Only a few researchers have yet investigated the intestinal microbiome in acne patients

In response to different secondary chemicals, ribosomal genes were also involved in host detoxification of different species of the R.pomonella complex. R. zephyria and R. pomonella are sister species in the R. pomonella complex that specialize in snowberry and domestic apple plants, respectively . In reciprocal transplant tests of these two Rhagoletis taxa, microarray data indicated significant enrichment of mitochondrial ribosomal proteins when the two fly species fed on their new hosts, which contain different complements of phenolic and glycosidic in laboratory studies . Several studies on lepidopteran species revealed the role of ribosomal genes in response to host expansion . For example, ribosomal genes were down regulated in C. suppressalis when extended to the novel host water oats , which may be a more suitable host for C. suppressalis than its native host, rice. In contrast, ribosomal genes were upregulated in H. armigera when shifting to unsuitable novel hosts .The role of genes associated with the oxidative phosphorylation pathway is primarily involved in energy metabolism and provides energy in the form of ATP for most organisms and most biological actions . The OXPHOS pathway is coupled with the mitochondrial electron transport chain, large round plant pots and mitochondria are major sites of reactive oxygen species production in the majority of eukaryotic cells . The level of mitochondrial oxygen flow through the OXPHOS pathway influences ROS homeostasis and regulates the energy supply in different biological processes .

OXPHOS genes can take part in many biological activities, and therefore they may also be important in the regulation of the response to host plant expansion of tephritid flies. Research on Bactrocera tau reared on two native cucurbit hosts and a novel host showed a large number of upregulated NADH genes in the OXPHOS pathway in transcript data of B. tau when feeding on banana. These results suggest that OXPHOS genes play an important role in the process of novel host fruit use in B. tau . OXPHOS was also involved in the host expansion of R. pomonella in response to the different phenologies of various hosts, as mentioned above. Certain genes in the fat bodies of tephritids are also involved in the energy supply for many biological processes, including digestion, detoxification, development, and immunity . Differentially expressed genes, such as the lipase gene, ATP synthase gene, and alpha-amylase genes , were documented in the tephritids B. dorsalis and P. utilis in response to different secondary chemical environments .The various types of genes summarized above led to multilevel responses in tephritids, including nervous-, behavioral-, chemical-, and physical-level responses, when the flies faced different host environments. These multilevel responses to host expansion result in multilevel adaptations in flies, which lead to successful expansion to a novel host . Adaptation to a novel host is a complex process. Multilevel adaptation in fruit flies results from multigene regulation rather than a single gene or several genes performing various regulatory roles.

The transcriptome data revealed that olfactory-, digestion- and detoxification-related genes and ribosomal genes were all involved in novel host adaptation in R. pomonella . Laboratory strains of B. tau also had activated OXPHOS genes and digestive and detoxification genes when the fly responded to a novel host environment . The multiple-gene regulation mechanism during host expansion to a novel host was also documented in other insects. For example, C. suppressalis launched three types of genes simultaneously to regulate adaptation to the new novel host water oat . S. yangi differentially expressed genes related to digestion, detoxification, oxidation–reduction, stress response, water deprivation, and osmoregulation during adaptation to the new host Ephedra lepidosperma . Various genes also regulate the adaptation of tephritids to new hosts via multiple mechanisms. As summarized above, the alteration of gene expression levels, gene family expansion, and the use of various gene types or subfamilies are the major mechanisms involved in novel host adaptation.Many tephritid species attack economically important crops, including vegetables and fruits. The economic losses caused by tephritids reach over US$2 billion annually . Control strategies for tephritids primarily involve chemical use inCas9 endonuclease recognizes a specific genomic region under the leading of chimeric single guide RNA . The CRISPR/Cas9 system editing the functional target gene shibire, tsl in B. tryoni and the white pupae gene wt in B. dorsalis, C. capitate, and Z. cucurbitae have been applied in the development of genetic sexing strain application in SIT control.

