Human Skin Metagenome Associated with Acne

Studies have emphasized the importance of disease-associated microorganisms in perturbed communities, however, the protective roles of commensals are largely under recognized and poorly understood. Using acne as a model disease, we investigated the determinants of the overall virulence property of the skin microbiota when disease- and health-associated organisms coexist in the community. By ultra-deep metagenomic shotgun sequencing, we revealed higher relative abundances of propionibacteria and Propionibacterium acnes phage in healthy skin. In acne patients, the microbiome composition at the species level and at P. acnes strain level was more diverse than in healthy individuals, with enriched virulence-associated factors and reduced abundance of metabolic synthesis genes. Based on the abundance profiles of the metagenomic elements, we constructed a quantitative prediction model, which classified the clinical states of the host skin with high accuracy in both our study cohort (85%) and an independent sample set (86%). Our results suggest that the balance between metagenomic elements, not the mere presence of disease-associated strains, shapes the overall virulence property of the skin microbiota. This study provides new insights into the microbial mechanism of acne pathogenesis and suggests probiotic and phage therapies as potential acne treatments to modulate the skin microbiota and to maintain skin health.]]> Subjects must: 1. be male or female age 13 or older. 2. understand the test procedure, and must read and sign the appropriate informed consent form indicating their willingness to participate. 3. agree to refrain from using any product on the skin during the study. 4. agree to adhere to the study procedures and requirements. 5. have visible acne lesions on skin, suitable for culture and/or biopsy (for acne patients only). Subjects must not: 1. have poor skin condition including erythema, sunburn, abrasions, etc. on the test sites. 2. have participated in a study wherein the test areas were previously indicated as test sites within one month prior to the start date of this study. 3. be involved in any aspect of test administration. 4. participate in any other study concurrently which the investigator feels may influence the results of this study. 5. have any medical condition or factor which the investigator believes might affect the response of the skin. ]]>