Isotretinoin therapy changes the expression of antimicrobial peptides in acne vulgaris

Borovaya, Alena; Dombrowski, Yvonne; Zwicker, Stephanie; Olisova, Olga Yu.; Ruzicka, Thomas; Wolf, Ronald; Schauber, Jürgen; Sárdy, Miklós

doi:10.1007/s00403-014-1477-3

Cited by 41 publications

(44 citation statements)

References 46 publications

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“…Borovaya et al () reported no alteration in dermcidin mRNA expression following isotretinoin therapy. Although it is likely that upregulation of gene activity leads to increased translation and thereby concentrations of the corresponding protein, the measurement of mRNA may not correlate positively with protein expression (Borovaya et al, ). In addition, this group could not find any correlation with relative expression values of AMP and acne scores.…”

Section: Comparison Of Dermcidin Level Between the Studied Groupsmentioning

confidence: 99%

The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris

Ragab

Omar

Collier

et al. 2018

Dermatologic Therapy

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The continuous low dose (LD) isotretinoin is frequently used in the treatment regimen for acne vulgaris. However, data about its antimicrobial are lacking. The present study aimed to investigate dermcidin expression and the effects of low and conventional dose isotretinoin on its expression in acne vulgaris patients. Skin dermcidin expression was investigated in 30 patients with moderate–severe acne vulgaris and 15 healthy control subjects using ELISA. 15 patients were given continuous low‐dose isotretinoin (20 mg/day) and the other 15 given the conventional high dose (0.5 mg/kg/day). Skin biopsies were taken at the start of the study and 6 months later. Dermcidin was significantly lower in acne vulgaris patients (p < .001). Both isotretinoin regimens significantly raised dermcidin levels compared to pre‐treatment values (p < .001). Relapse after 12 months was not statistically different among the two isotretinoin regimens (p = .464). Pretreatment global acne grading system score of 28.6 ± 6.4 was reduced to 6 ± 6.1 following isotretinoin treatment (p < .001). Relapse was significantly related to posttreatment dermcidin levels (p = .017). Dermcidin expression is reduced in acne vulgaris. Conventional and LD isotretinoin regimens are associated with increased dermcidin expression.

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Section: Comparison Of Dermcidin Level Between the Studied Groupsmentioning

confidence: 99%

The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris

Ragab

Omar

Collier

et al. 2018

Dermatologic Therapy

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“…Scoring of severity of acne was carried out by counting the inflammatory lesions (papules and pustules) according to Habif (Borovaya et al, 2014). About 3,525 patients were included in this study.…”

Section: Ma T Er I Al a Nd M E Th O Dsmentioning

confidence: 99%

Adverse effects of isotretinoin: A large, retrospective review

Brzeziński

Borowska

Chiriac

et al. 2017

Dermatologic Therapy

122

129

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Acne is a very common and disfiguring disease that affects mostly adolescents and, to some extent, adults. The objective of our study was to estimate the adverse effects after isotretinoin by treatment of 3,525 patients due to acne vulgaris in a 5-year observation. Retrospective, comparative study was carried out in Poland and Romania from January 2012 to August 2016. Inclusion criteria into this study were moderate, severe, and nodulocystic inflammatory acne vulgaris. Exclusion criteria were mild acne, pregnant, and lactating women. Statistical analysis was carried out using T test and Chi square. All patients were treated with oral isotretinoin. Patient age ranged from 13-35 years. Dry lips was the most commonly reported adverse effect, affecting 100% of users, followed by xerosis (94.97%) and facial erythema (66.21%). Of all adverse effects, psychiatric symptoms accounted for 25.16%; eye lesions accounted for 8.96%. In lab investigations an increase in the level of total cholesterol and serum triglycerides was observed. This study documents the adverse effect profile of isotretinoin in a large number of patients collected over a period of 4 years. Side effects were mild and well tolerated and did not necessitate stopping the treatment. However, it is important to educate patients about this potential consequence.

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“…Isotretinoin was noted to have no impact on other antimicrobial peptides, including granulysin, perforin, and dermcidin, among others. These findings raise the possibility of specifically targeting antimicrobial peptides in the treatment of acne [81].…”

Section: Oral Retinoidsmentioning

confidence: 96%

Recent Advances in Acne Pathogenesis: Implications for Therapy

2014

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Acne pathogenesis is a multifactorial process that occurs at the level of the pilosebaceous unit. While acne was previously perceived as an infectious disease, recent data have clarified it as an inflammatory process in which Propionibacterium acnes and innate immunity play critical roles in propagating abnormal hyperkeratinization and inflammation. Alterations in sebum composition, and increased sensitivity to androgens, also play roles in the inflammatory process. A stepwise approach to acne management utilizes topical agents for mild to moderate acne (topical retinoid as mainstay ± topical antibiotics) and escalation to oral agents for more resistant cases (oral antibiotics or hormonal agents in conjunction with a topical retinoid or oral isotretinoin alone for severe acne). Concerns over antibiotic resistance and the safety issues associated with isotretinoin have prompted further research into alternative medications and devices for the treatment of acne. Radiofrequency, laser, and light treatments have demonstrated modest improvement for inflammatory acne (with blue-light photodynamic therapy being the only US FDA-approved treatment). However, limitations in study design and patient follow-up render these modalities as adjuncts rather than standalone options. This review will update readers on the latest advancements in our understanding of acne pathogenesis and treatment, with emphasis on emerging treatment options that can help improve patient outcomes.

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Isotretinoin therapy changes the expression of antimicrobial peptides in acne vulgaris

Cited by 41 publications

References 46 publications

The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris

The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris

Adverse effects of isotretinoin: A large, retrospective review

Recent Advances in Acne Pathogenesis: Implications for Therapy

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