547 Modern Skincare
Both NHDF and HaCaT cell lines were cultured in Dulbecco’s Modified Eagle Medium
(DMEM, high glucose, pyruvate) with the addition of 10% fetal bovine serum (FBS),
10 mM N-2-hydroxyethylpiperazine-N-2-ethane sulfonic acid (HEPES), and 10 U/ml
Penicillin with 10 µg/ml Streptomycin (Pen/Strep). The nHEK cells were cultured in
EpiLife™ Medium, with 60 µM calcium and the addition of human keratinocyte growth
supplement. All growth mediums and their addition materials were purchased from
Thermo Fisher Scientific.
DOUBLE-LAYER AGAR (DLA) PLAQUE ASSAY
This assay allows for the calculation of the concentration, or titers, for a given phage sample
(Edvotek®, Washington, DC, USA). Five milliliters of the desired top agar was liquefied
and combined with 1 mL of bacterial culture and 100 µL of phage in a tube and gently
mixed without creating bubbles. The entire contents can then be poured over a LB agar
base plate. The plate is then gently but quickly tilted to ensure the entire base plate is
covered. Plates are allowed to solidify at room temperature. Once solidified, plates are
inverted and incubated overnight under anaerobic conditions at 37°C. After 24 hours,
check plates for any visible plaques. Plates should appear cloudy, with visibly cleared circles,
or plaques, throughout. Phage titers can be calculated by counting the number of visible
plaques, or PFU on a sample plate (PFU/100 µL), multiplying by any dilution factor that
was used on the phage sample itself, and then further multiplying by 1000 to convert from
microliters to milliliters. This calculated value provides the number of PFU/mL, otherwise
known as the phage titer.
CELL VIABILITY ASSAY
The relative cytotoxicity of the C. acnes phages on monolayers of skin cells was determined
using a resazurin viability assay. Briefly, cells were treated with varying concentrations of
individual phage material diluted in each designated growth media media without phage
was used as a control. Treated cells were incubated for 72 hours at 37°C with 5% CO
2 and humidity. Cell treatments were aspirated, and cells were washed twice with Hank’s
Balanced Salt Solution (HBSS, with calcium and magnesium, without phenol red) obtained
from Corning® (Corning, NY, USA). Wash HBSS was replaced with a 42 µM solution
of resazurin sodium salt in HBSS (resazurin sodium salt obtained from Sigma-Aldrich®
(St. Louis, MO, USA)) and placed at 37°C with 5% CO
2 and humidity, until a color change
was observed. After a color change was observed, samples of each solution were read on a
spectrophotometer with absorbance set to 570 nm and 690 nm. Optical density values at
690 nm were subtracted from 570 nm, and all test samples were compared to medium
control.
MINIMUM BIOFILM ERADICATION CONCENTRATION (MBEC) ASSAY
The triple phage cocktail was diluted from 4% to 0.03125% in bacterial growth media,
and the dilutions were tested against biofilms of C. acnes (#6919, ATCC) following the
protocol established by ASTM Standard E2799 (ASTM International, West Conshohocken,
548 JOURNAL OF COSMETIC SCIENCE
PA, USA). This assay determines the lowest dilution of the phage cocktail necessary to
diminish biofilms formed by C. acnes.
BLEMISHED THREE-DIMENSIONAL SKIN MODEL
The blemish-prone three-dimensional epidermal skin model was constructed by infusing a
reconstituted human epidermis (RHE, prepared from the foreskin of three Caucasian donors)
with C. acnes (#6919, ThermoFisher Scientific) at levels of approximately 106 colony forming
units (CFU) per milliliter. The bacterial suspensions (diluted in phosphate-buffered saline, PBS)
were topically applied to the RHE and incubated for 72 hours at 37°C. The three individual
C. acnes bacteriophages used in the cocktail were each diluted according to their respective
titers to provide equivalent dosages. The bacteriophage cocktail was incubated on the three-
dimensional RHE for 72 hours after which analyses of tissue toxicity, C. acnes reduction, and
inflammatory factor levels were evaluated relative to an RHE not inoculated with C. acnes.
The evaluation of tissue toxicity was conducted via imaging analysis of the tissue
morphology post-staining with hemalun (J.T. Baker®, Phillipsburg, NJ, USA blue/
purple color that stains nucleic acids) and eosin (Klinipath, Fisher Scientific, Hampton,
NH, USA pink color that stains basic structures such as proteins). For a non-cytotoxic
negative control, the tissue was treated with PBS. For the cytotoxic positive control, the
tissue was treated with 0.1% SDS. Afterwards, the tissue samples were fixed with 4%
paraformaldehyde, dehydrated, and paraffin embedded. The tissue was examined using a
Nikon Ni-E photomicroscope fitted with a Nikon DS-Ri2 camera (Tokyo, Japan).
Relative C. acnes levels were assessed by collecting bacteria with swabs soaked in PBS
containing 0.1% Tween-80, which were then inoculated onto brain-heart infusion media
plates and incubated under anaerobic conditions at 37°C for 5 days. The number of CFUs
were counted and the relative reductions were calculated as described.
Changes in the gene expression of various inflammatory factors (IL-8, MIP-1β, and MCP-1) were
evaluated using TaqMan Gene Expression Assay (Applied Biosystems, Waltham, MA, USA).
Briefly, RNA was collected and purified from the experimental and control tissue samples,
complementary DNA (cDNA) was synthesized, and the relative expression was determined via
reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR) using a QuantStudio7
PCR System (Applied Biosystems) using RPLP0 as a housekeeping gene to normalize against.
The relative expression was calculated as =2−(Ct treated condition Ct reference condition) ,where Ct =Ct
(target gene) Ct (housekeeping gene) in each cDNA sample.
PILOT CLINICAL STUDY
A pilot clinical study was conducted on a group of three female individuals (one Black, one
Caucasian, and one Hispanic/Latino) with mild to moderate blemished skin. Each participant
used a finished formulation containing 1% of the C. acnes targeted triple bacteriophage
cocktail twice daily once in the morning and once in the evening for a total of 7 days. The
participants were examined at baseline, 1 day, 3 days, and 7 days in the 1-week pilot study.
Investigated metrics included sebum levels that were determined using a Sebumeter® SM 815
PC (Courage and Khazaka electronic GmbH, Köln, Germany) and relative coproporphyrin
III fluorescence levels evaluated by porphyrins analysis algorithm on images captured in a
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