Ann Dermatol.  2020 Feb;32(1):21-30. 10.5021/ad.2020.32.1.21.

Minocycline and Its Impact on Microbial Dysbiosis in the Skin and Gastrointestinal Tract of Acne Patients

• Thompson K
• Rainer BM
• Antonescu
• Florea L
• Mongodin E
• Kang S
• Chien AL

• KMID: 2467197
• DOI: http://doi.org/10.5021/ad.2020.32.1.21

Abstract

BACKGROUND
Associations between acne and gastrointestinal comorbidities suggest that microbial dysbiosis and intestinal permeability may promote inflammatory acne, a condition often managed with oral antibiotics.
OBJECTIVE
We performed a case-control study to investigate the skin and gut microbiota in 8 acne patients before and after receiving oral minocycline compared to controls matched by age ±5 years, sex, and race.
METHODS
DNA was extracted from stool samples and facial skin swabs. Sequencing of the V3V4 region of the bacterial 16S rRNA gene was performed using Illumina MiSeq and analyzed using QIIME/MetaStats 2.0 software.
RESULTS
Acne patients included 7 female and 1 male, ages 20~32. Shannon diversity was not significantly different between the skin (p=0.153) or gut (p < 0.999) microbiota of acne patients before and after antibiotics. The gut microbiota in pre-antibiotic acne patients compared to acne-free controls was depleted in probiotics Lactobacillus iners (p=0.001), Lactobacillus zeae (p=0.001), and Bifidobacterium animalis (p=0.026). After antibiotics, the gut microbiota of acne patients was depleted in Lactobacillus salivarius (p=0.001), Bifidobacterium adolescentis (p=0.002), Bifidobacterium pseudolongum (p=0.010), and Bifidobacterium breve (p=0.042), while the skin microbiota was enriched in probiotics Bifidobacterium longum (p=0.028) and Leuconostoc mesenteroides (p=0.029) and depleted in Staphylococcus epidermidis (p=0.009) and Prevotella nigrescens (p=0.028). At the phylum level, significant enrichment of Bacteroidetes in stool of acne patients following antibiotic treatment (p=0.033) led to a decreased Firmicutes to Bacteroidetes ratio.
CONCLUSION
Minocycline produces significant derangements in the microbiota of the skin and gut, including many probiotic species, highlighting the potential for more targeted antimicrobial treatments for acne.

Keyword

Acne vulgaris; Bacteroidetes; Firmicutes; Microbiome; Minocycline; Propionibacterium

MeSH Terms

Acne Vulgaris*
Anti-Bacterial Agents
Bacteroidetes
Bifidobacterium
Case-Control Studies
Comorbidity
Continental Population Groups
DNA
Dysbiosis*
Female
Firmicutes
Gastrointestinal Microbiome
Gastrointestinal Tract*
Genes, rRNA
Humans
Lactobacillus
Leuconostoc
Male
Microbiota
Minocycline*
Permeability
Prevotella nigrescens
Probiotics
Propionibacterium
Skin*
Staphylococcus epidermidis
Sulfalene
Anti-Bacterial Agents
DNA
Minocycline
Sulfalene

Figure

• 

  Fig. 1 Rarefaction plots of mean alpha diversity were created with the Shannon diversity index metric to compare microbiota of the skin (all sites) and gut in controls, acne patients at baseline, and acne patients after 4 weeks of minocycline.

• 

  Fig. 2 Principal coordinates analysis (PCoA) plots of weighted UniFrac distances demonstrating beta diversity of the microbiota of the skin (all sites) and gut in controls, acne patients at baseline, and acne patients after 4 weeks of minocycline. PC: principal coordinates.

• 

  Fig. 3 Phylum level relative abundance distribution of gut microbiota in controls, acne cases at baseline, and acne cases after 4 weeks of minocycline.

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