Growth Of Propionibacterium Acnes Research Articles

Antibacterial activity of jamblang leaf ethanol extract (Syzygium cumini) against the growth of Propionibacterium acnes

Background: Propionibacterium acnes is a bacterium found on the skin that plays a significant role in acne vulgaris. The inappropriate use of antibiotics can lead to resistance, necessitating the search for alternative therapies from plants with high antibacterial potential. One such plant is jamblang (Syzygium cumini), which has demonstrated antibacterial properties. Objective: This research aims to test the antibacterial activity of jamblang leaf extract against the growth of P. acnes. Method: The study employed an experimental design with a posttest-only control group design. The treatment groups consisted of a positive control (clindamycin), a negative control (sterile distilled water), and jamblang leaf extract groups with concentrations of 100%, 50%, 25%, 12.5%, and 6.25% (n=4). Data analysis was conducted using the One-Way ANOVA statistical test. Results: The jamblang leaf extract exhibited antibacterial potential against the growth of P. acnes. The extract showed strong antibacterial activity at concentrations of 100%, 50%, 25%, and 12.5%, and moderate antibacterial activity at a concentration of 6.25%. Conclusion: This suggests that jamblang leaf extract could be a promising alternative therapy for treating acne vulgaris, offering a natural solution to combat antibiotic resistance.

Characterisation and Antibacterial Activity of Green Tea Extract-Enriched Solid Goat’s Milk Soap

Solid goat’s milk soap is organic and beneficial for the health and appearance of the skin. One of the components in green tea known to display antibacterial activities is epigallocatechin gallate (ECGC). In this study, the effects of solid goat’s milk soap containing 1%, 2%, and 4% green tea extract on the growth of Propionibacterium acnes, Staphylococcus aureus, and Staphylococcus epidermidis were examined. The soap was characterized for its organoleptic, pH, free fatty acid, alkalinity, water content, foam stability, and hardness. In addition, an in vitro antimicrobial test was performed utilising the well-diffusion method. The findings revealed that all the soap formulas matched the SNI 3533-2016 standards for water content, free fatty acid content, and free alkali content, and that they also had similar pH, foam stability, and hardness. The solid goat’s milk soap showed antibacterial activities against Propionibacterium acnes, Staphylococcus aureus, and Staphylococcus epidermidis, but the effect of the green tea extract on the soap did not increase these.

SUPLEMENTATION OF VIRGIN COCONUT OIL (VCO) PRODUCTS WITH INTARAN (Azadirachta indica) LEAF EXTRACT IN INHIBITING THE GROWTH OF ACNE BACTERIA Propianibacterium acnes

<p>The dangers of resistance to Propionibacterium acnes and the high cost of treatment prompted the discovery of medicinal sources from natural substances that could act as antibacterials. One of them is using post-harvest coconut products in the form of virgin coconut oil (VCO) with extract of intaran leaves (Azadirachta indica). The purpose of this study was to determine the phytochemical characteristics, inhibition zone and their categorization and to study the difference or effect of VCO supplemented with extracts of intaran leaves (Azadirachta indica) with various concentrations on the growth of Propionibacterium acnes. This study used a posttestonly control group design. The VCO mixed with extracts of intaran leaves with various concentrations of 5%, 10%, 15%, 20% and 25%. The antibacterial test was carried out using the Kirby-Bauer disc diffusion method. Data analysis used the Kruskall Wallis and Mann Whitney test. The VCO mixture supplemented with extracts of intaran leaves showed the presence of tannins, flavonoids, terpenoids, saponins, and alkaloids. The mean diameter of the inhibition zone of virgin coconut oil (VCO) supplemented with leaf extract at a concentration of 5%, 10%, 15%, 20% and 25% of the growth of P. acnes is 9.4 mm; 18.3 mm; 9.9 mm; 12.6 mm; and 9.9 mm. Data analysis showed that there were differences and the effect of adding extracts to the resulting inhibition zone diameter. The concentrations of leaf extract of 5%, 15%, and 25% were classified as moderate, while the concentrations of 10% and 20% of leaf extract were classified as strong. The 10% concentration had the highest inhibition zone diameter in inhibiting the growth of P. acnes. This combination has the potential to treat acne and needs to be carried out in vivo research.</p>

