Comparison of efficacy of doxycycline and isotretinoin on cutaneous human beta-defensin-1 and -2 levels in acne vulgaris

Abstract

Background:Recent studies have shown that human beta-defensin-1 (hBD-1) and (human beta-defensin-2 hBD-2), which are antimicrobial peptides produced by the skin, play a role in the pathogenesis of acne vulgaris (AV).Objective:The aim of this study was to determine the role of antimicrobial peptides in the pathogenesis of AV and enlighten the effects of doxycycline and isotretinoin in the expression of these defensins in AV.Materials and Methods:A total of 44 patients (22 patients in each group) with Grade 6 and 8 AV who were indicated doxycycline or isotretinoin for their treatment, and 20 healthy volunteers were included in this study. Pretreatment cutaneous samples were obtained from pustular lesions and uninvolved skin of AV patients and were repeated after the treatment. Only one biopsy was obtained from controls.Results:Cutaneous levels of hBD-1 and hBD-2 were significantly increased in AV patients when compared with healthy controls (P<0.05). Doxycycline therapy achieved a decrease in hBD-1 levels (P<0.05), whereas isotretinoin therapy achieved a reduction in hBD-2 levels when compared with pretreatment levels (P<0.05). Posttreatment hBD-1 and hBD-2 levels were not different between doxycycline and isotretinoin groups (P>0.05).Conclusion:In the light of these results, it was reasonable to assume the role of hBD-1 and hBD-2 in the pathogenesis of AV. Our results showing a significant reduction in hBD-1 staining with doxycycline treatment and in hBD-2 with isotretinoin suggested that some part of their anti-acne effect worked through these mechanisms.

Serum, saliva, and gingival tissue human β‐defensin levels in relation to retinoic acid use

“…According to Harder et al., 31 treatment of skin keratinocytes with ATRA downregulates the proinflammatory cytokine and P. aeruginosa ‐induced hBD‐2, ‐3, and ‐4 gene expression. Again, similar to our findings, systemic use of isotretinoin up to doses of 120 to 150 mg/kg decreased cutaneous hBD‐2 levels in humans, while it did not affect hBD‐1 levels 32 . These findings, together with our results, indicate that RA may suppress hBD‐2 expression of the epithelium with various origins.…”

“…Again, similar to our findings, systemic use of isotretinoin up to doses of 120 to 150 mg/kg decreased cutaneous hBD-2 levels in humans, while it did not affect hBD-1 levels. 32 These findings, together with our results, indicate that RA may suppress hBD-2 expression of the epithelium with various origins.…”

Plasma dermcidin levels in acne patients, and the effect of isotretinoin treatment on dermcidin levels

“…Isotretinoin, a retinoid derivative, is effective in inhibiting all mechanisms that contribute to acne pathogenesis (Aksoy, Adısen, Erdem, & Aksakal, 2018). P. acnes is an anaerobic bacterium found in normal skin flora that has inflammatory and immunomodulatory properties.…”

“…Isotretinoin, a retinoid derivative, is effective in inhibiting all mechanisms that contribute to acne pathogenesis (Aksoy, Adısen, Erdem, & Aksakal, ). P .…”