Evaluation of the HBD-2 and TLR2 gene expression in the skin of acne patients during combined treatment

Background. Not only risk factors such as androgenic stimulation, follicular hyperkeratosis, inflammation and activation of Cutibacterium acnes, but also the activation of innate and adaptive immunity are of great importance in the development of acne. An important role in the immunogenesis of acne belongs to interleukin-1 and a number of other cytokines; however, the literature sources indicate a number of conflicting data on the characteristics of the immune system during the development of various clinical forms of acne. Objective. Evaluation of the HBD-2 and TLR2 gene expression in the skin of patients with acne before treatment and assessment of the effect of the combined use of low doses of isotretinoin and phototherapy with broadband light with a wavelength of440-950 nm on the expression of these genes compared with therapy with standard doses of isotretinoin. Methods. 78 patients diagnosed with moderate papulopustular acne were followed-up in outpatient settings. By the method of simple randomization, 78 patients were divided into 2 groups depending on the method of therapy. These 2 groups were divided into 2 age subgroups: 12-24 years old (subgroups A1 and A2) and 25-45 years old (B1 and B2). The study evaluated the expression levels of the TLR2 and HBD-2 genes in the skin of acne patients before and after treatment and analyzed the results. Results. Decrease in the HBD-2 expression in the skin, an increase in the TLR2 level and the normalization of these parameters after treatment in patients with acne indicate their important role in the pathogenesis of this disease. Conclusion. Thus, the expression of defensin HBD-2 and TLR2 recognition receptor in the skin plays an important role in the pathogenesis of acne.

moderate papulopustular acne, defensin HBD-2, TLR2 recognition receptor, combined use of low doses of isotretinoin and phototherapy with broadband light with a wavelength of 440-950 nm