Akne vulgariste isotretinoin tedavisinin toll benzeri reseptör-2 ve interferon-? düzeylerine etkisi

Acne vulgaris is the most common skin disorder among young people. Recently, toll like receptors have been proposed as a pathogenetic factor for acne. In our study, we detected the tissue immunopositivity of TLR 2 and IFN-? and serum levels of TLR 2, IL-8, IL-12 and IFN-? for the purpose of recognizing the role of TLR2 and Th1 pathways in the pathogenesis of acne, revealing the possible relationship of isotretinion treatment to this mechanism.25 patients were diagnosed as isotretinoin indicated acne vulgaris (grade III and IV) and 20 healthy volunteers were enrolled in our study. Before commencement of the systemic treatment venous blood samples and two 3 mm punch biopsies (one from the pustular lesions on the back, the other from the clear skin at least 1 cm away from any lesion) were collected. After the completion of treatment, venous blood samples and punch biopsies from the previously sampled skin were taken from the patient with complete response. Results were compared both between pre- and post-treatment groups and between pre-treatment and healthy control groups.Acne patients had statistically significant higher serum TLR-2 levels compared to the controls (p<0,001). Serum TLR-2 levels were significantly lower in the post-treatment group compared to the pre-treatment group (p=0,004).TLR-2 and IFN-? infiltration was significantly higher in biopsy samples taken from the pustular lesions in pre-treatment patient group (p<0,001). Immunopositivity of biopsy specimens for TLR-2 and IFN-? were significantly lower in post-treatment group compared to the pre-treatment group (p<0,001 and p=0,008, respectively). Lesional biopsies were more immunopositive than perilesional biopsies for TLR-2 and IFN-? (p<0,001).No statistical correlation between TLR-2 and IFN-? was found concerning both the serum levels and the immunopositivity of the lesional biopsies.With these results, it is reasonable to assume that TLR-2 and IFN-? have roles in acne vulgaris immunopathogenesis and systemic isotretinoin functions as an anti-inflammatory treatment via the downregulation of TLR-2 receptors and decrement of IFN-? levels.