May 3, 2024

Common Acne Treatment Can Have Unintended Life-Long Effects on the Skeleton

In puberty, we accrue up to 40% of our peak bone mass, which correlates with the maturation of our microbiome. Interruption of the microbiome during puberty can have a long-lasting impact on skeletal health and fracture danger.
The Novince team further examined how the microbiome might communicate with and alter the structure of the skeleton. Remarkably, changing the gut microbiome with minocycline interfered with the normal communication in between the liver and the small intestinal tract. The gut microbiome constantly modifies the pool of bile acids in the little intestine.

Long-term use of a systemic antibiotic, such as minocycline, may have unanticipated repercussions uring the critical phase of teen bone development.
Minocycline treatment lowered protein expression in osteoblasts (yellow cuboidal bone-lining cells shown by arrows). Credit: Matthew Carson and Dr. Chad Novince of the Medical University of South Carolina.
” There are continual changes to the gut microbiome following long-term systemic minocycline treatment that leads to reduced bone maturation,” stated Matthew Carson, first author of this study and graduate trainee studying the effects of the gut microbiome on skeletal advancement in the Novince lab.
” From a scientific viewpoint, not only is minocycline treatment causing changes to the growing skeleton, the microbiome, and the skeleton arent able to recuperate fully after antibiotic therapy,” added Chad Novince, D.D.S., Ph.D., principal private investigator and associate teacher in the Department of Oral Health Sciences in the College of Dental Medicine.
This work develops off of previous work from the Novince laboratory that showed that a high-dose antibiotic mixed drink triggered a proinflammatory immune response that increased the activity of bone-eating osteoclasts and impaired bone maturation. The results of this research study triggered the Novince group to wonder whether there were medical situations in which systemic antibiotics might affect the developing skeleton.
They found that doctors use minocycline as a systemic antibiotic treatment for adolescent acne. Minocycline is an antibiotic of the tetracycline class, which also consists of sarecycline, tetracycline, and doxycycline. These prescription antibiotics work by stopping the growth and spread of germs; in acne, they damage the bacteria that contaminate pores and reduce certain natural oily compounds that cause acne.
To figure out if systemic minocycline treatment would have similar effects on the skeleton as previous antibiotic treatments had, Carson and Novince administered a medically relevant dose of minocycline to mice throughout pubertal/postpubertal development– the comparable age of teenage years in humans. They discovered that minocycline treatment does not cause any cytotoxic results or cause a proinflammatory action– as they observed previously; however, there were modifications in the structure of the gut microbiome that caused reduced bone mass accrual and impaired skeletal maturation.
In and of themselves, these data highlight a crucial, however underappreciated, repercussion of long-term systemic antibiotic usage throughout adolescence. However they also went on to reveal that long-term minocycline therapy prevented the ability of the gut microbiome and skeleton to recuperate to a steady state even after the therapy was stopped.
Early research recommended that our gut microbiome becomes a fully grown state in the first couple of years of life, however this concept has recently been cast doubt on, with recent investigations showing that the gut microbiome continues to develop into a steady, fully grown state throughout adolescence.
” Whats really fascinating is if you trigger modifications to the microbiome during this teen phase when your microbiota is still progressing toward a steady adult state, youre going to have extensive impacts on the developing skeleton,” explained Carson.
In puberty, we accrue as much as 40% of our peak bone mass, which associates with the maturation of our microbiome. If we interrupt the system throughout this important window of development and lower our peak bone mass, we might no longer have the ability to weather the storm of natural bone loss as a consequence of aging. Therefore, disruption of the microbiome during puberty can have a long-lasting effect on skeletal health and fracture threat.
The Novince team further analyzed how the microbiome could communicate with and change the structure of the skeleton. Surprisingly, altering the gut microbiome with minocycline disrupted the normal communication between the liver and the small intestinal tract. This communication focuses around little molecules called bile acids.
Typically, bile acids take a trip from the liver to the little intestinal tract to help in food digestion and aid to break down fats, but this view of bile acids is expanding.
” Bile acids had actually not previously been thought about as essential communication particles between the gut and the skeleton,” stated Novince. “By changing the gut microbiome, the makeup of the bile acids is changed, which affects host physiology, including skeletal maturation.”
The gut microbiome continuously customizes the pool of bile acids in the little intestinal tract. The bile acids then act as messenger particles and communicate with host cells in the intestine and at remote structural sites. Bile acids can promote bone formation when they talk to osteoblasts.
Interestingly, the modified gut microbiome arising from minocycline treatment produced a different pool of bile acids. This different profile of bile acids stopped working to trigger bone-forming osteoblasts and caused a significant reduction of more than 30% in bone formation and mineralization.
This work exemplifies the advantages of a cross-disciplinary method to science.
” This was truly collective science, which is where I believe were at today,” stated Novince. “To drive high-impact science, you need to bring in specialists from different professions and disciplines. We were lucky to have a really strong group. It was fun– the entire thing was exciting!”
In summary, this work reinforces the importance of the gut-liver-bone communication network. It exposes that systemic minocycline treatment has unintentional, extensive, and life-long results on the skeleton.
” Treatment of teen mice with minocycline caused a change in the gut microbiome and modified bile acid metabolic process,” summed up Carson. “We discovered that the change of these bile acids inhibited osteoblast function and impaired skeletal maturation.”
Recommendation: “Minocycline-induced disruption of the intestinal tract FXR-FGF15 axis hinders osteogenesis in mice” by Matthew D. Carson, Amy J. Warner, Jessica D. Hathaway-Schrader, Vincenza L. Geiser, Joseph D. Kim, Joy E. Gerasco, William D. Hill, John J. Lemasters, Alexander V. Alekseyenko, Yongren Wu, Hai Yao, Jose I. Aguirre, Caroline Westwater and Chad M. Novince, 22 November 2022, JCI Insight.DOI: 10.1172/ jci.insight.160578.
The study was funded by the National Institutes of Health and the American Society for Bone and Mineral Research..

When the hair follicles of your hair get plugged with oil and dead skin cells, acne is a skin condition that occurs.
Physicians have the very best objectives of treating teen acne with systemic prescription antibiotics; however, long-lasting usage can irritate the gut microbiome, resulting in modified profiles of flowing bile acids that reduce osteoblast function and bone mass accrual.
Sex hormonal agents drive significant physiologic changes throughout teenage years. Acne, a skin condition triggered by the plugging of hair follicles with oil and dead skin cells, is one of the most typical, and typically traumatic, experiences throughout adolescence. For some individuals whose acne is resistant to topical therapies, systemic antibiotics are used to assist to minimize signs and clear up the skin.
Dealing with acne with systemic antibiotics, such as minocycline, often requires long-lasting usage– in some cases approximately 2 years; nevertheless, the long-lasting results of antibiotic use remain unclear. Researchers from the Medical University of South Carolina (MUSC) found a strong link in between the structure of the gut microbiome– a neighborhood of microorganisms that cohabit in the gut– and healthy skeletal maturation in a research study released recently released in the Journal of Clinical Investigation (JCI) Insight.