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PubMed1987

Acne management. Primary care physician or dermatologist?

The question of who should treat acne patients--primary care physicians or dermatologists--is debatable. To determine physicians' attitudes toward, and referral patterns in, acne management, the authors conducted two studies. According to results of the first study, primary care physicians were less likely than dermatologists to feel referral was necessary for acne management. Primary care physicians felt that they should treat most patients with less severe (comedonal and papulopustular) acne and were neutral about referral of patients with nodulocystic acne. Dermatologists were neutral about referral of patients with less severe acne and recommended referral for most patients with nodulocystic acne. Results of the second study showed that almost all patients with less severe acne and most patients with nodulocystic acne were managed by primary care physicians. The authors feel that primary care physicians can and should handle most cases of acne without referral.

Acne Vulgaris↗
PubMed1996

Mild insulin resistance during oral glucose tolerance test (OGTT) in women with acne.

The purpose of this study was to evaluate serum levels of basal insulin and glucose-stimulated insulin, and to evaluate their correlations with androgen levels in women with acne. Serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IFG-1), and immunoreactive insulin (IRI) were measured and compared in thirty women with moderate or severe acne and thirteen healthy controls. Serum FT, DHT and DHEA-S levels in the acne group were significantly higher than those in the control group. In the acne group, there were no significant correlations between insulin or IGF-1 levels and T, FT, DHT and SHBG, despite the positive correlation between insulin and IGF-1. In order to determine the effects of insulin secretion as a dynamic response to an oral glucose tolerance test (OGTT) on serum androgen levels in acne patients, we examined the responses of serum insulin and androgen levels to a 75 g, 2 hour OGTT in the acne group and in the control group. Basal insulin levels were not significantly higher than those in the control group, but the summed insulin levels during the OGTT in the acne group were significantly higher than those in the control group. Serum T and FT levels in the acne group decreased during the OGTT, but these changes were not so significant when compared to normal controls. In conclusion, we tried to demonstrate mild insulin resistance during the OGTT in acne patients. However, postmeal transient hyperinsulinemia does not seem to play an important role in determining hyperandrogenemia in acne patients.

Acne Vulgaris↗
PubMed1981

Reduced sex hormone binding globulin and derived free testosterone levels in women with severe acne.

Reduced circulating sex hormone binding globulin (SHBG) levels were found in 54% of a group of women with moderate to severe acne and in 60% of another group of twenty-three women who had acne complicated by hirsutism and/or irregular menstrual cycles. The concentrations of SHBG for the women with acne alone (mean 48 +/- 24 nmol/l) and for those with acne and hirsutes (mean 39 +/- 18 nmol/l) were compared with the SHBG concentrations of fifteen unaffected women with normal menstrual cycles (mean 70 +/- 19 nmol/l). The differences in mean SHBG values for both groups of women with acne were significant (P less than 0.001) on comparison with the mean for the unaffected women. Twenty-nine per cent of the women with acne had elevated testosterone values (mean testosterone concentration for the group 1.5 +/- 0.3 nmol/l) and 41% had elevated 'derived' free testosterone levels (mean 21 +/- 6 pmol/l). Of the women with acne and hirsutes 65% had elevated plasma testosterone levels (mean 2.1 +/- 0.6 nmol/l) and 89% had elevated free testosterone concentrations (mean 31 +/- 10 pmol/l). The mean values for testosterone and free testosterone in the plasma of unaffected women (mean testosterone concentration 1.1 +/- 0.3 nmol/l and free testosterone 13 +/- 4 pmol/l) were significantly lower than in women with acne alone (P less than 0.01 and P less than 0.001) and in women with acne and hirsutism (P less than 0.001). This study indicates that a deficiency in SHBG and an elevation in 'derived' free testosterone is a frequent finding in women with severe acne and may be a significant factor in the aetiology and/or perpetuation of this condition.

Acne Vulgaris↗
PubMed1995

Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris.

