innovative, effective treatments that address the root causes of acne, fostering a future where this pervasive condition can be managed with greater efficacy and insight.
10 things to improve acne and microbiome
Eat a Whole-Food Diet, Berries and Beans
Reduce Stress
Hydrate
Eat Cruciferous Vegetables
Eat Fermented Foods
Red Light Therapy
Eat Dandelion Root
Maca Powder
vitamin B12, A, D
omega 3
zinc
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References
Lee YB, Byun EJ, Kim HS. Potential Role of the Microbiome in Acne: A Comprehensive Review. J Clin Med. 2019 Jul 7;8(7):987. doi: 10.3390/jcm8070987. PMID: 31284694; PMCID: PMC6678709.
Aguilera M, Gálvez-Ontiveros Y, Rivas A. Endobolome, a New Concept for Determining the Influence of Microbiota Disrupting Chemicals (MDC) in Relation to Specific Endocrine Pathogenesis. Front Microbiol. 2020 Nov 30;11:578007. doi: 10.3389/fmicb.2020.578007. PMID: 33329442; PMCID: PMC7733930.
Dréno B, Dagnelie MA, Khammari A, Corvec S. The Skin Microbiome: A New Actor in Inflammatory Acne. Am J Clin Dermatol. 2020 Sep;21(Suppl 1):18-24. doi: 10.1007/s40257-020-00531-1. PMID: 32910436; PMCID: PMC7584556.
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