Presented by: Marie Ryan
AV is the world’s most common inflammatory skin disease, and has been associated with a range of agents such as C.acnes, androgens, genetics, dairy products, stress, or sugary foods such as chocolate1. A pilot study spanning 15 days was completed in 2019-2020 in Vientiane, Laos2 to test if limiting the consumption of three simple sugar groups found in everyday foods could regulate inflammation occurring in AV and correlated with changes in the gut microbiome over the same period. An adult Lao AV cohort was advantageous as Lao people consume little to no dairy, wheat products, or highly processed foods that have often been cited as contributing to the development of AV.
Design and method: The study was a non-randomized, prospective observational dietary cohort of 27 healthy adult AV cases (25F/2M). A catered diet low in target sugars was supplied for 15 days, where glycemic load and dairy products were not restricted. IGA scores (IGA 1-5) were agreed (baseline and endpoint) by two dermatologists. Self-reported adherence was >90%. Fecal samples from 27 AV cases were taken at baseline and endpoint as well as samples from 4 non-AV healthy adults as controls, for DNA analysis (Shallow Shotgun Metagenomic Sequencing (SSMS) Diversigen Laboratories MN USA) Intestinal parasite exams were completed at pre-inclusion, baseline and endpoint, with treatment as appropriate.
Results at endpoint Day 15: Any IGA improvement was observed for 19/27 (70.3%) with at least a 2-point IGA improvement for 6 of them (22.2%) representing a clinically meaningful outcome (asspecified by the US-FDA). No change in IGA score was observed for 6 participants (22.2%) and worsening for 2 (7.4%). Positive parasite exams were found for 5/27 at baseline (18.5%), 5 at endpoint (18.5%) with 2 both at baseline and endpoint. Weight loss (-1-4 kg) was reported for 20/27 cases (74.1%) All participants reported bathroom frequency/ease improvement. Observed/reported excess consumption and resultant AV lesions (<2 hours) has meant analysis of the gut microbiome is focused on bacterial species/strains located in the proximal end of the small intestine.
Conclusions: Our dietary cohort results suggest that limiting target simple sugar groups (<40grams total/day) impacted positively on AV and improved bathroom frequency and ease in our cohort. Preliminary analysis for 26 subjects (1 sample excluded) suggest nine bacterial strains may be of interest in helping establish the etiology of AV.
Keywords: acne vulgaris, microbiome, simple sugar groups, malabsorption, inflammation
2 Ethics Approval No.075/NECHR Lao National Ethics Committee for Health Research
Marie Ryan – Poster Description (Audio Clip)