Serum irisin: A prognostic marker for severe acne vulgaris

Insulin Resistance in Patients with Acne Vulgaris

Acne vulgaris presents multifactorial pathogenesis, which may include insulin resistance. To investigate whether insulin resistance is a causative factor in acne vulgaris development, this cohort study and a systematic review were conducted. A cohort of 41 acne vulgaris patients and 47 healthy BMI-matched controls were recruited. Glucose and insulin fasting serum levels were obtained and the HOMA-IR was calculated; insulin resistance was diagnosed in cases with a HOMA-IR value over 2.1. The mean ± SD values for glucose fasting serum level were as follows: 94.88 ± 7.731 (mg/dL) in the study group and 79.51 ± 7.175 (mg/dL) in the controls (p < 0.001). The mean ± SD insulin fasting serum levels were 14.47 ± 6.394 (µIU/mL) and 11.83 ± 4.309 (µIU/mL) (p = 0.059), respectively. The HOMA-IR mean ± SD value calculated for the study group was 3.4 ± 1.49 and, in the control group, it was 2.34 ± 0.909 (p < 0.001). Out of 41 patients, 32 were diagnosed with insulin resistance (78%), and 26 of the 47 controls were diagnosed with IR (55%) (p = 0.026). An insulin resistance diagnosis was statistically more common among the acne patients, compared to the controls. In the articles reviewed in this paper, insulin resistance was found to be more frequent in acne vulgaris patients. Both our study and the papers analyzed in the review indicate that insulin resistance might be an independent factor in acne vulgaris development and should be considered when diagnosing and treating acne.

Incretin serum level as a biomarker of insulin Resistance in acne vulgaris patients

OBJECTIVE

To investigate the relationship between serum Incretin and acne vulgaris (AV) and insulin resistance (IR), and to find the biological indicators of acne vulgaris with insulin resistance.

METHODS

60 patients diagnosed with acne vulgaris in the dermatology department of Zagazig University and 56 healthy people in the health examination center of this hospital were collected respectively as the control group; all the included people were drawn fasting blood to test serum Incretin, blood lipids, sex hormones and INS release test to explore the role of serum Incretin in acne vulgaris and insulin resistance.

RESULTS

The average level of Incretin in the acne group was lower than that in the control group, and the difference was statistically significant (t=7.189, P<0.001). The average level of Incretin in the acne group with insulin resistance was lower than that in the acne without insulin resistance group, the difference was statistically significant (t=22.328, P<0.001). In the acne group, the insulin resistance index decreased with the increase of Incretin level, and the two showed a negative correlation. (R = -0.711, P<0.001.( CONCLUSIONS: Patients with acne vulgaris are prone to have insulin resistance. Insulin resistance in patients with acne vulgaris is negatively correlated with Incretin. Serum Incretin may be expected to be a biomarker for diagnosing acne vulgaris patients with insulin resistance. The severity of acne vulgaris may have no obvious correlation with insulin resistance and serum incretin.

The role of a recently discovered peptide—irisin—in physiological and pathological processes

Irisin, a cleaved fragment of fibronectin type III domain-containing protein 5 (FNDC5), was originally described as a factor stimulating browning of white adipose tissue, produced during physical exercise by skeletal muscles. However, irisin is not only a new and promising biomarker of metabolism; its expression has been found in a wide variety of tissues and organs such as the peripheral nerves, stomach, pancreas, and skin, and recent data also indicate its role in cancer. Numerous studies focus on the protective role of this protein, which could become an important factor in predicting disease risk, disease prognosis, or possible metastases in cancer patients. Possible use of irisin in therapy is also worth considering. The aim of this paper is to systematize knowledge on the role of irisin in patients and to draw attention to its role in skin diseases including acne vulgaris, psoriasis vulgaris, and hidradenitis suppurativa.

Progress and Challenges in the Biology of FNDC5 and Irisin

In 2002, a transmembrane protein-now known as FNDC5-was discovered and shown to be expressed in skeletal muscle, heart, and brain. It was virtually ignored for 10 years, until a study in 2012 proposed that, in response to exercise, the ectodomain of skeletal muscle FNDC5 was cleaved, traveled to white adipose tissue, and induced browning. The wasted energy of this browning raised the possibility that this myokine, named irisin, might mediate some beneficial effects of exercise. Since then, more than 1000 papers have been published exploring the roles of irisin. A major interest has been on adipose tissue and metabolism, following up the major proposal from 2012. Many studies correlating plasma irisin levels with physiological conditions have been questioned for using flawed assays for irisin concentration. However, experiments altering irisin levels by injecting recombinant irisin or by gene knockout are more promising. Recent discoveries have suggested potential roles of irisin in bone remodeling and in the brain, with effects potentially related to Alzheimer's disease. We discuss some discrepancies between research groups and the mechanisms that are yet to be determined. Some important questions raised in the initial discovery of irisin, such as the role of the mutant start codon of human FNDC5 and the mechanism of ectodomain cleavage, remain to be answered. Apart from these specific questions, a promising new tool has been developed-mice with a global or tissue-specific knockout of FNDC5. In this review, we critically examine the current knowledge and delineate potential solutions to resolve existing ambiguities.

HMGB1-RAGE-moesin axis may be indicted for acne vulgaris

BACKGROUND

High-mobility group box 1 (HMGB1)-receptor for advanced glycation end (RAGE)-moesin axis could be implicated in induction of inflammation. However, there is a scarcity in literature discussing the role of this axis in inflammatory skin disorders.

AIMS

The aim of the present study was to evaluate the serum levels of HMGB1 and moesin in patients with inflammatory acne vulgaris.

PATIENTS/METHODS

This comparative cross-sectional study included 66 inflammatory acne vulgaris patients classified according to Global Acne Grading System (GAGS) into three groups (22 patients each): mild, moderate, and severe acne vulgaris. In addition, 82 acne-free individuals were included as a control group. Serum HMGB 1 and moesin levels were measured using enzyme-linked immunosorbent assay kits.

RESULTS

High-mobility group box 1 and moe sin serum levels in acne patients were significantly higher than the levels in control subjects (p = 0.04, 0.0005 respectively). Serum levels of both markers in severe acne patients and in those with post-acne scarring were elevated when compared to the levels in the other groups, and however, this elevation was significant only for moesin levels. There was a significant positive correlation between the serum levels of HMGB1 and moesin in the studied patient's sample (r = 0.3079, p = 0.011).

CONCLUSION

High-mobility group box 1-receptor for advanced glycation end-moesin axis may be implicated in acne vulgaris pathogenesis, and it may be a promising therapeutic target.