The effect of isotretinoin therapy on CD3(+), CD4(+) T cell and ICAM-1 expression in acne vulgaris

Recently, it is dwelling on that such inflammatory mediators as CD3(+), CD4 (+) T cells andICAM -1 may play a role in the inflammation of AV. Although it is known that isotretinoin has anti-inflammatory activity in AV, the mechanism or mechanisms of action of isotretinoin has not beencompletely elucidated.In our study, pretreatment and posttreatment CD3(+), CD4 (+) T cell and ICAM-1 levels wereanalysed and compared by immunohistochemical methods on the skin samples of 25 AV case underisotretinoin treatment. Levels of skin samples were also compared with the skin samples of thecontrols. CD4 (+) T cell infiltrate was found significantly increased in the perivascular and theperiadnexial area in pretreatment pustul (p<0.05) when compared with the uninvolved normal skinand the control group. CD3 (+) T cell infiltrate was found significantly increased in the perivasculararea in the pretreatment pustule (p<0.05) when compared with the uninvolved normal skin and thecontrol group. Although the periadnexial CD3 (+) T cell infiltrate was significantly higher than theuninvolved normal skin (p<0.05), when compared with the control group a significant increase wasnot found in the pretreated pustule (p>0.05). The increase in ICAM-1 expression did not showstatistically significance as compared with the control group (p>0.05) in pretreated pustule anduninvolved normal skin. After isotretinoin therapy, perivascular and periadnexial CD3 (+) T cellinfiltrate and periadnexial CD4 (+) T cell infiltrate levels were decreased significantly in the pretreatedpustule (p<0.05) whereas perivascular CD4 (+) T cell infiltrate levels decreased insignificantly(p>0.05)The effect of isotretinoin on CD3 (+) and CD4 (+) T cell levels in inflammatory lesions was notfound to be significantly related in the cases with partial and complete recovery (p>0.05). This effectwas found to be unrelated with the cumulative doses of isotretinoin (p>0.05).It may be thought that CD3(+) and CD4 (+) T cells play a role in the inflammation of AV andisotretinoin therapy may indicate its anti-inflammatory activity by decreasing the CD3(+) and CD4 (+)T cell levels.