Ann Dermatol.  2012 Nov;24(4):393-397. 10.5021/ad.2012.24.4.393.

Acne Inversa: Evaluating Antimicrobial Peptides and Proteins

• Bechara FG
• Sand M
• Skrygan M
• Kreuter A
• Altmeyer P
• Gambichler T

• KMID: 2266032
• DOI: http://doi.org/10.5021/ad.2012.24.4.393

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 beta-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-alpha), matrix metalloproteinase-1 (MMP1), interleukin (IL)-1beta, IL-6, IL-8 and IL-10.
RESULTS
The mRNA levels of hBD-2, LL-37, IL-1beta, 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 (rho=0.53, p=0.03), and between hBD-2 and RNAse 7 (rho=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 beta, IL-6, IL-8, TNF-alpha 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.

Keyword

Antimicrobial peptides; Hidradenitis suppurativa; Human beta-defensin; LL-37; Ribonuclease 7

MeSH Terms

Acne Vulgaris
Axilla
Biopsy
Cytokines
Hidradenitis Suppurativa
Humans
Immune System
Interleukin-10
Interleukin-1beta
Interleukin-6
Interleukin-8
Interleukins
Leg Ulcer
Matrix Metalloproteinase 1
Peptide Hydrolases
Peptides
Perineum
Proteins
Ribonucleases
RNA, Messenger
Skin
Skin Diseases
Tumor Necrosis Factor-alpha
Up-Regulation
Cytokines
Interleukin-10
Interleukin-1beta
Interleukin-6
Interleukin-8
Interleukins
Matrix Metalloproteinase 1
Peptide Hydrolases
Peptides
Proteins
RNA, Messenger
Ribonucleases
Tumor Necrosis Factor-alpha

Figure

• 

  Fig. 1 Human β-defensin (hBD)-2 mRNA expression in acne inversa lesional skin and non-lesional skin. Significantly higher expression in lesional skin (p<0.01).

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  Fig. 2 LL-37 mRNA expression in acne inversa lesional skin and non-lesional skin. Significantly higher expression in lesional skin (p<0.01).

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