Serum Fetuin-A: A Novel Potential Link Between Post-adolescent Acne and Insulin Resistance.

Background: Post-adolescent acne is acne in patients aged older than 25 years. It is more common in women, suggesting an underlying hormonal imbalance. It has been postulated that insulin resistance (IR) may play a role in pathogenesis. Objective: To explore the relationship between fetuin-A, IR, and post-adolescent acne. Methods: Serum fetuin-A levels were assessed using an ELISA technique in 50 female patients with post-adolescent acne and 50 healthy controls, and IR was calculated using the Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR). Results: Studied patients had significantly higher HOMA-IR indices and serum fetuin-A levels than control subjects (P=0.001 and <0.001, respectively) and they were significantly increased in patients with severe lesions (P<0.001). Conclusion: We found that IR was more significantly prevalent among studied patients, especially those with more severe acne grades, and that could be attributed to higher serum fetuin-A levels. Fetuin -A might be a predictor for acne severity and associated metabolic comorbid conditions, such as IR. However, further large-scale studies will be needed.

Serum Soluble Intercellular Adhesion Molecule-1 (sICAM-1): A Novel Potential Biomarker in Severe Acne Vulgaris.

Background: Acne vulgaris (AV) is a chronic inflammatory disorder. Intercellular adhesion molecule-1 (ICAM-1) is a vital adhesion molecule mediating cellular adhesion during the inflammatory process. Aims and Objectives: To evaluate serum soluble intercellular adhesion molecule-1 (sICAM-1) level in AV patients as an attempt to elucidate its role in acne pathogenesis and to relate with studied clinical parameters. Materials and Methods: Serum sICAM-1 level was measured using ELISA technique in 60 patients and 60 controls. Results: Serum sICAM-1 level was significantly elevated in studied patients than controls (P < 0.001). Additionally, its level increased significantly with increased acne severity (P < 0.001) but not in patients with post acne scars (P > 0.05). Conclusion: Serum sICAM-1 could be a marker for acne etiopathogenesis. Furthermore, it might be considered as a predictor for disease severity.

Diagnostic implications of MicroRNAs; 155, 146 a, and 203 lesional expression in alopecia areata: A preliminary case-controlled study.

BACKGROUND: Alopecia areata (AA) is an immune mediated disorder that attacks hair follicles with unknown pathophysiology. MicroRNAs (miRNAs) are small noncoding RNA molecules, and their aberrant expression or function has been involved in different autoimmune conditions. OBJECTIVES: We aimed at exploring the association between some miRNAs lesional expression and AA pathogenesis by measurement of miRNAs-155, 146a, and 203 expression levels in the lesional skin from patchy AA patients and to evaluate their relation with the studied parameters. SUBJECTS AND METHODS: Skin expression levels of miRNAs-155, 146a, and 203 were evaluated in 50 patients with patchy AA and 25 healthy controls using reverse transcriptase-quantitative PCR (RT-qPCR). The activity and severity of alopecia were assessed according to AA Investigational Assessment Guidelines criteria. RESULTS: Studied patients showed significant up-regulation of miRNAs-203, 146a, and 155 lesional tissue expression levels when compared to control group (p < 0.05 each). Only miRNA-146a skin expression level was significantly higher in patients with multiple lesions (p < 0.001). However, patients with active AA had significantly higher tissue expression levels of the investigated miRNAs than those with inactive disease (P 0.001, 0.009, and 0.001, respectively). CONCLUSIONS: Investigated miRNAs seem to be role players in AA pathogenesis and may be considered potential indicators of disease activity. However, more research is needed to clarify their accurate role and clinical importance.

Association between angiotensin-converting enzyme gene insertion deletion polymorphism and androgenetic alopecia susceptibility among Egyptian patients: A preliminary case-controlled study.

