BERLIN — It is quite possible, 5-10 years from now, that adolescents will be able to get an antiacne vaccine, according to an acne expert.
That was one of the potential therapeutic developments Dr. Harald P. Gollnick discussed at the annual congress of the European Academy of Dermatology and Venereology.
For a quarter century, acne therapy has revolved around antimicrobials and retinoids, alone or together, but recent advances in the understanding of acne pathogenesis have opened the door to novel therapeutic possibilities, according to Dr. Gollnick, professor of dermatology and venereology at Otto von Guericke University in Magdeburg, Germany, and chairman of the Global Alliance to Improve Outcomes in AcnE, an international panel of experts.
An impetus for the development of these novel strategies is their nonreliance upon antimicrobials, which means they won't contribute to the growing problem of antimicrobial resistance. That is an important consideration, given the vast amount of antibiotics prescribed for a condition that affects more than 50 million patients in the United States alone.
He discussed several potential new acne therapeutic possibilities:
▸ Vaccination. Dermatologists at the University of California, San Diego, have developed Propionibacterium acnes vaccines with demonstrated efficacy in mouse models (Infect. Disord. Drug Targets 2008;8:160-5). Both inactivated whole P. acnes–based vaccines and vaccines built around cell wall–anchored sialidase of P. acnes are being studied.
▸ Dietary manipulations. The hormones present in commercial dairy–produced cow's milk as a potential aggravating factor in acne have drawn increasing attention, particularly in Europe. A low-glycemic-index diet proved effective in treating acne in an Australian randomized controlled study (Am. J. Clin. Nutr. 2007;86:107-15). A recent Harvard University study found skim milk consumption to be positively associated with acne in teenage boys (J. Am. Acad. Dermatol. 2008;58:787-93)
▸ Ectopeptidase inhibition. This may fight acne by inhibiting sebaceous hyperplasia, follicular hyperkeratosis, and inflammation.
▸ Insulin sensitizing agents. Metformin and the thiazolidinediones have demonstrated a beneficial anti-acne effect in the setting of polycystic ovarian disease (Expert Opin. Ther. Targets 2009;13:1205-26), and follow-up studies are underway.
Disclosures: Dr. Gollnick is an adviser for Immune Technologies and Medicine, manufacturer of IP10.C8, an ectopeptidase inhibitor.