Explore the vast range of titles available.

Acne vulgaris (AV) is a chronic inflammatory skin disorder, and cytokines such as interleukin-17 (IL-17), interleukin-19 (IL-19), and C-reactive protein (CRP) are thought to contribute to its immunopathogenesis. This study investigated serum and salivary levels of CRP, IL-17, and IL-19 in patients with AV and examined their relationship with disease severity. A total of 99 participants aged 15-30 years were classified into Control (n = 28), Moderate AV (n = 43), and Severe AV (n = 28) groups using the Global Evaluation Acne (GEA) Scale. Serum and saliva samples were analyzed using ELISA and immunoturbidimetric assays. Statistical comparisons and correlation analyses were performed. Serum IL-17 levels were significantly higher in the control group compared to both acne groups ( < 0.05), with no gender-related differences. Salivary cytokine levels showed no significant group differences. However, IL-17 and IL-19 were strongly correlated in both saliva (r = 0.672, < 0.005) and serum (r = 0.538, < 0.005) across the entire study population. Serum and salivary CRP levels showed no significant differences between groups. In contrast to previous reports, our study found lower serum IL-17 levels in AV patients compared to healthy controls, challenging the assumption of its purely pro-inflammatory role and suggesting a potential compensatory or regulatory immune mechanism to maintain homeostasis. These findings may also reflect distinct physiological pathways between systemic interleukin activity and localized skin inflammation. Although salivary cytokine levels did not differ significantly among groups, strong intra-sample correlations highlight their interaction and support saliva's potential as a non-invasive tool for monitoring immune activity.

Acne is a prevalent inflammatory disease in dermatology, and its pathogenesis may be associated with inflammation, immunity, and other mechanisms. It commonly manifests in young individuals and frequently imposes a heavy economic, physical, and psychological burden on patients. Gut microbes and blood metabolites, as significant immune and inflammatory regulators in the body, have been hypothesized to form the “neurocutaneous axis.” Nonetheless, the precise causal relationships among the gut microbes, circulating blood metabolites, and acne development have yet to be elucidated. This study employed bidirectional two-sample Mendelian randomization (MR) to probe the causal impacts of 412 distinct gut microbes and 249 blood metabolites on acne. Single nucleotide polymorphisms (SNPs), which are closely associated with gut microbes and blood metabolites, were utilized as instrumental variables. This approach was taken to discern whether these elements serve as pathogenic or protective factors in relation to acne. Furthermore, a mediation analysis encompassing gut microbes, blood metabolites, and acne was conducted to explore potential correlations between gut microbes and blood metabolites, as well as their cumulative effects on acne. This was done to substantiate the notion of causality. Bidirectional two-sample MR analysis revealed 8 gut bacteria, 6 bacterial metabolic abundance pathways determined by birdshot, and 8 blood metabolites significantly associated with acne. The mediation MR analysis revealed 2 potential causal relationships, namely, Bifidobacterium-DHA-Acne and Bifidobacterium-Degree of Unsaturation-Acne. This study identified gut microbes and blood metabolites that are causally associated with acne. A potential causal relationship between gut microbes and blood metabolites was obtained via mediation analysis. These insights pave the way for the identification of new targets and the formulation of innovative approaches for the prevention and treatment of acne.

In individuals with acne vulgaris, alterations occur in serum metabolite composition, yet the exact causal link between these metabolites and acne development remains elusive. Using genome-wide association datasets, we performed bidirectional Mendelian randomization (MR) to investigate the potential causal relationship between 309 serum metabolites and acne vulgaris. We performed sensitivity analysis to evaluate the presence of heterogeneity and pleiotropy. Forward MR analysis found 14 serum metabolites significantly associated with acne vulgaris, and reverse MR analysis found no significant association between acne vulgaris and these serum metabolites. Through validation using data from the FinnGen database of acne vulgaris studies, we found a conclusive and significant correlation between stearoylcarnitine and acne vulgaris. This provides new evidence in the search for new targets for the treatment of acne vulgaris.

Acne vulgaris (AV) is a chronic inflammatory skin disease with a complex pathogenesis, and its association with insulin resistance (IR) remains unclear. This study aimed to identify differential proteins linking AV and IR to improve diagnostic and therapeutic strategies. Plasma proteomic profiling by using LC-MS/MS was performed on 90 AV patients (with IR [ n  = 40], without IR [ n  = 50]) and 30 healthy controls (with IR [ n  = 11], without IR [ n  = 19]). Differentially expressed proteins were analyzed using bioinformatics tool to identify key molecules and pathways. Candidate molecules were screened based on their positive correlations with both AV severity and insulin levels. In group AV with IR, C4BPA was highly expressed, showed strong positive correlations (Pearson’s R  = 0.46, p  = 4.21E-6) with insulin levels and were enriched in complement agglutination cascade and B-cell-mediated immune pathways. In group AV, C4BPA (Pearson’s R  = 0.23, p  = 0.03) also correlated with AV severity (GAGS scores) and was enriched in complement and coagulation cascades and leukocyte-mediated immunity. C4BPA acted as a key molecule, bridging IR and AV pathogenesis. This study offers a highly valuable proteomic resource for AV associated with IR and proposes a mechanistic hypothesis, supported by existing literature, that insulin exacerbates acne by regulating lipid metabolism and inflammatory pathways with C4BPA potentially acting as a central mediator in this process.