BACKGROUND: Systemic and topical antimicrobials are effective in the treatment of inflammatory acne vulgaris; however, widespread use of these agents is becoming increasingly associated with the emergence of resistant pathogens raising concerns about microorganism resistance and highlighting the need for alternative nonantimicrobial agents for the treatment of acne. Nicotinamide gel provides potent antiinflammatory activity without the risk of inducing bacterial resistance. METHODS: In our double-blind investigation, the safety and efficacy of topically applied 4% nicotinamide gel was compared to 1% clindamycin gel for the treatment of moderate inflammatory acne vulgaris. Seventy-six patients were randomly assigned to apply either 4% nicotinamide gel (n = 38) or 1% clindamycin gel (n = 38) twice daily for 8 weeks. Efficacy was evaluated at 4 and 8 weeks using a Physician's Global Evaluation, Acne Lesion Counts, and an Acne Severity Rating. RESULTS: After 8 weeks, both treatments produced comparable (P = 0.19) beneficial results in the Physician's Global Evaluation of Inflammatory Acne; 82% of the patients treated with nicotinamide gel and 68% treated with clindamycin gel were improved. Both treatments produced statistically similar reductions in acne lesions (papules/pustules; -60%, nicotinamide vs. -43%, clindamycin, P = 0.168), and acne severity (-52% nicotinamide group vs. -38% clindamycin group, P = 0.161). CONCLUSIONS: These data demonstrate that 4% nicotinamide gel is of comparable efficacy to 1% clindamycin gel in the treatment of acne vulgaris. Because topical clindamycin, like other antimicrobials, is associated with emergence of resistant microorganisms, nicotinamide gel is a desirable alternative treatment for acne vulgaris.

Acne Vulgaris↗
PubMed2006

Effect of a single overnight topical application of miconazole nitrate paste on acne papules.

BACKGROUND: The classical management of acne calls for prolonged oral and/or topical treatments; however, some patients request a rapid effect to make the papules disappear within a few hours or days. OBJECTIVE: To test the effect of a single overnight application of a paste containing 0.25% miconazole nitrate on acne papules, and comparison with the effect of the same but unmedicated paste. METHOD: Narrow-band reflectance spectroscopy was used to assess the changes in E index (erythema) after overnight application of the pastes. In the first study, a total of 117 acne papules were assessed in 15 adolescents. Measurements of the E index were performed at 24-h intervals for 4 days on acne papules and the surrounding normal-looking skin. The last two assessments were performed the mornings preceding and following, respectively, a single application of the medicated paste. The second part of the study consisted of a double-blind, split-face study on 25 adolescents with acne. They applied each of the two formulations on a randomized part of the forehead. A total of 161 acne papules received the medicated paste and 160 received the same but unmedicated paste. Measurements were performed the mornings before and after the overnight treatment. RESULTS: In the first part of the study, no significant daily difference was observed between the three series of pretreatment E indices, on both acne papules and normal skin. The treatment did not affect the E index of normal skin. By contrast, it decreased significantly the E index of the acne papules. The second part of the study also showed that the medicated paste significantly decreased the E index of acne papules. This effect was significantly (P < 0.05) superior to that of the unmedicated paste. CONCLUSION: A single overnight application of miconazole nitrate paste appears to reduce the erythematous aspect of acne papules.

Acne Vulgaris↗
PubMed2004

Disease-specific quality of life is associated with anxiety and depression in patients with acne.

OBJECTIVE: We aimed to evaluate the relationships between acne severity, anxiety, depression and disease-specific quality of life in patients with acne. METHOD: A total of 61 patients with acne vulgaris and 38 healthy volunteers were included in the study. Acne severity was assessed by the Global Acne Grading System. All patients were asked to complete the Acne Quality of Life Scale (AQOL), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HAD), and healthy controls to fill only the HAD. RESULTS: The mean HAD anxiety subscale (HAD-A) and HAD depression subscale (HAD-D) scores of the patients were significantly higher than those of the controls. The rates of subjects at risk for anxiety (26.2%) and for depression (29.5%) were significantly higher in the patient group than in the control group (0% and 7.9%, respectively). We found no correlations between acne severity and scores of AQOL, DLQI, HAD-A and HAD-D. AQOL and DLQI scores were positively correlated with HAD-A and HAD-D scores in the patient group. The patients at risk for anxiety had significantly higher scores on AQOL and DLQI compared to those who were not at risk. There were no statistically significant differences between the female and male patients with respect to AQOL, DLQI, HAD-A and HAD-D scores. CONCLUSION: (1) Irrespective of the degree of severity, patients with acne are at increased risk for anxiety and depression compared to the normal population. (2) Acne negatively affects quality of life, and the greater the impairment of quality of life due to acne, the greater the level of anxiety and depression. (3) A greater impairment of dermatologic quality of life seems to put the patient at an increased risk for anxiety disorder.

