The effects of doxycycline and isotretinoin treatment on cutaneous human beta defensin 1 and 2 levels in acne vulgaris

The Effects of Doxycycline and Isotretinoin Treatment on Cutaneous Human Beta Defensin 1 and 2 Levels in Acne VulgarisAcne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. In addition to genetic, hormonal and environmental factors, abnormal colonization by Propionibacterium acnes has been implicated in the occurence of acne via induction of inflammatory mediators. Recent studies have shown that human beta defensin 1 (hBD-1) and 2, which are antimicrobial peptides producted by skin, play a role in the pathogenesis of acne vulgaris. But, the effects of doxycycline and isotretinoin, which are frequently prescribed therapeutic agents in acne vulgaris, on these antimicrobial peptides have not been investigated.The aim of our study was to determine the role of antimicrobial peptides in the pathogenesis of acne vulgaris and enlighten the probable mechanisms of antiinflammatory effects of doxycycline and isotretinoin in acne vulgaris.Forty-four patients (22 patients in each group) who were diagnosed as grade 6 and 8 acne vulgaris and indicated doxycycline or isotretinoin for their treatment, and 20 healthy volunteers included to our study. Before initiation of systemic treatment two (one from the acne lesions, other from the normal skin at least 1 cm away from acne lesions) cutaneous samples were taken from the back of patients. After the systemic treatment, second skin biopsies were taken from previously sampled skin of patients who had clinically satisfying improvement. The results were compared with each others and also with skin samples of healthy controls.Cutaneous levels of hBD-1 and -2 were significantly increased in patients with acne vulgaris when compared with healthy controls (p<0,05).After doxycycline therapy, cutaneous hBD-1 level was significantly decreased when compared with pre-treatment samples (p<0,05), whereas there was no statistically significant difference in hBD-2 levels (p>0,05). However, there was no statistically significant difference in cutaneous hBD-1 level after isotretinoin therapy when compared with pre-treatment samples (p>0,05), whereas statistically significant decrease was found in hBD-2 levels (p<0,05). There was no statistically significant difference between doxycycline and isotretinoin groups when compared post-treatment hBD-1 and hDB-2 levels (p>0,05).There was no statistically significant correlation between the levels of hBD-1 and hBD-2 in acne lesions and clinical improvement after treatment (p>0,05).In the light of these results; it is reasonable to assume that hBD-1 and hBD-2 have a role in the pathogenesis of acne, and doxycycline and isotretinoin may achieve some of their antiinflammatory effects by decreasing hBD-1 and hBD-2 levels.Key word: Acne, human beta defensin, isotretinoin, doxycycline