Acne Inversa: Evaluating Antimicrobial Peptides and Proteins
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Background: Acne inversa is a chronic, suppurative relapsing inflammatory skin disease that primarily affects the axillae, perineum and inframammary regions. Evidence suggests that the innate immune system is involved in the pathogenesis of acne inversa. Objective: To investigate the role of the innate immune system in acne inversa. Methods:Skin biopsies were obtained from inflammatory skin lesions (n=17) and from non-lesional skin (intraindividual control,n=17) of patients with acne inversa. Additional skin lesions were taken from patients with chronic venous leg ulcers (interindividual control, n=5). Quantitative real-time reverse transcription-polymerase chain reaction was used to determine the mRNA levels of antimicrobial peptides and proteins (AMPs), including human β-defensin (hBD)-1,hBD-2 and hBD-3, LL-37 (cathelicidin) and Ribonuclease 7(RNase 7). mRNA levels were also determined for inflammatory and anti- inflammatory cytokines, including tumor necrosis factor- alpha (TNF-α), matrix metalloproteinase-1 (MMP1), interleukin (IL)-1β, IL-6, IL-8 and IL-10. Results: The mRNA levels of hBD-2, LL-37, IL-1β,IL-6, IL-8, IL-10 and MMP1 were significantly higher in acne inversa lesions compared to non-lesional skin (p＜0.05). A significant positive correlation expression was observed between hBD-2 mRNA expression and LL-37 (ρ=0.53,p=0.03), and between hBD-2 and RNAse 7 (ρ=0.68,p=0.006). When compared to the chronic venous leg ulcer lesions, acne inversa lesions showed a significantly higher expression of RNase 7 mRNA, while IL-1 β, IL-6, IL-8, TNF-α and MMP1 mRNA expression was significantly higher in the chronic venous leg ulcer lesions (p＜0.05). Conclusion:The AMP, cytokine milieu and tissue proteases in acne inversa lesions differ significantly from non-lesional skin and chronic venous leg ulcers. The positively correlating up-regulation of AMPs in acne inversa indicates an important role of the innate immune system in the pathogenesis of this disorder.
Abstract
Background: Acne inversa is a chronic, suppurative relapsing inflammatory skin disease that primarily affects the axillae, perineum and inframammary regions. Evidence suggests that the innate immune system is involved in the pathogenesis of acne inversa. Objective: To investigate the role of the innate immune system in acne inversa. Methods:Skin biopsies were obtained from inflammatory skin lesions (n=17) and from non-lesional skin (intraindividual control,n=17) of patients with acne inversa. Additional skin lesions were taken from patients with chronic venous leg ulcers (interindividual control, n=5). Quantitative real-time reverse transcription-polymerase chain reaction was used to determine the mRNA levels of antimicrobial peptides and proteins (AMPs), including human β-defensin (hBD)-1,hBD-2 and hBD-3, LL-37 (cathelicidin) and Ribonuclease 7(RNase 7). mRNA levels were also determined for inflammatory and anti- inflammatory cytokines, including tumor necrosis factor- alpha (TNF-α), matrix metalloproteinase-1 (MMP1), interleukin (IL)-1β, IL-6, IL-8 and IL-10. Results: The mRNA levels of hBD-2, LL-37, IL-1β,IL-6, IL-8, IL-10 and MMP1 were significantly higher in acne inversa lesions compared to non-lesional skin (p＜0.05). A significant positive correlation expression was observed between hBD-2 mRNA expression and LL-37 (ρ=0.53,p=0.03), and between hBD-2 and RNAse 7 (ρ=0.68,p=0.006). When compared to the chronic venous leg ulcer lesions, acne inversa lesions showed a significantly higher expression of RNase 7 mRNA, while IL-1 β, IL-6, IL-8, TNF-α and MMP1 mRNA expression was significantly higher in the chronic venous leg ulcer lesions (p＜0.05). Conclusion:The AMP, cytokine milieu and tissue proteases in acne inversa lesions differ significantly from non-lesional skin and chronic venous leg ulcers. The positively correlating up-regulation of AMPs in acne inversa indicates an important role of the innate immune system in the pathogenesis of this disorder.
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