The never-ending debate around the best treatments for Acne Vulgaris could soon be resolved with the arrival of a new vaccine. Although still in development, a study published last week in the Journal of Investigative Dermatology reports important steps have been taken towards further development.
Though only trialled on mice and human tissue samples so far, researchers found, for the first time, that antibodies to a toxin secreted by an acne-causing bacteria can reduce inflammation in acne lesions.
“Once validated by a large-scale clinical trial, the potential impact of our findings is huge for the hundreds of millions of individuals suffering from acne vulgaris,” explained lead investigator Chun-Ming Huang, PhD, Department of Dermatology, University of California, San Diego.
“Current treatment options are often not effective or tolerable for many of the 85 percent of adolescents and more than 40 million adults in the United States who suffer from this multi-factorial cutaneous inflammatory condition. New, safe, and efficient therapies are sorely needed.”
This vaccine would be the first to target bacteria already in human skin, instead of invading pathogens. The bacteria targeted is the Propionibacterium Acnes (P. acnes) bacteria, which secretes a toxin called Christie-Atkins-Munch-Peterson (CAMP) factor; which can induce inflammatory responses. The latest trials show that, with the application of monoclonal antibodies to the CAMP toxin, the inflammatory response was reduced.
With instances of acne in adults are on the rise, many are welcoming the developments, and according to Joshua Zeichner; an acne specialist and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York, “the incidence of adult female acne is increasing every year.”
Others however are skeptical of the vaccine, arguing that it has too narrow a target, and may be a positive solution when coupled with other traditional treatments such as medication or topical treatments. This includes New York Dermatologist and founder of clinic Derma di Colore, Carlos Charles. “I wouldn’t envision it being a single agent but it may help to pare down some of the other things that we do.”
In his response to the new study, Emmanuel Contassot from the Dermatology Department, University Hospital and Faculty of Medicine of the University of Zürich, wrote: “While addressing an unmet medical need and providing an appealing approach, acne immunotherapies that target P. acnes-derived factors have to be cautiously designed to avoid unwanted disturbance of the microbiome that guarantees skin homeostasis. Whether or not CAMP factor-targeted vaccines will impact multiple P. acnes subtypes and other commensals has to be determined, but acne immunotherapy presents an interesting avenue to explore nonetheless.”
The next step, according to Huang, is further developing the vaccine for human trials. “The choice of the antigen to be targeted is critical, not only as a determinant of the efficacy of the vaccine, but also to minimize possible unintended effects or cross-reactivity impairing the microbial equilibrium and skin barrier homeostasis. Future studies will address these factors and focus on engineering a non-toxic chemical or targeted vaccine formulation for its human application.”