Uji Efektivitas Antibakteri Ekstrak Rimpang Kunyit (Curcuma domestica Val.) terhadap Pertumbuhan Propionibacterium acnes In Vitro

One of the treatments for acne vulgaris therapy is antibiotics, it can be applied topically and systemically. However, long-term and inappropriate use of antibiotics can increase the incidence of antibiotic drug resistance. Some medicinal plants are known to have antimicrobial properties, one of them is turmeric rhizome. Turmeric rhizome is known to contain essential oils and curcumin so that it can be useful as an antibacterial, antiviral, anti protozoa, anti-inflammatory, antioxidant, and antineoplasm. This study aims to determine the effectiveness of the antibacterial turmeric extract against the growth of Propionibacterium acnes . The type of this research is an experimental laboratory with disc diffusion method on Mueller Hinton Agar media. Turmeric extract was obtained from the Laboratory of Organic Chemistry at the University of Lampung with maceration techniques using 96% ethanol. Turmeric rhizome extract is divided into several concentrations namely 15%, 30%, 50%, 75%, and 100%. As negative control is aquades and positive control is clindamycin. Data was obtained based on the result of measurement Diameter of inhibition zone made through paper discs and measured by calipers. The data were analyzed by using One Way ANOVA. The result of this study indicated that the diameter of the inhibits zone at a concentration of 15%, 30%, 50%, 75%, and 100%. Sequentially is 11,35mm, 15,65mm, 17,575mm, 18,85mm, and 20,8mm. in the negative control is 0 mm and positive control is 28,1 mm (score p-value=0,000). There is antibacterial effectiveness of turmeric extract against the growth of Propionibacterium acnes in vitro, but it is no superior compared with clindamycin phosphate.

Water-dispersible unadulterated α-mangostin particles for biomedical applications

α-Mangostin, the extract from pericarp of Garcinia mangostana L. or mangosteen fruit, has been applied in various biomedical products because of its minimal skin irritation, and prominent anti-inflammatory, antimicrobial and immune-modulating activities. Owing to its low water solubility, the particle formulations are necessary for the applications of α-mangostin in aqueous media. The particle formulations are usually prepared using surfactants and/or polymers, usually at a larger amount of these auxiliaries than the amount of α-mangostin itself. Here, we show the self-assembly of α-mangostin molecules into water-dispersible particles without a need of any polymers/surfactants. Investigations on chemical structure, crystallinity and thermal properties of the obtained α-mangostin particles, in comparison to the conventional α-mangostin crystalline solid, confirm no formation of the new compound during the particle formation and suggest changes in intermolecular interactions among α-mangostin molecules and significantly more hydroxyl functionality positioned at the particles' surface. The ability of the water suspension of the α-mangostin to inhibit the growth of Propionibacterium acnes, the acne-causing bacteria, is similar to that of the solution of the conventional α-mangostin in 5% dimethyl sulfoxide. Moreover, at 12.7 ppm in an aqueous environment of RAW 264.7 cell culture, α-mangostin suspension exhibits five times higher anti-inflammatory activity than the conventional α-mangostin solution, with the same acceptable cytotoxicity of less than 20% cell death.

ANTIBACTERIAL ACTIVITIES OF BELIMBING WULUH (AVERRHOA BILIMBI L.) ETHYL ACETATE EXTRACT ON GEL FORMULATED AGAINST PROPIONIBACTERIUM ACNES AND STAPHYLOCOCCUS AUREUS