Acne Vulgaris↗
PubMed1989

Acne in schoolchildren: no longer a concern for dermatologists.

OBJECTIVE: To determine the prevalence and severity of acne among schoolchildren in Glasgow. DESIGN: Secondary schools in Glasgow were divided by postcode into five socioeconomic cluster groups. Different numbers of schools were selected at random from the five groups to ensure proportional representation. One class from each registration year of the chosen schools was selected at random and the whole class recruited into the study. SETTING: 15 Secondary schools in Glasgow. SUBJECTS: 2014 Randomly selected schoolchildren aged 12-17 (5% of total secondary school roll). INTERVENTIONS: None. END POINT: Assessment of facial acne by two independent examiners by a recognised acne scoring system. MEASUREMENTS AND MAIN RESULTS: The prevalence of acne in boys increased from 40% (75/189) at age 12 to 95% (108/114) at age 16, and in girls it increased from 61% (114/187) at age 12 to 83% (136/164) at age 16. On a scale of 0 to 10 only 18 boys (1.8%) and three girls (0.3%) had grades of acne of 1.0 or greater; most of the pupils had grade 0.05-0.375 (minimal) acne. Nine per cent of boys (88/973) and 14% of girls (145/1041) had visited their general practitioner specifically for advice on and treatment for acne; only five pupils (0.3%) had been referred to a dermatologist. CONCLUSIONS: Both the prevalence and severity of acne have decreased over the past 20 years. This has probably been due to improvement of treatment for acne by primary care doctors and the greater availability and use of over the counter preparations for acne.

Acne Vulgaris↗
PubMed2006

Expert committee recommendations for acne management.

In 2003, an international committee of physicians and researchers in the field of acne, working together as the Global Alliance to Improve Outcomes in Acne, developed consensus guidelines for the treatment of acne. These guidelines were evidence based when possible but also included the extensive clinical experience of this group of international dermatologists. As a result of the evaluation of available data and the experience, significant changes occurred in the management routines for acne. The greatest change arose on the basis of improved understanding of acne pathophysiology. The recommendation now is that acne treatments should be combined to target as many pathogenic factors as possible. A topical retinoid should be the foundation of treatment for most patients with acne, because retinoids target the microcomedo, the precursor to all acne lesions. Retinoids also are comedolytic and have intrinsic antiinflammatory effects, thus targeting 2 pathogenic factors in acne. Combining a topical retinoid with an antimicrobial agent targets 3 pathogenic factors, and clinical trials have shown that combination therapy results in significantly faster and greater clearing as opposed to antimicrobial therapy alone. Oral antibiotics should be used only in moderate-to-severe acne, should not be used as monotherapy, and should be discontinued as soon as possible (usually within 8-12 weeks). Because of their effect on the microcomedo, topical retinoids also are recommended as an important facet of maintenance therapy.

Acne Vulgaris↗
PubMed2006

Social sensitivity and acne: the role of personality in negative social consequences and quality of life.

BACKGROUND: Acne affects a majority of adolescents and a substantial number of adults. The adverse social impact of acne is well documented. Negative social consequences, however, are likely to be determined by personality features as well as acne severity. PURPOSE: To determine whether a personality trait--dispositional social sensitivity--is associated with the adverse social impact of acne. METHODS: A survey of 479 acne sufferers between the ages of 16 and 62 was conducted in the Piedmont region of North Carolina, United States. Respondents were classified as either high or low social sensitivity and compared on demographic, disease characteristics, and quality of life. Main and interaction effects were evaluated for acne severity and social sensitivity in relation to global and intimate social concerns and social interference. RESULTS: Greater acne severity was significantly associated with poorer social outcomes and quality of life (ps < 0.05). For women, higher social sensitivity was independently associated with poorer outcomes (ps < 0.05), while for men, higher social sensitivity interacted with acne severity and was associated with worse social outcomes and life quality (ps < 0.05). CONCLUSIONS: Acne is a biopsychosocial skin condition. Dispositional social sensitivity is an independent psychological factor associated with poorer social functioning and quality of life. Treatment of the acne patient should consider psychosocial factors as well as biological factors.

Acne Vulgaris↗
PubMed2001

[Correlations between acne and polycystic ovary. A study of 60 cases].

