A review of microscopy‑based evidence for the association of Propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue

Manu N Capoor, Christof Birkenmaier, Jeffrey C Wang, Andrew Mc Dowell, Fahad S Ahmed, Holger Bruggemann, Erin Coscia, David G Davies, Soren Ohrt-Nissen, Assaf Raz, Filip Ruzicka, Jonathan E Schmitz, Vincent A Fischetti, Ondrej Slaby

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose: Recent research shows an increasing recognition that organisms not traditionally considered infectious in nature contribute to disease processes. Propionibacterium acnes (P. acnes) is a gram-positive, aerotolerant anaerobe prevalent in the sebaceous gland-rich areas of the human skin. A ubiquitous slow-growing organism with the capacity to form biofilm, P. acnes, recognized for its role in acne vulgaris and medical device-related infections, is now also linked to a number of other human diseases. While bacterial culture and molecular techniques are used to investigate the involvement of P. acnes in such diseases, definitive demonstration of P. acnes infection requires a technique (or techniques) sensitive to the presence of biofilms and insensitive to the presence of potential contamination. Fortunately, there are imaging techniques meeting these criteria, in particular, fluorescence in situ hybridization and immunofluorescence coupled with confocal laser scanning microscopy, as well as immunohistochemistry. Methods: Our literature review considers a range of microscopy-based studies that provides definitive evidence of P. acnes colonization within tissue from a number of human diseases (acne vulgaris, degenerative disc and prostate disease and atherosclerosis), some of which are currently not considered to have an infectious etiology. Results/Conclusion: We conclude that P. acnes is an opportunistic pathogen with a likely underestimated role in the development of various human diseases associated with significant morbidity and, in some cases, mortality. As such, these findings offer the potential for new studies aimed at understanding the pathological mechanisms driving the observed disease associations, as well as novel diagnostic strategies and treatment strategies, particularly for degenerative disc disease. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

LanguageEnglish
Pages2951-2971
Number of pages21
JournalEuropean Spine Journal
Volume28
Issue number12
Early online date29 Jul 2019
DOIs
Publication statusPublished - 1 Dec 2019

Fingerprint

Propionibacterium acnes
Biofilms
Microscopy
Acne Vulgaris
Sebaceous Glands
Culture Techniques
Human Development
Infection
Fluorescence In Situ Hybridization
Confocal Microscopy
Fluorescent Antibody Technique
Prostate
Atherosclerosis
Immunohistochemistry
Morbidity
Equipment and Supplies
Skin
Mortality

Keywords

  • Acne vulgaris, Arthroscopy, Atherosclerosis, Biofilm, Cutibacterium acnes, Degenerative disc disease, FISH-CLSM, Propionibacterium acnes, Prostate cancer
  • Acne vulgaris
  • FISH-CLSM
  • Arthroscopy
  • Cutibacterium acnes
  • Atherosclerosis
  • Degenerative disc disease
  • Biofilm
  • Propionibacterium acnes
  • Prostate cancer

Cite this

Capoor, Manu N ; Birkenmaier, Christof ; Wang, Jeffrey C ; Mc Dowell, Andrew ; Ahmed, Fahad S ; Bruggemann, Holger ; Coscia, Erin ; Davies, David G ; Ohrt-Nissen, Soren ; Raz, Assaf ; Ruzicka, Filip ; Schmitz, Jonathan E ; Fischetti, Vincent A ; Slaby, Ondrej. / A review of microscopy‑based evidence for the association of Propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue. In: European Spine Journal. 2019 ; Vol. 28, No. 12. pp. 2951-2971.
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abstract = "Purpose: Recent research shows an increasing recognition that organisms not traditionally considered infectious in nature contribute to disease processes. Propionibacterium acnes (P. acnes) is a gram-positive, aerotolerant anaerobe prevalent in the sebaceous gland-rich areas of the human skin. A ubiquitous slow-growing organism with the capacity to form biofilm, P. acnes, recognized for its role in acne vulgaris and medical device-related infections, is now also linked to a number of other human diseases. While bacterial culture and molecular techniques are used to investigate the involvement of P. acnes in such diseases, definitive demonstration of P. acnes infection requires a technique (or techniques) sensitive to the presence of biofilms and insensitive to the presence of potential contamination. Fortunately, there are imaging techniques meeting these criteria, in particular, fluorescence in situ hybridization and immunofluorescence coupled with confocal laser scanning microscopy, as well as immunohistochemistry. Methods: Our literature review considers a range of microscopy-based studies that provides definitive evidence of P. acnes colonization within tissue from a number of human diseases (acne vulgaris, degenerative disc and prostate disease and atherosclerosis), some of which are currently not considered to have an infectious etiology. Results/Conclusion: We conclude that P. acnes is an opportunistic pathogen with a likely underestimated role in the development of various human diseases associated with significant morbidity and, in some cases, mortality. As such, these findings offer the potential for new studies aimed at understanding the pathological mechanisms driving the observed disease associations, as well as novel diagnostic strategies and treatment strategies, particularly for degenerative disc disease. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].",
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Capoor, MN, Birkenmaier, C, Wang, JC, Mc Dowell, A, Ahmed, FS, Bruggemann, H, Coscia, E, Davies, DG, Ohrt-Nissen, S, Raz, A, Ruzicka, F, Schmitz, JE, Fischetti, VA & Slaby, O 2019, 'A review of microscopy‑based evidence for the association of Propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue', European Spine Journal, vol. 28, no. 12, pp. 2951-2971. https://doi.org/10.1007/s00586-019-06086-y

