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A study performed on several skin cell types in vitro revealed that pathogenic C.acnes strains release extracellular vesicles (EVs) with a specific cargo that activates inflammation‑related factors such as IL‑8, IL‑6 and tumor necrosis factor (TNF) [36]

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However, random mutagenesis may not reveal a mechanism for increasing strain productivity that is additionally unstable in contrast to site-directed mutagenesis, which implies the presence of a target nucleotide sequence with a known function