Objective: Averrhoa bilimbi is a plant that is used as a food spice and traditional medicine in Indonesia. The purpose of this study was to obtain a gel formula and measure its activity in inhibiting the growth of skin bacteria, namely Propionibacterium acnes and Staphylococcus aureus.
 Methods: The gel formulation was tested organoleptically, homogeneity, pH, dispersibility test, and skin irritation test. Antibacterial activity test using agar diffusion method, inhibition of bacterial growth was compared with clindamycin as a positive control.
 Results: All gel formulations showed good homogeneity, pH of the preparations ranged from 4.5 to 6.1, the dispersion test was 5.5-6.5 cm, and none of them caused irritation to the skin. The results of the inhibitory activity against the growth of Propionibacterium acnes bacteria on concentrations 10, 15, and 20% were 16.67 + 0.40, 22.70 + 0.32 and 28.10 + 0.36 and Staphylococcus aureus bacteria were 18.53 + 0.22, 24.16 + 0.29 and 30.40 + 0.4. The inhibitory activity of clindamycin against Propionibacterium acnes and Staphylococcus aureus bacteria were 35.33+0.29 and 36.30+0.37.
 Conclusion: Ethyl acetate extract gel Averrhoa bilimbi had good activity in inhibiting the growth of Propionibacterium acnes and Staphylococcus aureus bacteria and has the potential to be used as an herbal anti-acne drug.

The Effectiveness Test of Betel Leaf Ethanol Extract Cream (Piper Betle Linn) Toward Propionibacterium acnes Bacterial Growth

Background: One of skin diseases that is frequently taking attention among teenagers and young adults is acne or in medical term called acne vulgaris. Acne treatment can be treated by repairing follicular abnormalities, decreasing sebum production, decreasing the number of Propionibacterium acnes colonies and reducing inflammation of the skin. The bacterial population of Propionibacterium acnes can be reduced by giving an antibacterial substance such as erythromycin, clindamycin and benzoyl peroxide. In the treatment of acne we can get antibacterial originating from nature, one of which can be obtained in the secondary metabolism of plants. The extracts and essential oils of betel leaf contain antibacterial and antifungal activities. The effectiveness of the use of betel leaf ethanol extract (Piper betle Linn) in acne treatment can be improved by creating formulations in form of cream preparations. Formulations in cream preparations will affect the amount and speed of active substances that can be absorbed. Objectives: To determine the effectiveness of the ethanol extract cream of betel leaf (piper betle linn) cream in formulas with what percentage of active substance has the most-inhibitory effect on the growth of Propionibacterium acnes. Methods:The study used experimental research. Propionibacterium acnes samples were diluted in 0.9% physiological NaCl sterile and embedded in Nutrient Agar (NA) media. The media was inserted into an incubator at 37 ° C for 24 hours. The test of antibacterial activity used the disk diffusion method. The antibacterial activity test results were statistically analyzed using the Statistical Product Services Solution (SPSS 17) program with a confidence level of 95% (α = 0.05). Results: The three creams containing betel leaf ethanol extracts at percentages of 5%, 10% and 15% for each had inhibitory zones: 9.8 mm, 15.85 mm, 17.35 mm. Conclusion: Cream that contains 15% active substance has the strongest inhibition.

UJI AKTIVITAS ANTIBAKTERI EKSTRAK DAUN SURUHAN (Peperomia pellucida L. Kunth) TERHADAP Propionibacterium acnes PENYEBAB JERAWAT

Acne is one of the most common skin diseases that occur at all ages, especially in adolescents who are just experiencing puberty. One of the plants that has antibacterial properties is the leaves of suruhan. However untill now not found research of suruhan leaf used as an acne medicine. The aim of this study was to determine the antibacterial activity of suruhan leaf extracts on the growth of Propionibacterium acnes. The method used is disc diffusion by given 5 treatments starting with a concentration of 15%, 20%, 25%, positive control of clindamycin and negative control of aquadest.. The results obtained from leaf extracts were able to inhibit the growth of P. acnes bacteria in various concentrations. Suruhan leaf extracts at a concentration of 25% showed response resistance was greater than other concentrations. The one way Anova SPSS test showed p <0.05 which means that there were differences in the inhibitory concentration of various extracts on the growth of P. acnes that cause acne