BACKGROUND: In this paper we correlated the clinical severity of the polycystic ovary with the clinical manifestation of acne. Acne is an inflammatory process of follicle sebaceous unites. Polycystic ovaries (PCOS) are characterized by several subcapsular cystic follicles with an increased production of androgens. Onset of polycystic ovaries in women with acne, ranges from 45 to 84% of cases. METHODS: Sixty patients, aged from 19 to 28 years, with acne and polycystic ovaries were enrolled. The clinical severity of acne was appraised by millimetric macrophotography. This technique evaluated subsequent phases of acne like comedo, papules or pustules, nodular or scarring lesions. Polycystic ovaries were studied by ultrasound and hormonal assay. Sonora Logic 500 MD, by GE Echography, with 3.5 MHz convex probe, were employed. US examination was performed, in each patient, on day 6th, 10th, 15th and 22th of the menstrual cycle. The following US parameters were considered: dimension of the ovaries, thickness of albuginea and number of cysts. Serum levels of FSH, LH, 17-b-estradiol, progesterone, DHEA-S, testosterone and LH/FSH ratio were determined. Furthermore, the presence of premenstrual syndrome (PMS) was evaluated. RESULTS: We found that in PCOS the increased levels of androgens can cause the onset of acne. Photographic score and ovaries ultrasonography may be useful in the assessment of the clinical association between acne and polycystic ovaries. We observed that the subsequent phases of acne were correlated with the clinical severity of polycystic ovaries and to the presence of Premenstrual Syndrome in 93% of the cases (56 of 60 patients). CONCLUSIONS: US images, compared with visual score, established the clinical association between acne and PCOS in three phases with a progressive severity.

Acne Vulgaris↗
PubMed2001

Polarized light photography and videomicroscopy greatly enhance the capability of estimating the therapeuic response to a topical retinoid (adapalene) in acne vulgaris.

Assessment of improvement in acne lesions following treatment is often based on clinical evaluation and photographs. However, limitations are associated with this sublective evaluation, making it difficult to accurately review individual acne lesions and to observe early response to therapy. Conventional photographs do not allow us to visualize small lesions, and it can be difficult to differentiate inflammatory lesions as papules or small nodules. Our objective was to evaluate a new standardized method for tracking individual acne lesions based on photographs. The effect of adapalene gel 0.1% on both inflammatory and noninflammatory acne lesions was evaluated using this technique. Polarized light photography and videomicroscopy were used to record the evolution of acne lesions over a 16-week period in 5 volunteers with moderate acne vulgaris. During the first 4 weeks before treatment, acne lesions were evaluated on a 3-times weekly basis to establish a pattern of progression and determine the length of time to resolution. Sebum secretion rates were monitored using Sebutape adhesive patches applied to the forehead and both cheeks for 1 hour. After 4 weeks, adapalene gel 0.1% was used once daily at bedtime for 8 weeks; polarized light photography, videomicroscopy, and assessment of sebum production followed treatment response. This treatment period was followed by a further 4-week phase, after which acne lesions and sebum secretion rates were evaluated. Our results showed that the new methodology was appropriate to track acne lesions and allowed an accurate and more oblective evaluation of individual lesions. Using this methodology demonstrated that adapalene gel 0.1% causes rapid resolution of inflammatory and noninflammatory lesions. The probability of clearing inflammatory and noninflamma tory lesions during the treatment period increased, and the probability of new lesions appearing decreased. Sebum secretion rates declined in patients while on study drug, returning to near pretreatment levels following therapy cessation. Using sophisticated photography and videomicroscopy every other day proved to be a valuable, noninvasive, and reliable method of following response to adapalene treatment in patients with moderate acne vulgaris.

Acne Vulgaris↗
PubMed2001

[Severe pruriginous acne in dialysed renal failure. Diagnostic difficulties and efficacy of isotretinoin].

INTRODUCTION: The occurrence of acne in dialysed renal failure patients has rarely been reported and the clinical characteristics and therapeutic issues rarely studied in these patients. CASE REPORTS: Two men and two women, 33 to 56 years-old, with chronic renal failure and no past history of acne, developed severe acne under dialysis. The acne was excoriated in all cases and associated with prurigo-like lesions and intense pruritus, which made diagnosis difficult. Acne was profuse on the face and the trunk, but also on the neck (1 case) and the upper limbs (2 cases). No patient was taking acne-inducing substances. Various to therapies attempting to control pruritus were ineffective. However, anti-acne treatments (cyclines associated with local tretinoin in 1 case and oral isotreninoin in 3 cases) led to complete regression of the acne, pruritus and the prurigo-like lesions without relapse after a follow-up time of 4 months to 2 years. DISCUSSION: Pruritus is frequent during renal failure. However, the occurrence of unexplained acne has only rarely been reported. Our patients' clinical picture was original, characterized by the late development, under dialysis, of severe and pruriginous acne, the pathogenesis of which is unknown. Because of the clinical and therapeutic implications (impaired quality of life, pigmentation or scarring and remarkable efficacy of oral isotretinoin) this clinical picture merits more attention, and the modalities for the prescription of isotretinoin in this context should be defined.

