The effects of doxycycline and isotretinoin treatments in acne vulgaris on antioxidant system

The Effects of Doxycycline and Isotretinoin Treatments in Acne Vulgaris on Antioxidant SystemA number of emerging studies suggest that acne patients may be under increased local and systemic oxidative stress. Only a few studies of antioxidative systems in acne pathophysiology, and the effects of systemic acne treatments on antioxidative defense system have been performed to date. For this purpose the present study was designed to determine the antioxidative mechanisms of systemic doxycycline and isotretinoin in acne vulgaris and the role of antioxidant system in the pathogenesis of acne.The study included two groups consisted of 15 patients with acne vulgaris whose clinical severity were grade 2 or above, and who have indicated systemic isotretinoin or doxycycline for their acne treatment, and a control group of 30 healthy subjects. Fasting peripheral venous blood was drawn for detecting pre- and posttreatment intra and extracellular antioxidant systems spectrophotometrically. The results were compared with each others and the healthy controls.Serum levels of vitamin A, ß-carotene, vitamin E, selenium, zinc, plasma vitamin C, LPO, and erythrocyte CAT activities were statistically insignificant from healthy subjects. The activity of erythrocyte GSH-Px was significantly decreased in the patient group (p<0.001). In contrast the activity of erythrocyte SOD was significantly increased in the patient group (p<0.001). No correlation was found between the disease severity and the activities of antioxidant enzymes.Activity of erythrocyte GSH-Px was significantly increased (p<0.001) and the serum ß-carotene levels and erythrocyte SOD activity were significantly decreased (p<0.025, and p<0.001, respectively) in the patient group after treatment with doxycycline. Serum ß-carotene, and plasma LPO levels, and activity of erythrocyte SOD were lower in patients than controls after isotretinoin treatment, being statistically significant (p<0.025, p<0.025, and p<0.001, respectively). The posttreatment serum levels of selenium were decreased in the doxycycline group, whereas they were increased in the isotretinoin group, being statistically significant (p<0.05). The posttreatment serum levels of ß-carotene in the isotretinoin group were significantly decreased when compared with doxycycline group (p<0.05). Plasma levels of LPO were significantly decreased only posttreatment with systemic isotretinoin (p<0.025).We concluded that our results supported the hypothesis of an increased oxidative stres in acne vulgaris, and systemic acne treatments like doxycycline or isotretinoin give rise to a decrease in oxidative stress. However, whether the disease severity have been related to the activities of antioxidant enzymes or the antioxidant capacity of systemic isotretinoin is greater than doxycycline needs further investigations.