1095 Effective image-guided medical management in effusive constrictive pericarditis

Abstract A 59 year old man was admited to hospitalization for persistent chest pain related to acute pericarditis. Within the admision tests, a transthoracic echography was performed, showing a moderate pericardial effusion with ventricular septal bounce and significant respiratory variations in mitral and tricuspid inflows, all of it consistent with effusive-constrictive pericarditis (Panel A). Anti-inflammatory treatment with ibuprofen and colchicine was started. During the first 48 hours of admission there was a clinical and hemodinamic worsening in the patient’s condition that forced the performance of a pericardial window, obtaining a very little quantity of dense pericardial fluid. Looking for a more accurate study of the pericardium, a cardiovascular magnetic resonance (CMR) was performed, revealing a thick heterogeneous pericardial effusion (Panel B) and a significant late gadolinium enhancement of both pericardial layers (Panel C). All these findings where consistent with an effusive constrictive pericarditis with persistent inflammatory activity despite high doses of conventional inflammatory treatment. Furthermore, the growth of Propionibacterium acnes in the pericardial fluid disclosed the etiology of this condition. Medical treatment was enhanced with high doses of intravenous corticosteroid, ceftriaxone and doxycycline. During the following days, the patient showed an excellent response achieving the complete clinical and echocardiographic relief of constrictive signs (Panel D). Effusive constrictive pericarditis is characterized by the presence of pericardial effusion and constriction secondary to an inflammatory process of the pericardium. Pericardiectomy might be necessary in case of failure of medical treatment, a very common scenario in this kind of .pericarditis. Our case is remarkable because it demonstrates the value of CMR to detect persistent inflammation of pericardium despite high doses of conventional medical treatment for pericaricarditis guiding the successful escalation to intravenous corticosteroid and avoiding the risk of an unnecessary cardiac surgery. Abstract 1095 Figure.

The Potency of Soursop Leaf Extracts for the Treatment of Acne Skin

Acne is a skin disease that mostly occurs in teenager aged 16-19 years to adult aged 30 years. Acne is generally caused by the growth of Propionibacterium acnes, Staphylococcus aureus, and Staphylococcus epidermidis. Anti-acne drugs usually contained synthetic antibiotics such as erythromycin and clindamycin, which can cause irritation, resistance, organ damage, and even immunohipersensitivity. Therefore we need alternative ingredients that are easy to find and can treat acne, such as soursop leaves. The aim was to analyze the potency of soursop leaf extracts for the treatment of acne skin. The literature review was conducting using reference sources from 24 articles by literature searching on Google Scholar and NCBI that were published in range of year 2005-2020. The keywords are used literature searching acne vulgaris, soursop leaves, propionibacterium acnes, staphylococcus aureus, and staphylococcus epidermidis. The literature which has been collected were analyzed by systematic literature review which include collecting, evaluating, and development of the research that focus on a particular topic. Analysis of various articels that it is known that soursop leaves contain antibacterial compounds such as flavonoids, alkaloids, saponins, tannins, steroids and terpenoids can be used as anti-acne drugs.

Hop Extract Acts as an Antioxidant with Antimicrobial Effects against Propionibacterium Acnes and Staphylococcus Aureus

Acne is associated with hyperkeratosis, elevated levels of skin sebum and growth of Propionibacterium acnes (P. acnes) and Staphylococcus aureus (S. aureus). Furthermore, P. acnes promotes inflammation by inducing IL-6 production and oxidative stress. The aim of this study was to assess the antioxidant, anti-inflammatory and antibacterial potential of a hop-CO2-extract with 50% humulone and lupulone. The susceptibility of P. acnes and S. aureus to the hop extract was tested by using the broth microdilution technique. The minimal inhibitory concentrations (MIC) for P. acnes and S. aureus were 3.1 and 9.4 µg/mL, respectively. In addition, the hop extract showed an antioxidative effect with a half maximal inhibitory concentration (IC50) of 29.43 µg/mL as well as additional anti-inflammatory effects by reducing the IL-6 expression (IC50: 0.8 µg/mL). In addition, a gel formulation with 0.3% hop extract (w/w) had antibacterial activity against P. acnes and S. aureus (inhibition zone value: 5.5 mm and 3 mm, respectively) which was significantly superior to the placebo gel. The positive control (a gel with the antibiotic clindamycin) showed an inhibition zone of 9 mm. Due to its antioxidant, anti-inflammatory and antibacterial effects hop extract might be a treatment option for acne-prone skin.

Effect of a botanical cleansing lotion on skin sebum and erythema of the face: A randomized controlled blinded half-side comparison.

