Anatomy of an acne treatment

Scientists studied the unique chemical structure of Sarecycline.

Sarecycline, a drug approved for use in the United States in 2018, is used to treat moderate to severe acne. This medication belongs to a class of drugs known as tetracycline antibiotics that treat acne by inhibiting bacterial protein synthesis. They block ribosome function in Cutibacterium acnes, the pathogenic bacterium in acne.

Scientists from Yale and the University of Illinois-Chicago now have uncovered the chemical structure of sarecycline that makes it effective. The study is the most detailed biological analysis to date for sarecycline.

Scientists found that unlike other tetracycline drugs, sarecycline binds to messenger RNA (mRNA) — molecules within a cell that provides a code for making proteins — in bacterial ribosomes.

Dr. Christopher Bunick, associate professor of dermatology at Yale and co-corresponding author of the study, said, “We show that the structure of sarecycline matters. 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.”

“Sarecycline thwarts TetM, a ribosome guardian protein that protects bacteria from outside interference. The broader implication of the study is that structural knowledge of tetracycline compounds could be used to engineer better antibiotics.”

“This could result in therapies with better or longer-lasting efficacy, fewer side effects, and lower drug resistance. Future agents could be used not just in acne, but potentially in other skin disorders and infections as well.”

The scientists report findings Aug. 3 in Proceedings of the National Academy of Science.

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