Heard of the gut-brain axis? Meet the gut-skin axis...
Investigations using the probiotic Lactobacillus rhamnosus SP1 (LSP1) appeared to normalise the skin expression of certain genes that are involved in insulin signalling.
Accumulating evidence suggests that alterations in insulin signalling may play a significant role in the pathogenesis of adult acne possibly via the regulation of intestinal permeability.
The observed actions of probiotics in this relationship has given rise to the gut-skin axis that has also been implicated in the fine tuning of systemic inflammation and tissue lipid content.
Pilot study details
Dr Enzo Emanuele, CEO of 2E Science, a private Italian-based research organisation devised a pilot, randomised, double-blinded, placebo-controlled study that was carried out on 20 adult subjects with acne.
Over a 12-week period, the probiotic group of 10 subjects consumed a liquid supplement (75mg/day) containing LSP1 at a dose of 3×109 colony forming units per day (cfu/day).
A placebo group was also added, where 10 subjects received a liquid containing no probiotics.
Skin biopsies that were carried out at the start and end of treatment were then analysed for the gene expression of insulin-like growth factor 1 (IGF1) and forkhead box protein O1 (FOXO1).
Based on a five-point scale rating improvement in skin appearance, the probiotic group showed a 32% reduction, as well as a 65% increase in IGF1 and FOXO1 gene expression in the skin, respectively.
The treatment appeared to be safe and well-tolerated. No such differences in skin appearance were observed in the placebo group.
“It is possible that this probiotic strain may improve insulin resistance through direct metabolic effects and/or by correcting a state of intestinal dysbiosis,” the study’s authors theorised.
“Alterations in the gut microbiome and gut permeability can increase levels of circulating toxin that in turn activate proteins (TLR-2 and TLR-4) that play a key role in the innate immune system.”
“Their activation can induce the release of cell-signalling molecules and the expression of enzymes that ultimately aggravate acne.”
LSP1 as a candidate
LSP1’s use is a decision based on previous studies identifying the strain’s effectiveness in improving gut permeability.
In this study, modulation of gut microbiota and permeability by LSP1 may have also been responsible for lowering FOXO1 skin expression, a key action in the progression of acne.
The encouraging safety profile and tolerability of the probiotic led the team to think that LSP1, as an aid to acne medical therapy (e.g. antibiotics, retinoids, and isotretinoin), warranted further scrutiny.
“Although the improvement in acne appearance elicited by LSP1 supplementation was promising, our data need to be confirmed in clinical trials with larger sample sizes and longer treatment duration.”
“Although preliminary evidence indicates that topical preparations derived from probiotics can find application, the question as to whether topical LSP1 may be helpful in acne is yet to be investigated in future clinical trials.”
This study was based on a collaboration between Enzo Emanuele and Biodue, a manufacturer of skin cosmetics and food supplements.
Source: Beneficial Microbes
Published online ahead of print: DOI 10.3920/BM2016.0089
“Supplementation with Lactobacillus rhamnosus SP1 normalises skin expression of genes implicated in insulin signalling and improves adult acne.”
Authors: Enzo Emanuele et al.
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