medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-340medsovet-9416Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESАкне: выявление ключевых факторов и лечение фиксированной комбинацией «адапален + метронидазол»Revealing the key factors associated with acne development and treatment with a fixed combination adapalene + metronidazolehttps://orcid.org/0000-0002-7781-7786ХисматулинаИ. М.KhismatulinaI. M.

Хисматулина Ирина Мансуровна - к.м.н., доцент кафедры дерматовенерологии, Казанский государственный медицинский университет; врач-дерматовенеролог, ООО «Здоровье семьи 1».

420012 Казань, ул. Бутлерова, д. 49; 420124, Казань, ул. Чистопольская, д. 15

Irina M. Khismatulina - Cand. Sci. (Med.), Associate Professor of the Department of Dermatovenerology, Kazan State Medical University; Dermatovenerologist, Family Health 1 LLC;

49, Butlerov St., Kazan, 420012; 15, Chistopolskaya St., Kazan, 420124

xomenko-aa@mail.ruhttps://orcid.org/0000-0002-4377-2567ЛисовскаяС. А.LisovskayaS. A.

Лисовская Светлана Анатольевна - к.б.н., доцент кафедры микробиологии, Казанский ГМУ; старший научный сотрудник лаборатории микологии, Казанский НИИ эпидемиологии и микробиологии; старший научный сотрудник научно-исследовательской лаборатории генетики микроорганизмов Института фундаментальной медицины и биологии, Казанский (Приволжский) федеральный университет.

420012, Казань, ул. Бутлерова, д. 49; 420015, Казань, ул. Большая Красная, д. 67; 420008, Казань, ул. Кремлевская, д. 18, стр. 1

Svetlana A. Lisovskaya - Cand. Sci. (Biol.), Associate Professor of the Department of Microbiology, Kazan SMU; Senior Researcher at the Department of Mycology, Kazan Scientific Research Institute of Epidemiology and Microbiology; Kazan Scientific Research Institute of Epidemiology and Microbiology.

49, Butlerov St., Kazan, 420012; 67, Bolshaya Krasnaya St., Kazan, 420015

s_lisovskaya@mail.ruГерманЯ. Э.GermanYa. E.

Герман Яна Эдуардовна - к.м.н., доцент кафедры акушерства и гинекологии, Казанская ГМА, главный врач, ООО «Здоровье семьи 1».

420012, Казань, ул. Бутлерова, д. 36; 420124, Казань, ул. Чистопольская, д. 15

Yana E. German - Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology, Kazan State Medical Academy; Chief Medical Officer, Family Health 1 LLC;

36, Butlerov St., Kazan, 420012; 15, Chistopolskaya St., Kazan, 420124

yanak77@mail.ruhttps://orcid.org/0000-0002-4227-008XКравцоваО. А.KravtsovaO. A.

Кравцова Ольга Александровна - к.б.н., доцент кафедры биохимии, биотехнологии и фармакологии Института фундаментальной медицины и биологии.

420008, Казань, ул. Кремлевская, д. 18, стр. 1

Olga A. Kravtsova - Cand. Sci. (Biol.), Associate Professor of the Department of Biochemistry, Biotechnology and Pharmacology, Institute of Fundamental Medicine and Biology.

18, Bldg. 1, Kremlevskaya St., Kazan, 420008

okravz@yandex.ruhttps://orcid.org/0000-0001-9869-4909СиницаА. М.SinitcaA. M.

Синица Александр Михайлович - старший научный сотрудник кафедры радиотехнических систем.

197022, Санкт-Петербург, ул. Профессора Попова д. 5ф

Aleksandr M. Sinitca - Senior Researcher at the Department of Radio Engineering Systems.

5f, Professor Popov St., St Petersburg, 197022

amsinitca@etu.ruhttps://orcid.org/0000-0002-0356-5651БогачевМ. И.BogachevM. I.

Богачев Михаил Игоревич - д.т.н., доцент, главный научный сотрудник кафедры радиотехнических систем.

197022, Санкт-Петербург, ул. Профессора Попова, д. 5ф

Mikhail I. Bogachev - Dr. Sci. (Eng.), Associate Professor, Principal Researcher at the Department of Radio Engineering Systems.

5f, Professor Popov St., St Petersburg, 197022

mibogachey@etu.ruhttps://orcid.org/0000-0001-7195-1557КаюмовА. Р.KayumovA. R.

Каюмов Айрат Рашитович - д.б.н., доцент, заведующий кафедрой генетики Института фундаментальной медицины и биологии.

420008, Казань, ул. Кремлевская, д. 18, стр. 1

Airat R. Kayumov - Dr. Sci. (Biol.), Associate Professor, Head of Department of Genetics at the Institute of Fundamental Medicine and Biology.