Elevated levels of skin sebum are associated with the growth of Propionibacterium acnes. Intensive degreasing of the skin reduces Propionibacterium acnes but also may cause skin irritation. We assessed the degreasing effect and skin tolerability of a botanical face cleanser with hops and willow bark extract and disodium cocoyl glutamate as mild cleansing agent compared to a standard face cleanser with sodium laureth sulfate (SLES). A total of 21 healthy volunteers with normal to oily skin were enrolled in this study. Both cleansers were applied twice a day on the left or right side of the forehead for 15 days in a standardized manner. Bioengineering measurements were performed on day 8 and 15 and on day 17 after an application break of 48 hours. The sebum level was determined using a Sebumeter® , and skin redness was measured using a Mexameter® . The botanical face cleanser significantly reduced the sebum level (P < .01) in the test area on day 17. The SLES containing cleanser showed a statistically relevant degreasing effect already on day 15, but after the application break the sebum level increased again on day 17. None of the cleansers caused skin irritation as determined by skin redness measurements. In contrast to the SLES containing cleanser, the botanical skin cleanser with hops and willow bark extract had a continuous degreasing effect without reactive seborrhoe after the treatment break. Skin cleansing without SLES might be advantageous for sensitive skin.

ID3024 Polymeric nanoparticles display bactericidal effect and selective fermentation for the treatment of acne vulgaris

The use of antibiotics in the treatment of acne in specific group (pregnant women) of patients can lead to serious complications. We have previously demonstrated that the nanoparticles made of block copolymers of poly (ethylene glycol) and poly(e-caprolactone) can inhibit the growth of Propionibacterium acnes (P. acnes), a bacterium highly associated with the progress of acne vulgaris in the human skin [Polymers 2016; 8, 321]. To reduce the amount of antibiotics used in the treatment of skin acne, we have further demonstrated that a bacterium in the human skin microbiome can utilize PEG-based polymers to produce various short-chain fatty acids (SCFAs) which suppressed the growth of P. acnes. PEG-based polymers were chosen as selective fermentation initiators which specifically induced the fermentation of the skin commensal bacterium but not P. acnes. Interestingly, PEG-based polymers can efficiently suppress the growth of P. acnes. An acne ex vivo explant was established by using acne biopsies collected from patients with acne vulgaris at the early and middle stages. The levels of pro-inflammatory interleukin (IL)-8 cytokine in early- and middle-staged acnes were significantly higher than those in healthy skins. Incubation of acne ex vivo explants with sucrose remarkably reduced the level of IL-8 and the number of P. acnes. Results from mouse studies revealed that PEG-based polymer functions as antibiotic adjuvants which can considerably reduce the effective doses of clindamycin, a clinically-used acne antibiotic

A Honey Trap for the Treatment of Acne: Manipulating the Follicular Microenvironment to ControlPropionibacterium acnes

Today, as 40 years ago, we still rely on a limited number of antibiotics and benzoyl peroxide to treat inflammatory acne. An alternative way of suppressing the growth of Propionibacterium acnes is to target the environment in which it thrives. We conjecture that P. acnes colonises a relatively “extreme” habitat especially in relation to the availability of water and possibly related factors such as ionic strength and osmolarity. We hypothesise that the limiting “nutrient” within pilosebaceous follicles is water since native sebum as secreted by the sebaceous gland contains none. An aqueous component must be available within colonised follicles, and water may be a major factor determining which follicles can sustain microbial populations. One way of preventing microbial growth is to reduce the water activity (a w) of this component with a biocompatible solute of very high water solubility. For the method to work effectively, the solute must be small, easily diffusible, and minimally soluble in sebaceous lipids. Xylose and sucrose, which fulfil these criteria, are nonfermentable by P. acnes and have been used to reduce water activity and hence bacterial colonisation of wounds. A new follicularly targeted topical treatment for acne based on this approach should be well tolerated and highly effective.

