Assessment of ADMA, IMA, and Vitamin A and E Levels in Patients with Acne Vulgaris

Changes of plasma amino acid levels and metabolic pathways in isotretinoin therapy: ınsights into managing acne vulgaris side effects

Acne vulgaris can be effectively treated with isotretinoin, however, there are several side effects both during and after the treatment. Preventing these side effects is important for continued treatment. This study focused on the relationship between the changes in the levels of plasma amino acids of patients with acne vulgaris after three months of isotretinoin treatment and the side effects. A pre- and post-treatment plasma sample of 35 patients was collected. Samples were analyzed by liquid chromatography-tandem mass spectrometry. After treatment, the plasma levels of 15 amino acids changed statistically. While L-arginine, taurine, L-asparagine, and L-proline levels decreased, L-serine, L-alanine, and L-cystine levels also increased. (p < 0.05) When the amino acid profiles of male and female patients before and after treatment were compared, the plasma levels of L-arginine (p = 0.0017), L-cystine (p = 0.0224) and L-histidine (p = 0.0167) were statistically different. Additionally, the correlation matrix analysis revealed a strong correlation (R > 0.8) between L-leucine, L-isoleucine, L-norvaline, and L-valine. The effect of isotretinoin treatment on eighteen metabolic pathways such as cysteine and methionine metabolism, glycine, serine and threonine metabolism, alanine, aspartate and glutamate metabolism, arginine and proline metabolism is strongly related to the treatment of therapeutic and side effects of isotretinoin. According to the results of the study, the use of L-arginine, L-asparagine, N-acetylcysteine and taurine supplements during isotretinoin treatment may help avoid side effects of skin dryness, blepharitis, nail fragility, and fatigue. As a result, the study provided useful information for enhancing the safety and efficacy of isotretinoin treatment, as well as lowering isotretinoin-related side effects.

The role of thiol-disulfide homeostasis and ischemia-modified albumin in osteosarcopenia

BACKGROUND

Oxidative stress results from an imbalance between the induction of reactive oxygen species and the ability of cells to metabolize them. Numerous markers can be used to assess the level of oxidative stress. Thiol-disulfide homeostasis (TDH) and ischemia-modified albumin (IMA) are some of them. The aim of this study is to investigate the role of TDH and IMA, which are indicators of oxidative stress, in older patients with osteosarcopenia (OS).

METHODS

The study was conducted cross-sectionally in a geriatrics outpatient clinic. Patients who applied to the outpatient clinic for three months were included in the study. Patients with acute infection, delirium, malignancy, severe liver, heart or kidney dysfunction and who did not give their consent for the study were excluded from the study. The study was conducted with 136 patients. Sarcopenia was diagnosed according to muscle ultrasonography (USG) and handgrip strength (HGS) results. Osteopenia/osteoporosis was diagnosed according to bone mineral densitometry (BMD) results. The combination of osteopenia/osteoporosis and sarcopenia was accepted as OS.

RESULTS

Native thiol, total thiol value and nativethiol /totalthiol*100 values were significantly lower in the group with OS (respectively; value = 265 ± 53.8 standard deviation (SD) μmol/L, p =  ≤ 0.001; value = 295.33 ± 55.77 SD μmol/L, p = 0.001; value = 90.06 (2.8) interquartile ranges (IQR), p = 0.033). Disulfide/native thiol*100 and disulfide/total thiol*100 values were significantly higher in the group with OS (respectively; value = 5.5 (1.7) IQR, p = 0.033; value = 4.97 (1.4) IQR, p = 0.034).

CONCLUSION

In our study, the role of oxidative stress in OS was demonstrated by using TDH as an oxidative stress parameter.

Metformin: A Potential Treatment for Acne, Hidradenitis Suppurativa and Rosacea

Metformin is a widely used drug for treatment of diabetes mellitus, due to its safety and efficacy. In addition to its role as an antidiabetic drug, numerous beneficial effects of metformin have enabled its use in various diseases. Considering the anti-androgenic, anti-angiogenic, anti-fibrotic and antioxidant properties of metformin, it may have the potential to improve chronic inflammatory skin diseases. However, further evidence is needed to confirm the efficacy of metformin in dermatological conditions, This review focuses on exploring the therapeutic targets of metformin in acne vulgaris, hidradenitis suppurativa and rosacea, by studying their pathogeneses.

Markers of Oxidative Stress in Patients with Acne: A Literature Review

Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous unit. Its pathogenesis is multifactorial and involves the overlap between four main processes: alteration of the keratinization, increased sebum production, colonization with Cutibacterium acnes, and inflammation. The role of oxidative stress (OS) has been intensively studied in inflammatory skin conditions such as psoriasis, vitiligo, or atopic dermatitis. However, the involvement of OS in the pathogenesis of acne is less known. The evidence accumulated over the last decade suggests that in the case of acne patients, there is an imbalance between oxidants and antioxidants. In this review, we analyzed studies that evaluated markers of OS in patients with acne, published in the last ten years, with the aim of providing new insights into the pathogenesis of acne.