18, Bldg. 1, Kremlevskaya St., Kazan, 420008

kairatr@yandex.ruКазанский государственный медицинский университет; ООО «Здоровье семьи 1»РоссияKazan State Medical University; Family Health 1 LLCRussian FederationКазанский государственный медицинский университет; Казанский научно-исследовательский институт эпидемиологии и микробиологии; Казанский (Приволжский) федеральный университетРоссияKazan State Medical University; Kazan Scientific Research Institute of Epidemiology and Microbiology; Kazan Federal UniversityRussian FederationООО «Здоровье семьи 1»; Казанская государственная медицинская академияРоссияFamily Health 1 LLC; Kazan State Medical AcademyRussian FederationКазанский (Приволжский) федеральный университетРоссияKazan Federal UniversityRussian FederationСанкт-Петербургский государственный электротехнический университет «ЛЭТИ»РоссияSt Petersburg Electrotechnical University “LETI”Russian Federation202530092025014125135Copyright © Хисматулина И.М., Лисовская С.А., Герман Я.Э., Кравцова О.А., Синица А.М., Богачев М.И., Каюмов А.Р., 20252025Хисматулина И.М., Лисовская С.А., Герман Я.Э., Кравцова О.А., Синица А.М., Богачев М.И., Каюмов А.Р.Khismatulina I.M., Lisovskaya S.A., German Y.E., Kravtsova O.A., Sinitca A.M., Bogachev M.I., Kayumov A.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9416Введение

Введение. Поиск эффективного подхода к лечению аcne vulgaris затрудняется сложным взаимодействием факторов, влияющих на течение и исход заболевания.

Цель

Цель. Выявить ключевые ассоциации факторов развития и тяжести течения акне с помощью реконструкции байесовской сети и сделать анализ результатов лечения фиксированной комбинацией адапален 0,1% + метронидазол 1%, гель.

Материалы и методы

Материалы и методы. Исследование проводилось с 2023 по 2025 г. в г. Казани, были включены 650 пациентов с акне, средний возраст – 23,0 ± 3,7 года. Изучаемые параметры включали: неизменяемые (общие характеристики, данные анамнеза) и изменяемые (лабораторные показатели, морфофункциональные параметры и состав микробиоты кожи лица) факторы. Полученными параметрами стали клинические характеристики и дерматологические индексы. На первом этапе была реконструирована непараметрическая байесовская сеть. На втором этапе была выделена группа пациентов с акне легкой и средней степени (n = 56), которой проведено лечение гелем адапален 0,1% + метронидазол 1% (препарат Метрогил® А)в течение 12 нед.

Результаты

Результаты. Наружная терапия в группе пациентов с акне легкой и средней степени, имевших нарушения микробиома кожи лица (n = 56), препаратом адапален 0,1% + метронидазол 1%, гель была эффективна: клиническая ремиссия наступила у 60,7% (n = 34), значительное улучшение – у 37,5% (n = 21). Нежелательные местные реакции характеризовались легкой степенью выраженности и не требовали отмены препарата.

Выводы

Выводы. Представленный подход полезен для визуализации сложных взаимосвязей между факторами и клиническими исходами при анализе мультифакториальных заболеваний. Основанная на результатах анализа наружная терапия акне (адапален 0,1% + метронидазол 1%, гель) в группе пациентов, имевших нарушения микробиома кожи лица, показала эффективность, безопасность и хорошую переносимость.

Introduction

Introduction. The search for an effective approach to the treatment of аcne vulgaris is complicated by the complex interaction of factors influencing the course and outcome of the disease.

Aim

Aim. To identify key associations of acne development factors and severity by reconstructing a Bayesian network and analyzing the results of treatment with a fixed combination of adapalene 0.1% + metronidazole 1% (Metrogyl® A gel).

Materials and methods

Materials and methods. The study was conducted from 2023 to 2025 in Kazan, 650 patients with acne were included, the average age was 23 ± 3.7 years. The independent parameters included: general characteristics, medical history, various clinical parameters depending on independent ones included: laboratory parameters, morphofunctional parameters and composition of the microbiota of the facial skin. The resulting parameters of the model were clinical characteristics and dermatological indices. At the first stage, a nonparametric Bayesian network was reconstructed. At the second stage, a group of patients with mild to moderate acne (n = 56) were treated with adapalene 0.1% + metronidazole 1% gel for 12 weeks.

Results

Results. The factors influencing the development and course of acne were identified, and two clusters of highly related features that describe the influence of hormone-associated and microbial pathogenesis factors were formed. Topical therapy in the group of patients with mild and moderate acne who had disorders of the skin microbiome (n = 56) with adapalene 0.1% + metronidazole 1% gel was effective: сlinical remission occurred in 60.7% (n = 34), significant improvement in 37.5% (n = 21). Local adverse reactions were characterized by mild severity and did not require drug withdrawal.

Conclusions

Conclusions. The present approach is useful for visualization of complicated relationships between factors and clinical outcomes for analysis of complex relationships between factors and clinical outcomes in the analysis of multifactorial diseases. Based on the results of the analysis, topical acne therapy (adapalene 0.1% + metronidazole 1%, gel) in a group of patients with skin microbiome disorders showed efficacy, safety and good tolerability.

акнемультифакториальный дерматозбайесовская сетьморфофункциональные параметры кожи лицамикробиом кожи лицатопическая терапиякомбинации адапаленаметронидазоладапаленacnemultifactorial dermatosisBayesian networkmorphofunctional parameters of facial skinmicrobiome of facial skintopical therapyadapalene combinationsmetronidazoleadapaleneРабота выполнена при финансовой поддержке Российского научного фонда, грант №24-14-00194. Авторы выражают благодарность ООО «Юник Фармасьютикал Лабораториз» за содействие в публикации статьиThis research was funded by the Russian Science Foundation (grant No. 24-14-00194). The authors express their gratitude to Unique Pharmaceutical Laboratories LLC for their assistance in publishing the articleReferencesChen H, Zhang T, Yin X, Man J, Yang X, Lu M. Magnitude and temporal trend of acne vulgaris burden in 204 countries and territories from 1990 to 2019: an analysis from the Global Burden of Disease Study 2019. 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The authors declare that there are no conflicts of interest present.