Akne

Seborrhea, follicular hyperkeratosis, propionibacteria, and inflammatory reactions are the most important factors leading to acne. The combination of increased sebum producation and follicular hyperkeratosis facilitates an increased growth of Propionibacterium acnes. Its metabolic products lead to follicular inflammation and, in extreme cases, even to perifollicular abscesses. Sebum production is influenced by androgens, so that abnormalities in androgen levels can produce seborrhea and acne. Follicular hyperkeratosis may be triggered by a relative deficiency in linoleic acid, peroxides from sebum components, and especially by inflammatory mediators such as interleukin-1. Bacterial metabolic products such as lipases, proteases, or chemotactic factors lead to the perifollicular inflammation. This inflammation is not only a response to other pathogenetic factors, but also a cause of acne. An initial mild perifollicular inflammation can induce comedogenesis via a variety of mediators. The influence of dietary factors on the initiation and course of acne has recently received increased recognition. A connection has been postulated between acne and a high nutrients with glycemic index, as well as with milk products.

국내 자생 향장식물 에탄올 추출물의 항균 효과

본 연구는 60여 종의 자생 향장식물 및 한약재의 에탄올 추출물의 항균활성을 분석하였다. 양성 대조군인 페녹시에탄올을 처리한 군에서의 저해존의 크기에 대한 실험군의 상대적 비율을 분석한 결과 P. aeruginosa 에 대해서는 단삼과 황련에서 가장 강한 항균력이 나타났다. 이는 양성 대조군에서 보인 저해존의 단삼의 경우 97%, 황련의 경우 84% 에 해당하였으며 그 외에도 작약, 스테비아, 때죽나무, 후리지아, 생강나무, 뽕나무, 오배자, 지유, 황금에서 항균력이 나타났다. S. aureus에 대해서는 오배자, 황련, 단삼이 가장 강한 항균력을 나타냈다. 이는 양성 대조군에서 보인 저해존의 오배자의 경우 78%, 황련의 경우 99%, 단삼의 경우 92%에 해당하였다. 또한 작약, 찔레, 스테비아, 창포, 후리지아, 오디, 생강나무, 구절초, 고삼, 관중, 지유, 황금, 은행나무, 소나무, 인동초, 이나무에서 항균력을 나타냈다. C. albicans에 대해서는 황금의 경우 35%, 황련의 경우 33%의 항균 활성을 보였다. M. furfur에 대해서는 오배자에서 가장 강한 항균력이 나타났는데 양성 대조군에서 보인 저해존의 57%에 해당하였으며 그 외에도 작약, 찔레, 황련, 진피, 목단피에서 항균력이 나타났다. P. acnes 에 대해서는 황련, 단삼, 오배자, 작약에서 가장 강한 항균력이 나타났다. 이는 양성 대조군에서 보인 저해존의 황련과 단삼의 경우 99%, 오배자의 경우 87%에 해당하였으며, 작약의 경우 꽃에서 추출한 경우 89%, 줄기에서 추출한 경우 35%, 뿌리에서 추출한 경우 22%에 해당하였다. 또한 찔레, 스테비아, 창포, 오디, 오이, 은방울꽃, 생강나무, 구절초, 고삼, 관중, 지유, 후박에서도 항균력이 나타났다. 이상의 결과에서 지리산 자생식물 중에서는 작약, 찔레, 생강나무, 구절초, 소나무에서, 한약재 중에서는 황련, 오배자, 지유, 단삼, 황금에서 강한 항균력을 보였고, 관련되는 성분과 가능한 작용 방식을 논의하였다. Antimicrobial activities of ethanol extracts of about 60 endemic Korean herbs and medicinal plants were investigated. When compared to the group treated with phenoxyethanol as a positive control, the growth of Pseudomonas aeruginosa was inhibited by Styrax japonica, Stevia rebaudiana, Morus Leaf, Coptis chinensis and Slavia miltorrhiza Bunge, the latter showing the strongest inhibition (97%). The growth of Staphylococcus aureus was inhibited by Acorus calamus, Pinus densiflora, Ginkgo biloba, Dryopteris crassirhizoma, Chrysanthemum zawadskii, Slavia miltorrhiza Bunge and Coptis chinensis, the latter showing the strongest inhibition (99%). The growth of yeast type fungi Candida albicans was inhibited to about 35% by Scutellaria baicalensis Geogr and about 33% by Coptis chinensis as determined by paper disk method. The growth of bacterium Malassezia furfur was inhibited by Paeonia lactiflora, Rosa multiflora, Coptis chinensis, Citrus aurantium L. subsp, Paeonia suffruticosa Andrews, and Galla rhois, the latter showing the strongest inhibition (57%). The growth of Propionibacterium acnes was inhibited by Galla rhois, Paeonia lactiflora, Morus bombycis, Cucumis sativus, Stevia rebaudiana, Coptis chinensis and Slavia miltorrhiza Bunge. Interestingly, Coptis chinensis and Slavia miltorrhiza Bunge showed the strongest inhibition (99%) similar to that in postive control. The possible components and their action modes were suggested and discussed.

