The Pathogenesis of Acne

Title: The pathogenesis of acne
Knor T
Publication: Acta Dermatovenerol Croat. 2005;13(1):44-9.

The author recounted the significant factors of acne: enlargement of the follicle, increased sebum production, presence of Propionium acnes (P. acnes) bacteria, and inflammation. Enlarged follicle and sebum production creates microcomedones or acne lesion, which results in growth of P. acnes, which in turn releases factors that promote inflammation. These factors include:

  • Lipases (enzymes that break down lipids or fat)
  • Proteases (enzymes that breakdown proteins)
  • Hyaluronidases (enzymes that breakdown hyaluronic acid and increase tissue permeability in the body)
  • Chemotactic factors (a chemotactic factor is a chemical that orient a cell toward or away from it)

The body’s immune response includes cell-mediated and blood-based immune reactions, and complement activation (a complex immune reaction process, involving a series of serum proteins that result in destruction of a marked cell and other profound effects).

Recent studies indicate that the immune system cells may be activated by the P. acnes binding to toll-like receptors (TLRs) and CD14 molecules. Other molecules such as CD1 may also recognize altered lipid content in the sebum, and production of inflammatory cytokines follows.

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