A microRNA focus on acne

Acne (syn. acne vulgaris) is a common inflammatory skin disorder associated with puberty and adolescence. Driven by complex interactions between the pilosebaceous unit and Cutibacterium acnes (C. acnes) bacteria, the disease is characterised by comedonal lesions, papules, pustules and nodules that appear predominantly on the face. Acne and sequelae such as scarring and pigment changes affect health-related quality of life negatively. Approvals for nucleic acid therapies (NATs) such as short-interfering RNA (siRNA) drugs and antisense oligonucleotides (ASOs) have surged in recent years, for rare disorders with little or no effective treatments. These advances, along with clinical trials for microRNA (miRNA) modulation in skin contexts, raise the possibility that NATs may have potential for future acne treatment regimens. In this review, we highlight potential miRNA targets for anti-acne therapy. We provide a brief overview of acne pathophysiology and highlight roles of C. acnes. We then focus on recently discovered differential effects of planktonic and biofilm C. acnes on a Toll-like receptor 2 (TLR2) axis spanning miR-146a-5p. We appraise miR-146a-5p in sebocytes before addressing the putative contributions of miR-21-5p, miR-233-3p and miR-150-5p to inflammatory axes in acne. We conclude with translational perspectives and considerations of patient involvement in miRNA-related research for acne.