Acne vulgaris is a common disorder that affects 40–50 million people in the USA alone. The pathogenesis of acne is multifactorial, including hormonal, microbiological and immunological mechanisms. One of the factors that contributes to the pathogenesis of acne is Propionibacterium acnes; yet, the molecular mechanism by which P. acnes induces inflammation is not known. Recent studies have demonstrated that microbial agents trigger cytokine responses via Toll-like receptors (TLRs). TLRs are pattern recognition receptors that recognize pathogen-associated molecular patterns conserved among microorganisms and elicit immune responses. We investigated whether TLR2 mediates P. acnes- induced cytokine production in acne. Using transfectant cells we found that TLR2 was sufficient for NF-ĸB activation in response to P. acnes. In addition, peritoneal macrophages from wild-type, TLR6 knockout and TLR1 knockout mice, but not TLR2 knockout mice, produced IL-6 in response to P. acnes.P. acnes induced activation of IL-12 and IL-8 production by primary human monocytes, and this cytokine production was inhibited by anti-TLR2-blocking antibody. Finally, in acne lesions, TLR2 was expressed on the cell surface of macrophages surrounding pilosebaceous follicles. These data suggest that P. acnes triggers inflammatory cytokine responses in acne by activation of TLR2. As such, TLR2 may provide a novel target for the treatment of this common skin disease.

1.
Guy R, Kealey T: Modelling the infundibulum in acne. Dermatology 1998;196:32–37.
2.
Norris JF, Cunliffe WJ: A histological and immunocytochemical study of early acne lesions. Br J Dermatol 1998;118:651–659.
3.
Leyden JJ, McGinley KJ, Mills OH, Kligman AM: Propionibacterium levels in patients with and without acne vulgaris. J Invest Dermatol 1975;65:382–384.
4.
Gilchrist TC: The etiology of acne vulgaris. J Cutan Dis Syphilis 1903;21:107–120.
5.
Leyden JJ, McGinley KJ, Vowels BR: P. acnes colonization in acne and nonacne. Dermatology 1998;196:55–58.
6.
Oberemok SS, Shalita AR: Acne vulgaris. I. Pathogenesis and diagnosis. Cutis 2002;70:101–105.
7.
Kamisango K, Saiki I, Tanio Y, Okumura H, Araki Y, Sekikawa I, Azuma I, Yamamura Y: Structures and biological activities of peptidoglycans of Listeriamonocytogenes and Propionibacterium acnes. J Biochem (Tokyo) 1982;92:23–33.
8.
Vowels BR, Yang S, Leyden JJ: Induction of proinflammatory cytokines by a soluble factor of Propionibacterium acnes: Implications for chronic inflammatory acne. Infect Immun 1995;63:3158–3165.
9.
Hoeffler U: Enzymatic and hemolytic properties of Propionibacterium acnes and related bacteria. J Clin Microbiol 1977;6:555–558.
10.
Hoeffler U, Ko HL, Pulverer G: Antimicrobiol susceptibility of Propionibacterium acnes and related microbial species. Antimicrob Agents Chemother 1976;10:387–394.
11.
Ingham E, Holland KT, Gowland G, Cunliffe WJ: Purification and partial characterization of an acid phosphatase (EC 3.1.3.2) produced by Propionibacterium acnes. J Gen Microbiol 1980;118:59–65.
12.
Puhvel SM, Reisner RM: The production of hyaluronidase (hyaluronate lyase) by Corynebacterium acnes. J Invest Dermatol 1972;58:66–70.
13.
Medzhitov R, Preston-Hurlburt P, Janeway CAJ: A human homologue of the Drosophila Toll protein signals activation of adaptive immunity. Nature 1997;388:394–397.
14.
Yang RB, Mark MR, Gray A, Huang A, Xie MH, Zhang M, Goddard A, Wood WI, Gurney AL, Godowski PJ: Toll-like receptor-2 mediates lipopolysaccharide-induced cellular signalling. Nature 1998;395:284–288.
15.
Suzuki N, Suzuki S, Duncan GS, Millar DG, Wada T, Mirtsos C, Takada H, Wakeham A, Itie A, Li S, Penninger JM, Wesche H, Ohashi PS, Mak TW, Yeh WC: Severe impairment of interleukin-1 and Toll-like receptor signalling in mice lacking IRAK-4. Nature 2002;416:750–756.
16.
Takeda K, Kaisho T, Akira S: Toll-like receptors. Annu Rev Immunol 2003;21:335–376.
17.
Doyle S, Vaidya S, O’Connell R, Dadgostar H, Dempsey P, Wu T, Rao G, Sun R, Haberland M, Modlin R, Cheng G: IRF3 mediates a TLR3/TLR4-specific antiviral gene program. Immunity 2002;17:251–263.
18.
Poltorak A, He X, Smirnova I, Liu MY, Van Huffel C, Du X, Birdwell D, Alejos E, Silva M, Galanos C, Freudenberg M, Ricciardi-Castagnoli P, Layton B, Beutler B: Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: Mutations in Tlr4 gene. Science 1998;282:2085–2088.
