Study design of Treating Acne with Phage
David Pai Zhang
Background
Acne, also called whelks, is a common skin problem in adolescents and female
population. Research has demonstrated that propionibacterium acne is one of the most
important induction factors. Propionibacterium acnes refers to the bacteria
parasitizing in the pores and causing acne. And propionibacterium acnes
bacteriophage belongs to a virus family parasitizing on human skin. This virus family
is harmless to people, but is able to kill propionibacterium acnes which causes acne.
When propionibacterium acnes overwhelm the immune system, acne appears. The
most efficient treatment is to decrease the number of propionibacterium acnes
parasitizing on one’s skin.
Researchers in UCLA and Pittsburgh University published their study in the
journal of mBio (mbio.asm.org), Sep. 25th, 2013. The authors stated that
bacteriophage was born to target and kill specific bacteria. Thus propionibacterium
acnes bacteriophage will only attack propionibacterium acnes but not other bacteria.
This characteristic implicated that they could be used for targeted treatment.
Researchers believed that by applying cream or ointment with this propionibacterium
acnes bacteriophage on affected area, acne could be eliminated. However,
propionibacterium acnes bacteriophage could also prevent the infection of other
microorganisms. Thus, a question remains of how to control the magnitude of the
reproduction of bacteriophage as an issue that needs further research.
Material
Identify subjects diagnosed with acne and complete informed consent to
participate in the study. Find propionibacterium acnes that cause acne and produce
this bacteria and bacteriophage in laboratory. Next package, quantify, and preserve
samples according to the corresponding experimental requirements. Finally, apply the
antibiotics treating acnes and quantify the results by evaluating the clinical rank of
acne severity pre- and post-treatment.
Experimental design
The study design includes three intervention groups; antibiotics group,
bacteriophage group and placebo group. The experiment is double-blinded with only
the study designer having knowledge of the specific medication each participant was
taking. Each group contained 15 people, with acne severity ranked on a scale from 1
(low severity) to 15 (high severity). Subjects are grouped based on rankings: 1 to 5
refers to those who have mild acne, 6 to 10 moderate, acne, and 11 to 15 severe.
People with the same number in each group are matched on the age, gender, and clinic
rank of acne. Rhythm, diet, skin care products and other factors that have impact on
the skins were strictly controlled.
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Experiment
groups
Antibiotics group
No. 1 to15
15 people in total
Bacteriophage group
No. 1 to15
15 people in total
Placebo group
No. 1 to15
15 people in total
mild：No. 1-5
moderate：No. 6-10
severe：No. 11-15
mild：No. 1-5
moderate：No. 6-10
severe：No. 11-15
mild：No. 1-5
moderate：No. 6-10
severe：No. 11-15
Intervention treatment and effect summery
Each intervention group received the corresponding dose and will be observed
regularly. The affected skin will be divided into 6 areas, including forehead, left cheek,
right cheek, nose, chin, and chest and back. A rating scale will be used to evaluate
each each area according to the severity of acne on each key area of the skin. Acne on
the forehead, left and right cheek will be counted as 2 points, on the nose and chin
counted as 1 point, and on the chest and back counted as 3 points. Severity of acne
will be rated on the following scale: 0 to 4: zero refers to no damage, 1 refers to one
or more than one comedo; 2 refers to one or more than one papula; 3 referrs to one or
more than one pustule; 4 refers to one or more than one nodular cyst. The highest rank
of each area and the score of that area was scored, and added as a product of each area
to compute a final total score. Those who scored 0 meant none, those scored 1-18
meant mild, 19-30 meant moderate, 31-38 meant severe, above 39 meant extremely
severe. After finishing the course of treatment for the antibiotic group and life cycle
for the bacteriophage group there will be comparisons on the effect for each of the
three groups.
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Results
Antibiotic group
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
No.9
No.10。
No.11
No.12
No.13
No.14
No.15
Bacteriophage
group
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
No.9
No.10。
No.11
No.12
No.13
No.14
No.15
Placebo group
Result
comparison
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
No.9
No.10。
No.11
No.12
No.13
No.14
No.15
Conclusion
The purpose of the study is to evaluate whether bacteriophage will demonstrate
greater improvement in acne severity in comparison to the other two intervention
groups.
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