Background The management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required. Objective Our aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females. Methods The review was conducted according to a previously published protocol. Three reviewers independently selected relevant studies from the search results, extracted data, assessed the risk of bias, and rated the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Ten randomized controlled trials (RCTs) and 21 case series were retrieved. All trials were assessed as being at a ‘high risk’ of bias, and the quality of evidence was rated as low or very low for all outcomes. Apart from one crossover trial that demonstrated statistical superiority of a 200 mg daily dose versus inflamed lesions compared with placebo, data from the remaining trials were unhelpful in establishing the degree of efficacy of lower doses versus active comparators or placebo. Menstrual side effects were significantly more common with the 200 mg dose; frequency could be significantly reduced by concomitant use of a COC. Pooling of results for serum potassium supported the recent recommendation that routine monitoring is not required in this patient population. Conclusion This systematic review of RCTs and case series identified evidence of limited quality to underpin the expert endorsement of spironolactone at the doses typically used (≤100 mg/day) in everyday clinical practice.

Background Acne vulgaris (AV) is a common inflammatory skin disease during adolescence. Metformin (MET) has recently been found to have the effects of regulating lipid disorders, suggesting its potential benefits in the treatment of AV patients. Method Recruited 18 patients with moderate to severe AV, and then received MET treatment (AVM group) for a continuous period of 12 weeks, while 20 healthy controls (HC group) served as the control group. The Global Acne Grading System (GAGS) score and VISIA‐CRTM imaging system were used to evaluate the severity of AV patients before and after treatment, and the serum lipid metabolomics differences were detected by liquid chromatograph mass spectrometer (LC–MS) before and after treatment. Multivariate statistical analysis of differentially expressed lipid metabolites was performed using partial least squares discriminant analysis (PLS‐DA) and orthogonal partial least squares discriminant analysis (OPLS‐DA). The Mann–Whitney U test was used to analyze the differences in lipid metabolites between groups. Spearman correlation analysis was conducted to examine the correlation between differentially expressed serum lipid metabolites and the acne severity index. The Kyoto Encyclopedia of Genes and Genomes (KEGG) database was used to predict the metabolic pathways involved in the differentially expressed lipid metabolites in the AVM group. Results Compared to before treatment, the GAGS score (p < 0.001), red zone (p < 0.001) and Porphyrin (p < 0.01) indices of AV patients significantly improved after oral administration of MET. The results of PLS‐DA and OPLS‐DA indicated a clear separation in the composition of lipid metabolites between AV patients and the HC group; however, after MET treatment, the composition of lipid metabolites in AV patients showed a trend towards resembling that of the HC group. The 25 lipid metabolites with the most significant differences between AV patients and the HC group were all restored to the levels of the HC group after MET treatment. The Spearman correlation results showed that the serum PC (16:1/22:6) concentration in AV patients before treatment was positively correlated with the porphyrin area index (r = 0.47, p = 0.049). The KEGG analysis revealed 6 metabolic pathways that showed significant downregulation after treatment with MET. Conclusion The therapeutic effect of MET on patients with moderate to severe AV may be achieved through the positive regulation of lipid metabolism. Its molecular mechanism may be related to the downregulation of inflammatory mediators associated with choline metabolism and arachidonic acid metabolism.

Background Previous studies reported that patients with keloid, acne, or hypertrophic scar (HS) had lower serum vitamin D levels compared to healthy controls. Whereas, these works failed to verify their causal relationships. Hence, we performed a Mendelian randomization (MR) aimed to investigate the causal relationship between vitamin D and keloid, acne, or HS. Methods Utilizing summary datasets from genome‐wide association studies, we conducted a two‐sample MR analysis to explore the causal relationship between vitamin D and keloid, acne, or HS. The inverse‐variance weighted MR approach served as the primary analysis, with additional support from various sensitivity methods, including MR‐Egger, weighted median, simple mode, weighted mode, and MR‐PRESSO, to enhance the reliability of our findings. Results From our MR analyses, no causal relationships were found between vitamin D level and keloid (OR: 1.15, 95% CI: 0.853–1.16, p = 0.36), acne (OR: 0.94, 95% CI: 0.66–1.30, p = 0.65) or HS (OR: 1.20, 95% CI 0.79–1.82, p = 0.40) formation. After eliminating outliers through MR‐PRESSO, no significant associations were found between serum vitamin D level and keloid, acne, as well as HS. Conclusion Our findings, backed by rigorous IV selection and consistent outcomes across various MR approaches, suggest no causal link between serum 25(OH)D levels and keloid, acne, or HS. While vitamin D is involved in wound healing, its connection to these conditions may not be straightforward, emphasizing the need for further research.