Acne Vulgaris↗
PubMed2002

Effect of topical benzoyl peroxide/clindamycin versus topical clindamycin and vehicle in the reduction of Propionibacterium acnes.

Propionibacterium acnes is one of the primary factors involved in the pathogenesis of acne vulgaris; proliferation of this bacteria is present in all patients with inflammatory lesions. Combination topical therapy with agents that have different but complementary antimicrobial mechanisms of action has the potential to increase efficacy and to prevent the emergence of resistant organisms. The onset of action and effectiveness of 3 topical preparations (benzoyl peroxide 5%/clindamycin phosphate 1% gel, clindamycin phosphate 1% solution, and vehicle gel) in reducing P acnes were compared in a randomized, open-label, evaluator-blinded, comparative trial involving 60 healthy volunteers who were free of acne but had high levels of facial P acnes. Treatment with benzoyl peroxide 5%/clindamycin phosphate 1% gel significantly (P<.001) reduced P acnes levels by >1 log10/cm2 from baseline (91% inhibition) 24 hours after application. Progressive declines were observed throughout the 2-week study period, with a 3 log10/cm2 reduction (99.9% inhibition) from baseline in P acnes at the end of the 2-week treatment period. In contrast, significant (P<.05) reductions from baseline in P acnes levels following treatment with clindamycin phosphate 1% solution were only observed at the last assessment period (2 weeks), with an average reduction of 0.64 log10/cm2 (77% inhibition). Patients receiving vehicle gel had no measurable reductions in P acnes from baseline. These results demonstrate that topical benzoyl peroxide 5%/clindamycin phosphate 1% gel produces rapid and clinically relevant reductions in P acnes greater than those produced by single-agent therapy. This activity is likely responsible for the quick onset of clinical efficacy produced by this combination regimen.

Administration, Topical↗
PubMed2003

Knowledge, beliefs and perception of youth toward acne vulgaris.

OBJECTIVE: This study was carried out to assess the knowledge, concepts and perceptions of the youth towards Acne. METHODS: This cross-sectional study included 700 students of both genders from all geographic areas in Riyadh, Kingdom of Saudi Arabia during the year 2001. They were asked to complete a self administered questionnaire that contained several items measuring different areas in there beliefs, knowledge and perceptions about acne. Acne and non-acne sufferers were included. Responses were matched with demographic data. RESULTS: Five hundred and seventeen students (73.9%) responded to the questionnaire. Male and female responders were 267 (51.6%) and 250 (48.4%). More than half of them reported that they suffered from acne 276 (53.4%). Three quarters (76%) of the sample considered psychological conditions contribute to occurrence of acne, 72.1% believe that diet is one of etiologic factor. Only 15.9% reported that acne is an infectious disease. Sixty-two percent believed that acne is not a serious problem, while 56.7% consider it as both a cosmetic and health problem. CONCLUSION: The results of this study pointed out that misconceptions and false beliefs on acne are widespread and enduring among the youth. Health education program on acne is needed to improve their understanding of the condition.

Acne Vulgaris↗
PubMed2006

Subject preferences for acne treatments containing adapalene gel 0.1%: results of the MORE trial.