This gene tool also has broad application prospects in tephritid management based on host plant adaptation-related genes in the future. Regulation of host adaptation would be an important mechanism to target because this adaptation allows tephritids to expand in new habitats and change to new biotypes. Therefore, developing suitable novel host adaptation functional genes as target genes in genetic disruption control strategies could help prevent tephritids in an environmentally friendly manner.Acne affects between 40 and 50 million individuals in the United States, including mainly adolescents and adults. Factors influencing acne development include excessive sebum production, follicular hyperkeratinization of pilosebaceous ducts, and an increased release of inflammatory mediators. Additionally, some have hypothesized that androgens and microbial colonization with Propionibacterium acnes contribute to the pathogenesis of acne. The role of P. acnes is not clear, as this bacterium is ubiquitous. However, certain strains of acne may be more associated with acne and be pro-inflammatory. Regardless of the ongoing debate regarding P. acnes, antibiotics used in the treatment of acne appear to have anti-inflammatory effects independent of their antimicrobial effects. As a result, the first-line treatment of acne involves broad-spectrum oral and topical antibiotics, which require protracted treatments of a minimum of 3–6 months. Chronic antibiotics may have long-term side effects and detrimental effects on the host microbiome, including selection for multidrug resistant bacteria on the skin and in the gut. For example, the use of clindamycin has been associated with pseudomembranous colitis, tetracycline has been shown to change skin color, and erythromycin can precipitate hepatic dysfunction. Other medications used for acne such asisotretinoin, while effective, require close monitoring and have many side effects, including a risk of teratogenicity. Therefore, there is a need for safe and effective alternatives to treat acne. Plant-based approaches have been practiced in multiple medical perspectives, including Chinese medicine and Ayurveda. Our understanding of medicinal plant efficacy and their mechanisms is growing as demand for natural, holistic approaches and fears over the ramifications of chronic antibiotic use increase. Here, we discuss the importance of the gut microbiome in acne pathogenesis and the potential for phytotherapeutic treatments .The bacteria in our intestines function akin to an organ. Our gut bacteria perform multiple functions, including maintaining structural and functional integrity of the gut, immune system regulation, food breakdown, providing nutritional benefits to the host , and preventing the growth of harmful bacteria. In the 1930s, Stokes and Pillsbury used experimental evidence and anecdotes to identify an association between microbial flora and inflammation of the skin. They found as many as 40% of those with acne had hypochlorhydria and hypothesized a lack of acid would induce a migration of bacteria from the colon to the small intestine and disrupt normal intestinal flora. In recent years, hypochlorhydria has been confirmed to be a significant risk factor for small intestinal bacterial overgrowth , plant pots round which can cause increased intestinal permeability , leading to systemic inflammation. The excess bacteria can compete with the host for nutrients, produce toxic metabolites, and cause direct injury to enterocytes in the small intestine. Studies as early as 1916 suggested intestinal permeability might be augmented in acne vulgaris. In one such study of 57 acne patients, researchers used a blood serum complement fixation test to demonstrate enhanced reactivity to stool-isolated coliforms in 66% of the acne patients compared to none of the control patients. Later in 1983, a study involving 80 acne patients showed the presence of lipopolysaccharide endotoxins from Escherichia coli in the serum of acne patients. These results suggest that gut microbes may enhance the presence of circulating endotoxins in the blood of acne vulgaris patients compared to healthy controls. Although the mechanisms for how the gut and skin communicate are poorly understood, acne appears to have a potential gut-skin connection that may be a manifestation of a systemic problem involving intestinal bacteria and increased permeability.

The human intestine is colonized by a complex microbial ecosystem that is hypothesized to be involved in the bioavailability of orally-administered drugs, as well as a number of disease states. The intestinal microbiota is a complex and dynamic bacterial community that plays an important role in human health. Alterations in microbiota composition and function have been related to different intestinal and extra-intestinal diseases. The first attempts to examine the intestinal bacterial flora in acne patients was conducted in 1955 by Loveman et al.. The authors concluded there were no major differences in a small subset of pathogenic bacteria. However, Bacteroides species were more commonly isolated from the acne patients. Russian investigators who studied 114 patients with acne vulgaris noted that 54% of acne patients have differences in their intestinal flora. Additionally, they found when acne patients with dysbiosis in their intestinal flora received probiotics, there was a reduction in the duration of treatment. The potential dysbiosis in the enteric microbial profile of acne patients needs further investigation and remains a potential source for alternative treatments. Differences in the gut microflora are not unique to patients with acne vulgaris. Investigators have identified lower counts of Bifidobacterium in fecal specimens from patients with atopic dermatitis compared to healthy controls. Furthermore, the composition and diversity of the gut microbiota in young children who develop atopic dermatitis were found to be different from children who never develop the disease. The mechanisms by which the gut microbiome exerts its effects and links between the gut flora and the pathogenesis of skin disease are not clear yet and remain an active area in research.Numerous studies have reported beneficial interactions between the human body and its microbiota. These relationships have suggested that modulation of the microbiota through prebiotics and probiotics may prevent or resolve various diseases such as pediatric infectious diseases, skin disease, gastrointestinal disorders, and allergic diseases . Probiotics are live microorganisms that can alter gut homeostasis and immunity. Here, we discuss current evidence supporting probiotics for the treatment of acne vulgaris. Bifidobacteria and Lactobacilli are lactic acid-producing bacteria normally found in the gut that may assist in the treatment of inflammatory skin diseases, such as acne. Physicians, as early as the 1930s, used orally-administered Lactobacillus acidophilus cultures as a probiotic to treat acne. Despite various anecdotal reports, there was little research to determine efficacy at the time. The first formal case reports describing the use and benefits of Lactobacilli were not until 1961. The study gave probiotic tablets containing both L. acidophilus and Lactobacillus bulgaricus to 300 patients for 16 days with an interim two-week washout after the first eight days. The author reported 80% of patients with acne had some degree of clinical improvement, with the greatest improvement in those with severe inflammatory acne. Unfortunately the study did not have controls, and the authors simply concluded that there is an interaction between the skin manifestation of acne vulgaris and metabolic processes in the intestinal tract. In recent decades, only a few studies have investigated oral probiotics in the treatment of acne vulgaris. One study tested an oral supplement composed of lyophilized L. acidophilus and Bifidobacterium bifidum in 40 patients as an adjuvant to standard antibiotics in half of the group. The authors reported patients treated with a probiotic had improved clinical outcomes and reported fewer side effects from the standard antibiotics. Likewise, a Russian study tested the effectiveness of probiotics as adjuvants to standard acne treatment and found that patients taking probiotics experienced improvements sooner in their acne treatment compared to controls. While the mechanism of probiotics is not well understood, recent research has shown that they may reduce oxidative stress and inflammation. Patients with acne have a high local burden of lipid peroxidation placing a high demand on blood-derived antioxidants. Orally-consumed pre- and pro-biotics have been shown to reduce systemic markers of inflammation and oxidative stress. Additionally, oral probiotics have been shown to regulate the release of inflammatory cytokines in the skin and reduce interleukin-1 α. Lastly, probiotics can change the microbial community at distant sites outside of the gastrointestinal tract. Therefore, the ability of oral probiotics to reduce systemic oxidative stress, regulate cytokines, and reduce inflammatory markers may all contribute to its effects on acne.


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