The current landscape of acne therapeutics is notably lacking in targeted treatments, highlighting a critical need for the discovery of new drug targets to improve treatment outcomes. This study aims to investigate the connections between proteomics and genetics in relation to acne across extensive population cohorts, aspiring to identify innovative preventive and therapeutic approaches. Employing a longitudinal cohort of 54,306 participants from the UK Biobank Pharmacological Proteomics Project (UKB-PPP), we performed an exhaustive evaluation of the associations between 2,923 serum proteins and acne risk. Initial multivariate Cox regression analyses assessed the relationship between protein expression levels and acne onset, followed by two-sample Mendelian Randomization (TSMR), Summary-data-based Mendelian Randomization (SMR), and colocalization to identify genetic correlations with potential protein targets. Within the UKB cohort, we identified 19 proteins significantly associated with the risk of acne. Subsequent analysis using Two-Sample Mendelian Randomization (TSMR) refined this to two specific proteins: FSTL1 and ANXA5. Each one-standard deviation increase in the expression levels of FSTL1 and ANXA5 was associated with a 24% and 32% increase in acne incidence, respectively. These results were further validated by additional Summary-data-based Mendelian Randomization (SMR) and differential expression analyses. Our comprehensive analysis of proteomic and genetic data from a European adult cohort provides compelling causal evidence that several proteins are promising targets for novel acne treatments.

Acne is a chronic inflammatory skin disease affecting pilosebaceous unit. However, its specific mechanism remain incompletely understood. This study aims to identify and analyze the differential expression of serum exosomal miRNA in severe acne, revealing new insights into the pathogenesis of acne. MiRNAs were extracted from serum exosomes of 15 patients with severe acne and 15 healthy controls. MiRNA libraries were constructed and sequenced using Illumina HiSeq 2500. The DESeq2R was applied to identify differentially expressed miRNAs. The candidate target genes were predicted using multiple miRNA databases. The DAVID database was used to enrich GO function and KEGG pathway analysis of target genes. Cytoscape3.10.0 was employed to construct a PPI interaction network and further screen hub genes. The most significantly differentially expressed miRNAs were validated using RT-qPCR detection. Small RNA-Seq analysis identified a total of 96 serum exosome miRNAs, with 33 up-regulated and 63 down-regulated. Target prediction across four miRNA databases identified 10,569 target genes. GO analysis showed that target genes were mainly enriched in transcriptional regulation, signal transduction and protein binding; KEGG analysis revealed enrichment in 160 pathways including PI3K-Akt and MAPK signaling pathway. Cytoscape 3.10.0 identified 7 hub genes: PIK3R1, PIK3CA, SRC, EGFR, JAK2, ERBB2, and IGF1R, along with 35 corresponding differentially expressed miRNAs. RT-qPCR results indicated a significant reduction in exosomal miR-124-3p levels in severe acne. Serum exosomal miRNA expression in patients with severe acne significantly differed from that in healthy individuals. The exosomal miR-124-3p expression was markedly reduced in severe acne compared to healthy controls. Consequently, the increase of miR-124-3p expression may have potential therapeutic implications for severe acne.

Amidst the existing literature on the effect of isotretinoin on serum interleukin-17 levels in acne patients, the effects of oral antibiotics azithromycin and doxycycline on serum interleukin-17 is scarce. We conducted an investigator blinded randomized interventional study to compare the effect of doxycycline, azithromycin and isotretinoin on inflammatory markers and Interleukin-17A (IL-17A) levels in acne. Patients were randomized and received the treatment according to treatment arm till 12 weeks. At baseline and 12 weeks/treatment completion, clinical improvement and Red-cell-distribution width (RDW),Neutrophil-lymphocyte ratio(NLR),Platelet-lymphocyte ratio(PLR), Mean-Platelet volume(MPV), Platelet-distribution width(PDW) and Interleukin-17A levels were analysed. P -value < 0.05 was considered statistically significant. Out of 120 patients, 110 patients completed the study. Baseline Global acne grading scale (GAGS) in doxycycline, azithromycin or isotretinoin group was 24.32  ± 3.119, 24.12 ± 2.804 and 25.10 ± 3.985 respectively and post-treatment was 5.216  ± 1.88, 7.265 ± 2.17 and 2.769 ± 1.08. All the drugs caused a statistically significant decrease in RDW and IL-17 A levels. Baseline levels of IL-17 A were significantly higher in patients with higher GAGS and post-acne scarring. One of the limitations of our study was that we excluded severe nodulocystic acne patients thereby these results have to be carefully extrapolated.