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Open Access Acne vulgaris, probiotics and the gut-brain-skin axis: from anecdote to translational medicine

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Acne vulgaris has long been postulated to feature a gastrointestinal mechanism, dating back 80 years to dermatologists John H. Stokes and Donald M. Pillsbury. They hypothesised that emotional states (e.g. depression and anxiety) could alter normal intestinal microbiota, increase intestinal permeability, and contribute to systemic inflammation. They were also among the first to propose the use of probiotic Lactobacillus acidophilus cultures. In recent years, aspects of this gut-brain-skin theory have been further validated via modern scientific investigations. It is evident that gut microbes and oral probiotics could be linked to the skin, and particularly acne severity, by their ability to influence systemic inflammation, oxidative stress, glycaemic control, tissue lipid content, and even mood. This intricate relationship between gut microbiota and the skin may also be influenced by diet, a current area of intense scrutiny by those who study acne. Here we provide a historical background to the gut-brain-skin theory in acne, followed by a summary of contemporary investigations and clinical implications.
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Keywords: acne; anxiety; brain; depression; diet; gastrointestinal tract; gut; microbiota; probiotics; skin

Document Type: Research Article

Publication date: June 1, 2014

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  • Beneficial Microbes is a peer-reviewed scientific journal with a specific area of focus: the promotion of the science of microbes beneficial to the health and wellbeing of man and animal. The journal contains original research papers and critical reviews in all areas dealing with beneficial microbes in both the small and large intestine, together with opinions, a calendar of forthcoming beneficial microbes-related events and book reviews. The journal takes a multidisciplinary approach and focuses on a broad spectrum of issues, including safety aspects of pro- & prebiotics, regulatory aspects, mechanisms of action, health benefits for the host, optimal production processes, screening methods, (meta)genomics, proteomics and metabolomics, host and bacterial physiology, application, and role in health and disease in man and animal. Beneficial Microbes is intended to serve the needs of researchers and professionals from the scientific community and industry, as well as those of policy makers and regulators.
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