BACKGROUND: Androgenetic alopecia (AGA) is a prevalent condition with a complex etiopathogenesis. Angiotensin-converting enzyme (ACE) gene located on the chromosome 17q23 contains an insertion (I) and deletion (D) polymorphism in the intron 16. This gene polymorphism plays a role in multiple inflammatory disorders. However, there are no studies investigating its association with AGA susceptibility. OBJECTIVES: In this work, we aimed at exploring the association of ACE gene I/D polymorphism in AGA susceptibility in a group of Egyptian patients. METHODS: This study included 100 AGA patients, and 100 apparently healthy controls. The ACE gene I/D polymorphism was analyzed by polymerase chain reaction. RESULTS: The DD, ID genotypes, and D allele showed higher frequent distribution among studied AGA patients than controls (p < 0.05 each). Positive family history and ACE gene I/D polymorphism were considered AGA susceptibility predictors in both uni- and multivariable analyses [p < 0.05 each (OR (95% CI)] on applying logistic regression analysis for risk factors prediction. CONCLUSIONS: This study highlights the possible contribution of the suspected genetic polymorphism as a susceptibility indicator for AGA development in the examined group of patients.

Cross talk between oxidative stress and inflammation in alopecia areata.

BACKGROUND: Although the etiopathogenesis of alopecia areata (AA) is still unclear, inflammation, oxidative stress, and subsequent DNA damage might be considered role players in disease development. AIM: We aimed at exploring the potential link between oxidative DNA damage and inflammation in AA patients through measuring 8-hydroxy deoxyguanosine (8-OHdG), high mobility group box 1 protein (HMGB1), and one of the inflammatory mediators, C-reactive protein (CRP). METHODS: A total of 79 subjects (49 AA patients in addition to 30 apparently healthy control subjects) were tested for serum levels of 8-OHdG, HMBG1, and CRP. RESULTS: Compared with the control group, serum 8-OHdG, HMBG1, and CRP levels were significantly elevated in the studied patients group (0.031, <0.001, and <0.001, respectively). Moreover, logistic regression analysis revealed that disease course, serum levels of 8-OHdG, and HMBG1 were considered independent predictors for AA severity in both uni- and multivariable analyses. CONCLUSION: Our results suggest a possible role of oxidative stress together with proinflammatory biomarkers in development of AA and their benefit in predicting a severe form of the disease.

Serum YKL40: A novel potential link between inflammation and dyslipidemia in acne vulgaris.

BACKGROUND: Acne vulgaris (AV) is an inflammatory skin disorder that may be associated with metabolic disorders. The relation between lipid profile in acne is not widely investigated. Chitinase-3-like protein 1 (YKL-40) has been found to be implicated in different inflammatory conditions. AIMS: We aimed at investigating the role YKL-40 in acne pathogenesis and associated dyslipidemia in acne patients. PATIENTS/METHODS: This study included 50 acne vulgaris patients and 30 matched control subjects. Serum YKL-40 in addition to lipid profile were assessed in all studied subjects. RESULTS: Serum YKL-40 level was significantly elevated in acne patients than healthy controls (P < .001). We also found a significant positive correlations between serum YKL-40, serum TGs, TC, and LDL-C (P value: .022, .001, .017 respectively) while, a significant negative correlation between serum YKL-40 and HDL-c (P value: .036) was detected. CONCLUSION: Our study results suggest that YKL-40 might have a role in AV pathogenesis. In addition, it could provide a new potential link between inflammation and dyslipidemia observed in acne patients.

Serum interleukin-17 as a novel biomarker in patients with acne vulgaris.

BACKGROUND: Acne vulgaris is a common chronic inflammatory skin disease involving pilosebaceous units. Both innate and adaptive immunity, especially the T helper 17 pathway, may contribute to the inflammatory response in acne. OBJECTIVES: We aimed at evaluation of serum interleukin-17 (IL-17) level in patients with acne vulgaris in order to assess its role in disease pathogenesis and its clinical significance. METHODS: Serum IL-17 level was measured by an ELISA technique in 80 acne vulgaris patients and 80 apparently healthy controls. RESULTS: Serum IL-17 level was significantly higher in acne vulgaris patients than control group (P < 0.001). Moreover, it was increasing significantly with the increase in disease severity and in patients with scarring lesions (P < 0.001 each). CONCLUSIONS: Serum IL-17 is not only a biomarker of disease pathogenesis but also it could be a potential prognostic predictor for severity and scarring in acne vulgaris.