Clinical and Immunological Evaluation of Isotretinoin in Patients with Acne Vulgaris

Abstract

Objective: To study the clinical and immunological influence of isotretinoin drug in the management of acne vulgaris by evaluation some immunological parameters which include ( IL-1β, IL-8, IFN-γ, TNF-α and TLR2).Methods: This study is a randomized clinical trial carried out in clinical dermatology in Merjan Teaching Hospital in Babylon from September-2018 to March -2019.The number of patients in the present study was 30,their age between (14-30 years), who were diagnosed by dermatologist to having moderate to severe acne and measured the immunological parameters (IL-8, IL-1β, IFN-γ, TNF-α) and ( TLR-2 ) before treatment, then treated with isotretinoin (20mg) once daily for thirty days, the response were evaluated clinically and immunologically after one month of therapy, by measure the concentration of proinflammatory cytokines (IL-8, IL-1β, IFN-γ, TNF-α) and ( TLR-2 ) by using enzyme-linked Immunosorbent assay (ELISA) technic.Results: Significant elevation in the serum levels ( p ≤ 0.001) of immunological parameter (TLR-2, IL-8, IL-1β, TNF-α, and IFN-γ) among acne patients were noted in comparison to the control.After one months of treatment the clinical response in group treated with isotretinoin was good, moderate and poor in 9 (60%), 6(40%), 0(0%) respectively, the immunological results showed that significant reduced ( p ≤ 0.001) in the serum levels of (IFN-γ, IL-8, IL-1β,TNF-α and TLR-2) of pretreatment in comparison to post treatment after one month of therapy. Conclusion:Significant elevation (p≤ 0.001) in the serum levels of (TLR-2,IL-8, IL-1β, TNF-α, and IFN-γ) among moderate to severe acne patients before treatment in comparison to control group. Clinically isotretinoin efficient in treatment of patients with acne after one month of therapy. Immunologically isotretinoin significant reducing (p≤ 0.001) serum levels of (TLR-2, IL-8, IL-1β, TNF-α and IFN-γ ) of pretreatment patients in comparison to post treatment after one month of therapy.