Azithromycin: an anti-inflammatory effect in chronic recurrent multifocal osteomyelitis? A preliminary report

In this preliminary communication we report our experience with Azithromycin in patients with Chronic Recurring Multifocal Osteomyelitis (CRMO). Seven out of 13 patients, mainly teenager, showed a fast clinical improvement after they were started on Azithromycin. The immediate therapeutic effect of Azithromycin in patients with CRMO was surprising and lead us to the hypothesis that Azithromycin could have an antiphlogistic in addition to it's antibiotic effect in this disease setting. In patients with reactive chronic pelvic osteomyelitis Azithromycin obviously had a direct influence on the sympathic coxitis. Half of the patients reported an immediate reduction of pain and a significant improvement in range of movement after they were started on Azithromycin. In all cases the clinical and radiographic signs on MRI showed a reduction of the inflammatory process. Experimental animal models have recently shown that macrolids have independent additional antiinflammatory and immunomodulatory effects. The assumed local immunomodulatory effect of Azithromycin potentially is an additional activity to the already known synergistic antimicrobial and antiinflammatory effect. Right now we are in the process of collecting data from patients with SAPHO Syndrome who underwent bone-biopsies for microbiologic and histomorphologic investigations. All patients with the growth of propionibacterium acnes were started on a long-term antibiotic therapy with Azithromycin. This study will possibly help to answer the question of the additional antiphogistic/immunomodulatory effect of Azithromycin in this disease entity and the related CRMO.

The Possible Role of Reactive Oxygen Species Generated by Neutrophils in Mediating Acne Inflammation

The purpose of this study was to investigate the possible role of reactive oxygen species (ROS) generated by neutrophils in mediating acne inflammation. Antibiotics used for the treatment of acne significantly inhibited ROS generated by neutrophils, when compared to other antibiotics. Metronidazole, which is effective in the treatment of acne, markedly inhibited ROS generated by neutrophils. The drug is known to have no significant effect on the growth of Propionibacterium acnes. The proportion of linoleic acid is markedly decreased in acne comedones. Linoleic acid significantly suppressed ROS generated by neutrophils. The ability of neutrophils to produce ROS was significantly increased in patients with acne inflammation. These results seem to reveal the involvement of ROS generated by neutrophils in the disruption of the integrity of the follicular epithelium, which is responsible for inflammatory processes of acne.

The Aerobic Growth of Propionibacterium acnes in Primary Cultures from Skin

Although Propionibacterium acnes ordinarily grows as an anaerobe, this organism was commonly seen on aerobic primary cultures (directly from skin) of the forehead, axilla, deltoid area, and antecubital fossa. On subculture, strains from aerobic primary cultures showed their normal anaerobic state. On repeated tests of the foreheads of 7 subjects over periods of 1 to 4 yr, 24% of all cultures were positive for propionibacteria (P. acnes) on aerobic culture. This phenomenon was equally common in cultures from those with relatively sparse or dense populations of P. acnes on the skin surface. Several different patterns of aerobic growth were observed: satellitism, profuse growth at one dilution and none on the next higher dilution, and proportionate growth in successive dilutions. These different growth patterns indicate that more than one mechanism is operative in stimulating the aerobic growth of propionibacteria. Whether one or more of these mechanisms is operative in vivo, we do not know, but it appears that they do not account for the great individual differences in population density of P. acnes on such sites as the forehead.