痤疮丙酸杆菌的研究进展及痤疮皮肤护理新方向

doi:10.3969/j.issn.2097-2806.2025.07.013

摘要/Abstract

摘要：

痤疮丙酸杆菌是一种革兰氏阳性兼性厌氧菌，是人体皮肤共生微生物组的一部分，它定植于身体的各个部位，包括面部、背部和胸部。痤疮丙酸杆菌被认为在寻常痤疮的病理生理学中起到重要作用，在近年研究中发现不同系统型的菌株与皮肤健康和不同的疾病类型相关。本文综述了痤疮丙酸杆菌的分类及目前的研究现状，总结了不同的皮肤类型下痤疮丙酸杆菌的存在状态，强调了在痤疮护理中使用抗生素产生的耐药性风险以及微生物群失衡的风险，讨论了新的痤疮护理方法，旨在为痤疮的护理和护肤品开发及其功效评价开辟新的思路，为皮肤微生态的研究提出新方向。

关键词: 痤疮丙酸杆菌, 系统发育型, 发病机制, 微生物群, 护肤方案

Abstract:

Cutibacterium acnes （C. acnes） is a gram-positive facultative anaerobic bacterium and a part of the human skin symbiotic microbiome. It colonizes various parts of the body, including the face, back and chest. C. acnes is regarded as playing a significant role in the pathophysiology of acne vulgaris. In recent studies, it has been found that strains of different systemic types are associated with skin health and various disease types. This article reviews the classification of C. acnes and the current research status, summarizes the existence status of C. acnes under different skin types, emphasizes the risk of drug resistance and microbiota imbalance caused by the use of antibiotics in acne care, and discusses new acne care methods, aiming to open up new ideas for the care of acne, the development of skin care products and the evaluation of their efficacy. It proposes a new direction for the research of skin microecology.

Key words: Cutibacterium acnes, phylogenetic type, pathogenesis, microbiota, skin care program

中图分类号:

TQ658

毛欣宇, 杨素珍, 李燕, 韩婷婷, 袁春颖, 杲款款. 痤疮丙酸杆菌的研究进展及痤疮皮肤护理新方向[J]. 日用化学工业（中英文）, 2025, 55(7): 920-927.

Xinyu Mao, Suzhen Yang, Yan Li, Tingting Han, Chunying Yuan, Kuankuan Gao. Research progress of Cutibacterium acnes and new direction of acne skin care[J]. China Surfactant Detergent & Cosmetics, 2025, 55(7): 920-927.

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分型方法	系统型^[8]	RecA type	核糖型^[9]	MLST₄^[10]	MLST₉^[11]	SLST^[12]
具体类型	IA-1	IA	RT1	IA₁（CC1）	I-1a （CC18）	A1-34
与疾病的关联	痤疮相关			痤疮相关	痤疮相关
具体类型	IA-2	IA	RT1	IA₁（CC3）	I-1a （CC3）
与疾病的关联				痤疮相关	痤疮相关
具体类型	IA-2	IA	RT4、RT5	IA₁（CC3）	I-1a （CC3）	C1-5
与疾病的关联			痤疮相关	痤疮相关	痤疮相关
具体类型	IB-1	IB	RT8	IA₁（CC4）	I-1b
与疾病的关联			痤疮相关	痤疮相关
具体类型	IB-2	IB	RT3	IA₂	I-1a （CC28）
与疾病的关联				术后感染的眼内炎症	痤疮相关
具体类型	IB-3	IB	RT1	IB	I-2（CC36）	H1-8
与疾病的关联				医疗器械感染、组织相关
具体类型	IC	IA	RT5	IC		G1
与疾病的关联			痤疮相关	痤疮相关
具体类型	Ⅱ	Ⅱ	RT2	Ⅱ	Ⅱ	K1-25
与疾病的关联				医疗器械感染、血液相关
具体类型	Ⅱ	Ⅱ	RT6	Ⅱ（ST7）	Ⅱ
与疾病的关联			健康肌肤	医疗器械感染、血液相关
具体类型	Ⅲ	Ⅲ		Ⅲ		L1-10
与疾病的关联				健康肌肤、椎间盘感染

非抗生素治疗	作用方式	痤疮的临床应用	对皮肤微生物组的影响
维A酸类药物曲法罗汀（Trifarotene） 0.005%的乳膏	选择性RARγ激动剂，溶解粉刺、抗炎和色素沉着	FDA和EMA批准用于9岁以上患者的面部和躯干痤疮^[36]	不会导致抗菌素耐药性
局部雄激素受体抑制类药物克拉司酮（Clascoterone）1%的乳膏	局部雄激素受体拮抗剂，阻断引起痤疮病变的关键驱动因素——二氢睾酮的局部效应	FDA批准用于12岁及以上患者的痤疮^[37]	不会导致抗菌素耐药性
口服螺内酯（Spironolactone）	口服抗雄激素药物	用于成年女性的痤疮治疗^[38]	不会导致抗菌素耐药性
光动力疗法（PDT）	5-氨基乙酰丙酸介导的PDT（ALA-PDT）	用于治疗重度痤疮，且具有良好的耐受性^[39]	有助于增强痤疮患者的α多样性^[40]，抑制了滤泡微生物组内C. acens的存在，同时增加了常驻菌（主要是芽孢杆菌和乳球菌）的丰度
30%超分子水杨酸（SSA）	一种改良的水杨酸，进行焕肤	用于治疗中度至重度痤疮^[41]	通过增加α和β多样性指数，降低葡萄球菌（Staphylococcus）、罗尔斯顿菌（Ralstonia）、链球菌（Streptococcus）的相对丰度，使得总体菌属分布趋于健康状态
桃金娘素（Myrtacine?）	一种含有桃金娘酮的天然活性剂	可用于痤疮的辅助治疗^[42]	可以靶向针对生物膜，并克服对抗生素的耐药性增加并恢复平衡的皮肤微生物组