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

Katherine G Thompson; Barbara M Rainer; Corina Antonescu; Liliana Florea; Emmanuel F Mongodin; Sewon Kang; Anna L Chien

doi:10.5021/ad.2020.32.1.21

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

Ann Dermatol. 2020 Feb;32(1):21-30. doi: 10.5021/ad.2020.32.1.21. Epub 2020 Jan 9.

Authors

Katherine G Thompson¹, Barbara M Rainer^{1

2}, Corina Antonescu³, Liliana Florea³, Emmanuel F Mongodin⁴, Sewon Kang¹, Anna L Chien¹

Affiliations

¹ Department of Dermatology, Johns Hopkins University, Baltimore, MD, USA.
² Department of Dermatology, Medical University of Graz, Graz, Austria.
³ Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁴ Institute for Genome Sciences, University of Maryland, Baltimore, MD, USA.

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.

Keywords: Acne vulgaris; Bacteroidetes; Firmicutes; Microbiome; Minocycline; Propionibacterium.