The Impact of FOXO1 Gene Expression and Cytokine Profiling in Acne Patients Treated with Isotretinoin

Background: Acne vulgaris is an inflammatory skin disease which is genetically and immunologically determined. Transcriptor FOXO1 controls oxidative stress and sebocyte differentiation, while cytokines (IL-35 and TRAIL) regulate the immune responses in acne. Objectives: The aim of our work is to detect the modification of FOXO1 gene expression and cytokine levels (IL-35 and TRAIL) in acne vulgaris patients before and after isotretinoin therapy for disease control. Methodology: This case-control study involved 85 individuals in 15–35-year olds. They were divided into three groups pre isotretinoin treatment (n=30), post isotretinion treatment (n=30) and healthy controls (n=25). Serum cytokine concentrations of (IL-35 and TRAIL) were measured by ELISA and FOXO1 mRNA levels were determined by RT-qPCR. Statistical analyses assessed treatment-induced changes. Results: FOXO1 mRNA was significantly down regulated in untreated acne patients as compared with controls (p=0.001). Treatment with isotretinoin increased FOXO1 expression 2.7-fold. In the untreated patients, IL-35 and TRAIL levels were both suppressed. IL-35 and TRAIL significantly (p<0.05) increased in comparison with controls after treating with Isotretinion. Conclusion: This FOXO1 and cytokines (IL-35 and TRAIL) activity is modulated by isotretinoin which further emphasizes their involvement in the acne pathogenesis and response. These results highlight FOXO1 and cytokine profiling as biomarkers for treatment efficacy and as targets for novel therapy in acne vulgaris.