19.
Yoshimura A, Lien E, Ingalls RR, Tuomanen E, Dziarski R, Golenbock D: Cutting edge: Recognition of gram-positive bacterial cell wall components by the innate immune system occurs via Toll-like receptor 2. J Immunol 1999;163:1–5.
20.
Hayashi F, Smith KD, Ozinsky A, Hawn TR, Yi EC, Goodlett DR, Eng JK, Akira S, Underhill DM, Aderem A: The innate immune response to bacterial flagellin is mediated by Toll-like receptor 5. Nature 2001;410:1099–1103.
21.
Hemmi H, Takeuchi O, Kawai T, Kaisho T, Sato S, Sanjo H, Matsumoto M, Hoshino K, Wagner H, Takeda K, Akira S: A Toll-like receptor recognizes bacterial DNA. Nature 2000;408:740–745.
22.
Alexopoulou L, Holt AC, Medzhitov R, Flavell RA: Recognition of double-stranded RNA and activation of NF-kappaB by Toll-like receptor 3. Nature 2001;413:732–738.
23.
Brightbill HD, Libraty DH, Krutzik SR, Yang RB, Belisle JT, Bleharski JR, Maitland M, Norgard MV, Plevy SE, Smale ST, Brennan PJ, Bloom BR, Godowski PJ, Modlin RL: Host defense mechanisms triggered by microbial lipoproteins through Toll-like receptors. Science 1999;285:732–736.
24.
Ozinsky A, Underhill DM, Fontenot JD, Hajjar AM, Smith KD, Wilson CB, Schroeder L, Aderem A: The repertoire for pattern recognition of pathogens by the innate immune system is defined by cooperation between Toll-like receptors. Proc Natl Acad Sci USA 2000;97:13766–13771.
25.
Kim J, Ochoa MT, Krutzik SR, Takeuchi O, Uematsu S, Legaspi AJ, Brightbill HD, Holland D, Cunliffe WJ, Akira S, Sieling PA, Godowski PJ, Modlin RL: Activation of Toll-like receptor 2 in acne triggers inflammatory cytokine responses. J Immunol 2002;169:1535–1541.
26.
Takeuchi O, Kawai T, Muhlradt PF, Morr M, Radolf JD, Zychlinsky A, Takeda K, Akira S: Discrimination of bacterial lipoproteins by Toll-like receptor 6. Int Immunol 2001;13:933–940.
27.
Takeuchi O, Sato S, Horiuchi T, Hoshino K, Takeda K, Dong Z, Modlin RL, Akira S: Role of TLR1 in mediating immune response to microbial lipoproteins. J Immunol 2002;169:10–14.
28.
Webster GF, Leyden JJ, Tsai CC, Baehni P, McArthur WP: Polymorphonuclear leukocyte lysosomal release in response to Propionibacterium acnes in vitro and its enhancement by sera from inflammatory acne patients. J Invest Dermatol 1980;74:398–401.
29.
Windhagen A, Newcombe J, Dangond F, Strand C, Woodroofe MN, Cuzner ML, Hafler DA: Expression of costimulatory molecules B7–1 (CD80), B7–2 (CD86), and interleukin 12 cytokine in multiple sclerosis lesions. J Exp Med 1995;182:1985–1996.
30.
Balashov KE, Smith DR, Khoury SJ, Hafler DA, Weiner HA: Increased interleukin 12 production in progressive multiple sclerosis: Induction by activated CD4+ T cells via CD40 ligand. Proc Natl Acad Sci USA 1997;94:599–603.
31.
Bucht A, Larsson P, Weisbrot L, Thorne C, Pisa P, Smedegard G, Keystone EC, Gronberg A: Expression of interferon-gamma (IFN-gamma), IL-10, IL-12 and transforming growth factor-beta (TGF-beta) mRNA in synovial fluid cells from patients in the early and late phases of rheumatoid arthritis (RA). Clin Exp Immunol 1996;103:357–367.
32.
Parronchi P, Romagnani P, Annunziato F, Sampognaro S, Becchio A, Giannarini L, Maggi E, Pupilli C, Tonelli F, Romagnani S: Type 1 T-helper cell predominance and interleukin-12 expression in the gut of patients with Crohn’s disease. Am J Pathol 1997;150:823–832.
33.
Via CS, Rus V, Gately MK, Finkelman FD: IL-12 stimulates the development of acute graft-versus-host disease in mice that normally would develop chronic, autoimmune graft-versus-host disease. J Immunol 1994;153:4040–4047.
34.
Williamson E, Garside P, Bradley JA, Mowat AM: IL-12 is a central mediator of acute graft-versus-host disease in mice. J Immunol 1996;157:689–699.
35.
Nishimura T, Sadata A, Yahagi C, Santa K, Otsuki K, Watanabe K, Yahata T, Habu S: The therapeutic effect of interleukin-12 or its antagonist in transplantation immunity. Ann NY Acad Sci 1996;795:371–374.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.