A review of microscopy‑based evidence for the association of Propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue. / Capoor, Manu N; Birkenmaier, Christof; Wang, Jeffrey C; Mc Dowell, Andrew; Ahmed, Fahad S; Bruggemann, Holger; Coscia, Erin; Davies, David G; Ohrt-Nissen, Soren; Raz, Assaf; Ruzicka, Filip; Schmitz, Jonathan E; Fischetti, Vincent A; Slaby, Ondrej.

In: European Spine Journal, Vol. 28, No. 12, 01.12.2019, p. 2951-2971.

Research output: Contribution to journalReview article

TY - JOUR

T1 - A review of microscopy‑based evidence for the association of Propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue

AU - Capoor, Manu N

AU - Birkenmaier, Christof

AU - Wang, Jeffrey C

AU - Mc Dowell, Andrew

AU - Ahmed, Fahad S

AU - Bruggemann, Holger

AU - Coscia, Erin

AU - Davies, David G

AU - Ohrt-Nissen, Soren

AU - Raz, Assaf

AU - Ruzicka, Filip

AU - Schmitz, Jonathan E

AU - Fischetti, Vincent A

AU - Slaby, Ondrej

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AB - Purpose: Recent research shows an increasing recognition that organisms not traditionally considered infectious in nature contribute to disease processes. Propionibacterium acnes (P. acnes) is a gram-positive, aerotolerant anaerobe prevalent in the sebaceous gland-rich areas of the human skin. A ubiquitous slow-growing organism with the capacity to form biofilm, P. acnes, recognized for its role in acne vulgaris and medical device-related infections, is now also linked to a number of other human diseases. While bacterial culture and molecular techniques are used to investigate the involvement of P. acnes in such diseases, definitive demonstration of P. acnes infection requires a technique (or techniques) sensitive to the presence of biofilms and insensitive to the presence of potential contamination. Fortunately, there are imaging techniques meeting these criteria, in particular, fluorescence in situ hybridization and immunofluorescence coupled with confocal laser scanning microscopy, as well as immunohistochemistry. Methods: Our literature review considers a range of microscopy-based studies that provides definitive evidence of P. acnes colonization within tissue from a number of human diseases (acne vulgaris, degenerative disc and prostate disease and atherosclerosis), some of which are currently not considered to have an infectious etiology. Results/Conclusion: We conclude that P. acnes is an opportunistic pathogen with a likely underestimated role in the development of various human diseases associated with significant morbidity and, in some cases, mortality. As such, these findings offer the potential for new studies aimed at understanding the pathological mechanisms driving the observed disease associations, as well as novel diagnostic strategies and treatment strategies, particularly for degenerative disc disease. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

KW - Acne vulgaris, Arthroscopy, Atherosclerosis, Biofilm, Cutibacterium acnes, Degenerative disc disease, FISH-CLSM, Propionibacterium acnes, Prostate cancer

KW - Acne vulgaris

KW - FISH-CLSM

KW - Arthroscopy

KW - Cutibacterium acnes

KW - Atherosclerosis

KW - Degenerative disc disease

KW - Biofilm

KW - Propionibacterium acnes

KW - Prostate cancer

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DO - 10.1007/s00586-019-06086-y

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JO - European Spine Journal

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