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The Effect of Probiotics on Skin

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The Effect of Probiotics on Skin December 2014 The effect of probiotics on skin Probiotics in dermatology — from theory to enterprise ACADEMIC CONSULTANCY TRAINING Group 1457 Bob van den Berg Jiang Chang Aafke Duizendstra Renate Jansen Ana Jimena Pacheco Gutierrez Tian Zhao Coach: Carel Weijers Content coach: Willemien Lommen Commissioner: Skinwiser, Dr Jetske Ultee & Matthijs Boog Ana Jimena Pacheco Gutierrez [email protected] 0626667543 Stichting Skinwiser Matthijs Boog ([email protected]) Maasstraat 11 3016 DB Rotterdam Source image: “ The trillions of microbes in and on our bodies are key to understanding our health ” Follow Up on AO+ Living Bacterial Skin Tonic - Allergies & Your Gut (Accessed December 5, 2014) Disclaimer This report (product) is produced by students of Wageningen University as part of their MSc- programme. It is not an official publication of Wageningen University or Wageningen UR and the content herein does not represent any formal position or representation by Wageningen University. Part of MSc course Academic Consultancy Training (9 ECTS) Copyright © 2014 All rights reserved. No part of this publication can be reproduced or distributed in any form or by any means, without the prior consent of the authors. i The effect of probiotics on skin ACT group 1457 Team logo of ACT group 1457, all rights reserved “ Staphylococcus epidermidis protects our skin from the invading pathogens ” ii Executive summary This project was commissioned by Skinwiser to examine whether probiotics can have a positive effect on the skin. We assessed if topical application of probiotics can improve healthy or affected skin. The skin conditions included are rosacea, acne and atopic dermatitis. First, literature about healthy skin, skin conditions and (gut) probiotics was studied. Based on that, we pinpointed mechanisms in healthy and affected skin that could be targeted using probiotics. Next, we looked for bacterial strains that could tackle the selected mechanisms. Simultaneously, we performed a short market study on (non-oral) probiotics. We conclude that healthy skin could be best targeted by improving skin barrier function using sphingomyelinase-producing Streptococcus thermophilus, thereby increasing ceramide levels in the skin. No suitable strains were found for improving rosacea. In acne, Propionibacterium acnes overgrowth could be tackled by inhibiting this bacterium using Staphylococcus epidermidis. Atopic dermatitis could be improved using sphingomyelinase-producing Streptococcus thermophilus. Furthermore, inhibiting Staphylococcus aureus using Esp-secreting Staphylococcus epidermidis could improve atopic dermatitis symptoms. Moreover, clinical studies using Vitreoscilla filiformis lysate showed promise in improving atopic dermatitis, potentially by improving immune tolerance. We also conclude that the market study showed that most available products were intended for disease prevention, healthy skin or skin cleaning. Information about specific strains included was rarely disclosed and claimed working mechanisms were mostly competitive exclusion of pathogens and strengthening of the skin. In our opinion probiotics can have a positive effect on the skin. However, more research is needed to verify the efficacy of the strains found. We recommend further research into the previously mentioned strains for the development of probiotics–containing skin care products. Oral probiotics are more promising to target rosacea than topical probiotics based on current research. A combination of pre- and probiotics could be used to increase their effect, while a combination of pro- and postbiotics could include products of pathogenic bacteria. Inclusion of spores from spore- forming bacteria can be a promising approach to store microorganisms in a product. We advice Skinwiser to research (some or all of) the selected strains. Recommendations for further research are included to help in this process. iii Abbreviations AD : Atopic dermatitis SIBO : Bacterial Overgrowth in Small AMP : Antimicrobial protein Intestine APC : Antigen Presenting Cell SCFAs : Short chain fatty acids APN : Amino-peptidase N SCORAD: SCORing Atopic Dermatitis CE : Cornified envelope SOD : Superoxide dismutases CFMW : CM4-fermented milk whey SP : Substance P CGRP : Calcitonin gene related SST : Somatostatin peptide TEWL : Transepidermal water loss CRH : Corticotrophin Releasing Th-cells : T helper cells Hormone TLR : Toll-like Receptor DCs : Dendritic cells T-regs : Regulatory T-cells DHEA : Dehydroepiandrosterone TRPV1 : Transient receptor potential DHT : Dihydrotestosterone vanilloid subfamily member 1 DP-IV : Dipeptidyl peptidase IV UVB : Ultraviolet B EGFβ : Epidermal growth factor beta VIP : Vasoactive Intestinal Peptide Esp : Extracellular serine protease WHO : World Health Organization ETR : Erythematotelangiectatic YopP : Yersinia outer protein P Rosacea FAO : Food and Agriculture Organization FDA : Food and Drug Administration FOS : Fructo-oligosaccharides GI : Gastro-intestinal GOS : Galacto-oligosaccharides GST : Glutathione S-transferase hBD2 : Human β-defensin-2 IBD : Inflammatory bowel disease IBS : Irritable Bowel Syndrome IFNγ : Interferon γ IL-12 : Interleukin-12 IMO : Isomalto-oligosaccharide ITF : Nulin-type fructants KLK5 : Kallikrein 5 LC : Langerhans Cells LGG : Lactobacillus rhamnosus GG LRP : La Roche Posay MAMP : Microbe Associated Molecular Pattern MAP : Mitogen activated protein mEASI : Modified eczema area severity index MED : Minimal Erythemal Dose MMPs : Matrix metalloproteinases MRSA : Methicillin-resistant Staphylococcus aureus NFκB : Nuclear factor κB NK cells : Natural Killer cells NMF : Natural Moisturizing Factor PAR-2 : protease-activated receptor-2 PPR : Papulopustular Rosacea PRR : Pattern Recognition Receptor ROS : Reactive Oxygen Species iv Table of Contents 1. INTRODUCTION ................................................................................................................................................... 3 1.1 Introduction to the report ............................................................................................................................ 3 1.1.1 Scope ..................................................................................................................................................... 3 1.1.2 Organization of the report .................................................................................................................... 4 1.2 Background ................................................................................................................................................... 5 1.2.1 Overview of the immune system .......................................................................................................... 5 1.2.2 Host-microbe interactions ................................................................................................................... 10 1.2.3 Gut microbiome .................................................................................................................................. 11 1.2.4 Probiotics, prebiotics and postbiotics ................................................................................................. 13 2. METHODOLOGY ................................................................................................................................................ 20 3. RESULTS ............................................................................................................................................................. 23 3.1 Healthy skin ................................................................................................................................................ 23 3.1.1 The skin................................................................................................................................................ 23 3.1.2 Microbiome on the skin ...................................................................................................................... 25 3.1.3 Photoprotection by oral probiotics ..................................................................................................... 26 3.2 Rosacea ....................................................................................................................................................... 30 3.2.1 Symptoms ............................................................................................................................................ 30 3.2.2 Quality of life patients ......................................................................................................................... 31 3.2.3 Risk factors .......................................................................................................................................... 32 3.2.4 Molecular mechanisms ....................................................................................................................... 36 3.2.5 Interactions between the possible risk factors and molecular mechanisms ...................................... 39 3.2.6. Treatments ......................................................................................................................................... 40 3.2.7 Summary rosacea ................................................................................................................................ 44 3.3 Acne ...........................................................................................................................................................
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