Increased Vitamin A Level is associated with Clinical Improvement in Mild Acne Vulgaris: A Pre-test and Post-test Clinical Trial

AV is a global cutaneous disorder that although is benign, can significantly affect the patient’s quality of life. The pathognomonic feature of the disease is the emergence of comedones. There are four known pathophysiology of AV, increased sebum production, ductal cornification, colonization of the bacteria P. acnesin the pilosebaceous unit, and inflammation. Furthermore, Vitamin A although already a well-established acne treatment that can affect all four of these factors, here are still limited data regarding the quantitative measurement of vitamin A itself in acne vulgaris cases. This study seeks to review the association between vitamin A levels measured quantitatively using ELISA with the outcome of inflamed lesions and comedones prior and after treatment with Tretinoin 0.025% in patients with mild AV. Our studies found that increased level of vitamin A is associated with significant clinical improvements in both inflamed and non-inflamed AV lesions.

Ischemia-Modified Albumin—A Potential New Marker of Oxidative Stress in Dermatological Diseases

There is growing evidence that oxidative stress is involved in the pathogenesis of numerous conditions, including dermatological diseases. Various markers are available to assess oxidative stress, but none of these can be considered the ideal marker. Recent studies have shown that ischemia-modified albumin (IMA) is not only an indicator of ischemia, but also a marker of oxidative stress. We have conducted a narrative review to evaluate the role of IMA in dermatological diseases. We have identified 24 original articles that evaluated IMA in skin disorders (psoriasis, acne vulgaris, hidradenitis suppurativa, urticaria, vitiligo and Behcet’s disease) and hair disorders (alopecia areata, androgenetic alopecia and telogen effluvium). The results of the studies analyzed reveal that IMA may be considered a new marker of oxidative stress in dermatological diseases and offer new insights into the pathogenesis of these disorders and the theoretical basis for the development of new, effective, targeted therapies. To the best of our knowledge, this is the first review that gathers up data on the role of IMA in dermatological diseases.

Elevated survivin levels in patients with acne vulgaris

OBJECTIVE

Acne vulgaris is a multifactorial disease of the pilosebaceous unit. As the most common skin disease, it may affect approximately 85% of the young population. Survivin, a member of the inhibitors of the apoptosis (IAP) gene family, can inhibit apoptosis and regulate cell division and proliferation. In the study, we aimed to investigate the potential role of serum survivin in acne vulgaris.

METHODS

Forty individuals who were diagnosed with acne vulgaris and forty healthy subjects as the control group were enrolled in the study. Venous blood samples were collected from each participant, and the serum levels of survivin were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using SPSS software version 25.

RESULTS

The serum survivin levels were statistically significant between the groups, and the levels of survivin were measured as acne vulgaris patients group 153.44 and control group 104.17 pg/ml, respectively (p < 0.018). When the serum survivin levels were compared according to gender, females had higher levels of survivin than the males (168.16 versus 50.45 pg/mL, p = 0.001). A significant correlation was found between acne severity (p = 0.017) and Scale for Acne Scar severity (SCAR-S) score (p = 0.001) according to the survivin levels. In terms of age, no significant relationship was found between age and survivin (p = 0.4048).

CONCLUSION

Elevated serum levels of survivin were determined in acne vulgaris. Moreover, there was a significant correlation between acne stage and SCAR-S score according to survivin levels.

Serum vitamin E levels and chronic inflammatory skin diseases: A systematic review and meta-analysis

Background

Vitamin E has long been linked to skin health, including all of its possible functions in cosmetic products, to its roles in membrane integrity and even the aging process. However, reports on the relationship between serum vitamin E levels and the risk of chronic inflammatory skin diseases have been inconsistent. We performed a systematic review and meta-analysis to evaluate the association between serum vitamin E levels and chronic inflammatory skin diseases.

Methods

We searched the PubMed, Web of Science and Scopus databases, with no time limit up to 30.06.2021. Studies examining serum vitamin E levels in patients with chronic inflammatory skin diseases were selected.

Results

Twenty articles met the inclusion criteria. Compared with controls, a lower vitamin E level was found in patients with vitiligo (SMD: -0.70, 95% CI: -1.21 to -0.19), psoriasis (SMD: -2.73, 95% CI: -3.57 to -1.18), atopic dermatitis (SMD: -1.08, 95% CI: -1.80 to -0.36) and acne (SMD: -0.67, 95% CI: -1.05 to -0.30).

Conclusions

Our meta-analysis showed that serum vitamin E levels were lower in patients suffering from vitiligo, psoriasis, atopic dermatitis and acne. This study highlights the need to evaluate vitamin E status to improve its level in patients with skin diseases.