Acne Vaccines Could Offer Robust Defense

Acne vaccines could offer a robust defense

By Benjamin Plackett

This article is part of Perspectives of nature: skinan independent editorial supplement produced with financial support from Leo Pharma. About this content.

Acne has long been rejected as an unhappy cosmetic question – a rite of passage which is ultimately unimportant. But this attitude changes. Many scientists now accept that acne is a condition worthy of attention.

About 80% of adolescents worldwide suffer from acne, who can persist later in adulthood. Because the beginning of acne can coincide with the stage of development when self-image is formed, epidemics “can lead to a social withdrawal, low self-esteem and even depression,” explains dermatologist Anjali Mahto, spokesperson for the British Skin Foundation based in London.

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Topical acne treatments offer only partial and temporary reductions in symptoms. Even antibiotic isotretinoin, which has significant side effects, is only a short -term solution – acne often rebounds a few months after the end of treatment. There is therefore a considerable need for treatments that can really ban acne, rather than hiding it.

Of the management of this charge are two vaccine candidates who aim to engage the immune system in the fight against the underlying cause of the acne. Acne is influenced by hormones and genetics, but it is motivated by inflammation and lesions caused by bacteria that develop in obstructed pores. Vaccines – which would deal with the condition and which would act as a preventive measure – would try to cause the immune system to target these bacteria causing acne. “It took time for the field to treat acne as a disease of immune regulation, rather than a simple surface problem,” explains Mahto. “What matters most is this change in the state of mind.”

Messenger RNA money manufacturer

In the United States, people with acne generally spend up to US $ 200 each year on over-the-counter products designed to treat imperfections. Isotretinoin can cost up to $ 3,000 for a four to six months’ lessons. The global acne medication market was estimated at $ 9.22 billion in 2023 and is expected to increase by around 5% per year for the rest of this decade. The Sanofi pharmaceutical company in Paris suggests that the acne vaccine it develops could bring in more than $ 2 billion per year of income.

The company is recruiting up to 400 people with moderate to severe acne in the United States to participate in a phase I clinical trial for its therapeutic vaccine. Participants will receive two injections initially and a booster fired a year later. Sanofi intends to recruit 200 additional people with light acne for a second clinical trial in Singapore.

These trials follow Sanofi’s experiences with the acne prevention agent in mice. The researchers tested two versions of the vaccine in animals: one containing protein fragments of bacteria associated with acne, and the other composed of messenger RNA pieces which code these proteins. After injected the mice, the team checked if the animals had produced antibodies. The bacteria causing acne were then exposed to these laboratory antibodies to verify that antibodies could limit the growth of bacteria. The mRNA vaccine has proven to be the most effective of both and is the version which is now tested in humans. “If we can reduce the use of antibiotics, we are not only creating value for people who take the vaccine, but also for society also, reducing microbial resistance,” explains Jean-François Toussaint, who directs the research and development of the vaccine in Sanofi.

A prevention rival

The pediatrician George Liu at the University of California in San Diego, and his colleagues also work on an acne vaccine – but they have adopted a different approach (ia hajam and al. Common nature. 148061; 2023).

Instead of using mRNA, they target an enzyme called hyaluronidase, which is secreted by bacteria causing acne. Hyaluronidase breaks down hyaluronic acid, a protective substance produced by the skin. This triggers the inflammatory response that manifests itself as acne. Liu hopes to disrupt the biochemical path that culminates in this inflammation.

His team injected mice with hyaluronidase fragments and has coated the skin of animals with an oily substance to imitate the affections of human skin. Scientists then modeled acne in mice by infecting the humanized skin of animals with bacteria; The mice of a control group were infected in a similar way, but did not receive the vaccine. The result clearly showed that the vaccine prevented the start of acne in mice. He does so, said Liu, inducing antibodies that bind to the enzyme and neutralize it. Unlike the Sanofi vaccine, which is intended to treat people with acne, them would be mainly used for prevention.

One of the challenges that the two efforts will face is the rise of vaccination hesitation. In a telephone survey in 2024 by the global analysis company Gallup, of 1,010 American adults, only 40% said that it was “extremely important” for parents to have their children vaccinated for serious illnesses such as measles (see Go.Nature.com/4ietfak). If this is what people think of wild vaccines, a stroke of acne could be a difficult sale.

But Mahto sees an opening. “It depends on how the vaccine is positioned and communicated,” she said. “These vaccines are not offered as part of a national vaccination program – they would be optional.” The absence of an effective alternative could motivate many people to get it, she said. “If a vaccine was safe, effective and offered a longer -term remission without the need for drugs in progress, many would be open.”

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