P53 Gene Expression, Antibiogram Profile of Staphylococcus aureus and Hormonal Modulation in Acne Patients Treated with Isotretinoin

Background: Acne is a complex skin disorder caused by hormonal changes, bacterial infections and the genetic background. Staphylococcus aureus, cause inflammatory reactions in acne patients. Sebaceous gland hyperactivity and inflammation are intensified by hormonal regulation (particularly high free testosterone levels). P53 is a key mediator of sebocyte death and inflammation. Objectives: The aims of the study are to detect the involvement of Staphylococcus aureus, and hormonal dysregulation in acne patients, and to evaluate the p53 gene expression, as a relation between acne patients and healthy controls, and evaluates therapeutic effects of isotretinoin on the p53 gene expression in acne patients. Methodology: S. aureus were detected by the routine bacteriology methods. The hormone tests evaluated free testosterone by ELISA kit. The qRT-PCR of the P53 gene expression was measured both before and after administration of isotretinoin. The statistical significance of the results were carried using t-tests; p<0.05, and one-way ANOVA; p<0.05. Results: Staphylococcus aureus was identified in 35 % of acne patients and 15 % of healthy volunteers, where it was especially resistant to antibiotics showed 40% resistance to clindamycin and 35% to fusidic acid. Free testosterone level increased in acne patients (634.69±83.92 ng/dL) compared with healthy control subjects (469.50±66.55 ng/dL, p=0.001). The gene expression of P53 were much less in patients who didn’t receive isotretinoin treatment. Conclusion: Free testosterone is high in acne patients and makes sebaceous glands reactiv, while isotretinoin increases p53 signaling in a therapeutically effective way. Future treatments is required to resistant S. aureus.