Acne vulgaris can affect adolescents at a time of profound physical, social, and psychological change. The negative impact of acne on self-image and self-confidence can be severe, leading to potential psychiatric problems and limiting social interactions, even in adults. Adherence is necessary for successful treatment of acne, and patient satisfaction is crucial for adherence. The Measuring Acne Outcomes in a Real-World Experience (MORE) trial enrolled 1979 subjects who used combination acne treatments, all containing adapalene gel 0.1%. Among other measures, subjects were surveyed regarding their satisfaction with treatment. Adherence to treatment protocol was high throughout the study (94.5% and 88.0% at weeks 6 and 12, respectively, determined by self-report, and 93.7% and 80.3%, respectively, determined by filled prescriptions). Of the subjects who completed preference surveys, more than 70% rated adapalene gel 0.1% as much superior or superior to other acne treatments; more than 85% of subjects were very satisfied or satisfied with adapalene gel 0.1% to treat their acne; and more than 85% of subjects reported feeling more confident or positive after using this treatment. About 75% of subjects planned to continue using adapalene gel 0.1% and/or use it in the future if they needed acne treatment, and close to 75% of subjects indicated that they would recommend this treatment to a friend. The high level of patient satisfaction with adapalene gel 0.1% as an acne treatment is likely to translate into a high level of adherence to treatment, including maintenance treatment, and a major improvement in quality of life (QOL) for patients with acne.

Acne Vulgaris↗
PubMedDate not supplied

[Akne-Mycyna in the local treatment of acne].

Akne-Mycyna, a new preparation for external treatment of acne containing 1% erythromycin, was used in 30 cases of acne: 12 cases of papulo-pustolous acne, 13 with pustulous acne, 5 with acne conglobata. The age of the patients ranged from 16 to 27 years, the mean duration of acne was 3.5 years. Selected lesions were smeared with Akne-Mycyna twice daily, mostly on one side of the face; symmetrical lesions were treated by conventional external methods. In the light of the study it is concluded that Akne-Mycyna is a very effective preparation for external treatment of papulo-pustulous acne and in milder cases of pustulous acne, with the duration of treatment at least 3 weeks. In deep forms of acne, particularly acne conglobata, Akne-Mycyna may be a valuable supplementation of systemic treatment.

Acne Vulgaris↗
PubMed1986

[Parameters of cellular and humoral immunity in patients with severe acne].

Severe forms of acne, characterized by predominance of inflammatory reactions and persistence of the disease for years, still present therapeutic problems. The purpose of our study was to investigate the role of the immune system in severe persisting forms of acne by means of determination of cellular and humoral immunobiological parameters. The study was performed on 52 patients (47 males and 5 females) having suffered from severe acne for six years on an average, including papulopustular acne grade IV resistant to therapy, nodulocystic acne, conglobate acne, and acne tetrade. The results were compared with those of 52 healthy controls of the same age showing no inflammatory diseases, who were tested on the same day. In 56% of the acne patients, one or more parameters showed pathological values, while in nodulocystic and conglobate acne there were similar results with regard to cellular defects and acute phase reactants. The lymphocytic proliferation induced by mitogens was significantly decreased in 35% of the acne patients. We assume that the immunodeficiency observed in these patients may be mainly secondary; however, it may contribute to the perpetuance of the disease and its resistance to therapy.

Acne Vulgaris↗
PubMed1984

Comparison of antimetastatic effect against Lewis lung carcinoma after intratumoral and intravenous injections of cell-wall skeleton of Propionibacterium acnes C7 in C57BL/6 mice.

Antimetastatic activity of cell-wall skeleton of Propionibacterium acnes C7 (P. acnes-CWS) in C57BL/6 mice varied depending on the injection route. The kinetics of antimetastatic effect against Lewis lung carcinoma (3LL) revealed that the sooner intratumoral (it) injection of P. acnes-CWS was carried out, the better the result. However, intravenous (iv) injection of P. acnes-CWS produced the best result if P. acnes-CWS was injected at about the time when metastases began to develop in the lungs. Pretreatment with intrafootpad (ifp) injection of P. acnes-CWS inhibited primary tumor growth and subsequent pulmonary metastases especially when given 7 days before tumor inoculation into the same footpad, but tended to enhance artificial pulmonary metastases when given 7 days before iv injection of tumor cells. In contrast, pretreatment with iv injection of P. acnes-CWS enhanced spontaneous pulmonary metastases especially when given 7 days before ifp inoculation of tumor cells, but inhibited artificial pulmonary metastases when given one day or 7 days before iv injection of tumor cells. These results suggest the difficulty of treatment of tumor metastases with immunological adjuvants. In T-cell-deprived mice, it injection of P. acnes-CWS showed no antimetastatic effect against 3LL, but iv injection was still effective. This indicates that T-cells are required for the antimetastatic effect of it injection of P. acnes-CWS, but iv injection of P. acnes-CWS is able to inhibit pulmonary metastases in T-cell-deprived mice.

Animals↗