Acne treatment and inflammatory bowel disease: What is the evidence?

Alikhan, Ali; Henderson, Gregory P.; Becker, Lauren; Sciallis, Gabriel F.

doi:10.1016/j.jaad.2011.04.016

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…Antibiotics are known to cause shifts in microbial composition and use in infancy [Shaw et al 2010], childhood [Kronman et al 2012], and adult life [Shaw et al 2011] has been associated with an increased risk of IBD [Modi et al 2014]. Tetracycline in the treatment of acne has been associated with increased risk of CD [Margolis et al 2010;Alikhan et al 2011].…”

Section: Medicationsmentioning

confidence: 99%

The intestinal microbiome, barrier function, and immune system in inflammatory bowel disease: a tripartite pathophysiological circuit with implications for new therapeutic directions

Vindigni

Zisman

Suskind

et al. 2016

Therap Adv Gastroenterol

170

118

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We discuss the tripartite pathophysiological circuit of inflammatory bowel disease (IBD), involving the intestinal microbiota, barrier function, and immune system. Dysfunction in each of these physiological components (dysbiosis, leaky gut, and inflammation) contributes in a mutually interdependent manner to IBD onset and exacerbation. Genetic and environmental risk factors lead to disruption of gut homeostasis: genetic risks predominantly affect the immune system, environmental risks predominantly affect the microbiota, and both affect barrier function. Multiple genetic and environmental 'hits' are likely necessary to establish and exacerbate disease. Most conventional IBD therapies currently target only one component of the pathophysiological circuit, inflammation; however, many patients with IBD do not respond to immune-modulating therapies. Hope lies in new classes of therapies that target the microbiota and barrier function.

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Section: Medicationsmentioning

confidence: 99%

The intestinal microbiome, barrier function, and immune system in inflammatory bowel disease: a tripartite pathophysiological circuit with implications for new therapeutic directions

Vindigni

Zisman

Suskind

et al. 2016

Therap Adv Gastroenterol

170

118

View full text Add to dashboard Cite

show abstract

“…These proposed biological mechanisms and pathways are based upon findings from laboratory studies (Norris et al, 1987; Osanai et al, 2007; Kang et al, 2007; Mucida et al, 2007; Mora et al, 2009). Previous authors have noted that epidemiologic studies have suggested that there may be a positive association between antibiotic use and inflammatory bowel disease (Alikhan et al, 2011). …”

Section: Discussionmentioning

confidence: 99%

Clarifying the Purported Association between Isotretinoin and Inflammatory Bowel Disease

Coughlin

2015

JEHS

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Isotretinoin was approved by the Food and Drug Administration (FDA) in 1982 and revolutionized acne therapy. Soon afterwards, case reports appeared suggesting a link between inflammatory bowel disease and use of isotretinoin. As reviewed in this article, an increasing number of case-control and prospective (cohort) studies have been reported that examined associations between use of isotretinoin and inflammatory bowel disease. Published epidemiologic studies of the use of isotretinoin and risk of Crohn's disease and ulcerative colitis vary according to whether the design was a case-control study or cohort study and by other important design differences. The strengths and limitations of the studies, such as their ability to control for important confounding variables (e.g., the severity of acne and use of antibiotics), also differ widely. Results across epidemiologic studies have been inconsistent and most studies have not found a strong association or a dose-response relationship. Based upon results from laboratory studies, several biological mechanisms have been proposed to account for either a positive (pathogenic) or inverse (protective) association between isotretinoin and inflammatory bowel disease. Although epidemiologic study findings are generally consistent with a correct temporal relationship (i.e., exposure to isotretinoin preceded the onset of inflammatory bowel disease), Crohn's disease and ulcerative colitis often have an insidious onset with some symptoms occurring well before a clinical diagnosis of inflammatory bowel disease is made. Taken overall, results from epidemiologic (case-control and cohort) studies completed to date do not show a consistent association between isotretinoin use and risk of inflammatory bowel disease. There is no clear evidence of a causal link.

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“…Some theorize that the discovery of IBD in patients with a history of isotretinoin use may be incidental rather causal . Additionally, severe acne itself may be associated with IBD, independent of isotretinoin .…”

Section: Adverse Eventsmentioning

confidence: 99%

“…The risk of depression and suicide was added to the package insert of isotretinoin in 1988. In November 2010, the American Academy of Dermatology issued a statement on the issue of isotretinoin and depression, as follows: “A correlation between isotretinoin use and depression/anxiety symptoms has been suggested but an evidence‐based causal relationship has not been established” .…”

Section: Adverse Eventsmentioning

confidence: 99%

Isotretinoin updates

Zeichner

2013

Dermatol Ther

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Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles commonly affecting adolescents and young adults. This disease has a profound psychological impact on affected individuals and treatment has been shown to significantly improve both self-esteem and quality of life. Isotretinoin is an effective medication used primarily in severe cystic acne patients. Over the past 30 years, this medication has revolutionized the treatment of acne. However, despite its popularity there are numerous side effects associated with its use. Most of its side effects are predictable and dose dependent, which has led to the development of variable dose regimens. Unfortunately, rare but significant side effects (e.g., depression, inflammatory bowel disease) do occur and necessitate careful monitoring to improve clinical outcomes and minimize potential adverse events.

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Acne treatment and inflammatory bowel disease: What is the evidence?

Cited by 8 publications

References 15 publications

The intestinal microbiome, barrier function, and immune system in inflammatory bowel disease: a tripartite pathophysiological circuit with implications for new therapeutic directions

The intestinal microbiome, barrier function, and immune system in inflammatory bowel disease: a tripartite pathophysiological circuit with implications for new therapeutic directions

Clarifying the Purported Association between Isotretinoin and Inflammatory Bowel Disease

Isotretinoin updates

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