Study Details How Sarecycline Acts As Acne Treatment

Researchers at Yale University and the University of Illinois-Chicago have published a paper detailing the unique chemical structure of sarecycline and how it works to treat acne. The drug received FDA approval in 2018, is the first new antibiotic approved to treat acne in more than 40 years.

The American Academy of Dermatology says that acne is the most common skin condition in the U.S. Although not a life-threatening condition, acne can be painful especially when it is severe. It can also cause emotional distress.

Acne occurs when:

• Bacteria build up in the pores of the skin
• Dead skin cells accumulated in the pores
• Follicles produce too much oil

The new study, published in the journal Proceedings of the National Academy of Sciences, is so far the most detailed biological analysis for sarecycline, a narrow-spectrum tetracycline-derived antibiotic used for the treatment of moderate to severe acne vulgaris.

Usually, the first choice for treating acne is tetracycline, such as minocycline or doxycycline, or a macrolide. Oral antibiotics should be used for the shortest time possible to prevent antibiotic resistance. Oral antibiotics are best used with topical retinoids and benzoyl peroxide.

In the paper, the researchers wrote that sarecycline binds to messenger RNA (mRNA) - molecules within a cell that provides a code for making proteins - in bacterial ribosomes, a behavior that cannot be found in other tetracycline drugs. Sarecycline helps in the treatment of acne by putting a halt to bacterial protein synthesis. They inhibit ribosome function in the pathogenic bacterium found in acne or Cutibacterium acnes.

"We show that the structure of sarecycline matters," said Dr. Christopher Bunick, co-corresponding author of the study. "This mode of action has never been seen before in this class of antibiotics, and suggests that sarecycline has unique properties among the tetracycline class."

Perhaps the more important part of the research is the explanation for why sarecycline has such a low drug-resistance profile, which makes it a highly effective acne treatment. Sarecycline prevents TetM, a ribosome guardian protein that protects bacteria from outside interference.

According to Bunick, this study could pave the way for how antibiotics are engineered to make them more effective, which could lead to lower drug resistance, fewer side effects, longer-lasting efficacy of drugs.

Antibiotics completely changed the way infectious diseases were treated. When it was introduced average human life expectancy jumped by eight years, with antibiotics used to treat infections that were previously likely to kill patients.