Can monocyte/HDL show inflammatory activity of isotretinoin treatment in acne patients?

Area of Science:

• Dermatology and Immunology
• Clinical Pathology
• Pharmacology

Background:

• Isotretinoin (ISO) is a potent acne medication with reported associations with inflammatory conditions.
• The Monocyte to HDL ratio (MHR) is recognized as an inflammation and atherosclerosis marker.
• Understanding ISO's impact on immunoinflammatory responses is crucial for patient safety.

Purpose of the Study:

• To investigate the effect of isotretinoin (ISO) on immunoinflammatory markers in acne patients.
• To assess changes in routinely measured blood parameters and inflammation indicators during ISO therapy.

Main Methods:

• Retrospective analysis of 116 nodulocystic acne patients treated with ISO (0.5-1 mg/kg) for at least three months.
• Evaluation of pre-treatment and post-treatment levels of various hematological parameters, including WBC, neutrophils, lymphocytes, monocytes, platelets, MPV, and MHR.
• Analysis included lipid profiles (total cholesterol, LDL, HDL, triglycerides) and inflammation ratios (NLR, PLR).

Main Results:

• Significant increases in Mean Platelet Volume (MPV) and Monocyte to HDL ratio (MHR) were observed post-treatment (p < 0.05).
• Neutrophil count significantly decreased (p < 0.05), while WBC, lymphocyte, monocyte, and platelet counts showed no significant changes.
• Lipid profile alterations included significant increases in total cholesterol, LDL, and triglycerides, and a significant decrease in HDL cholesterol (p < 0.05).

Conclusions:

• Isotretinoin (ISO) treatment may potentially trigger inflammation, as evidenced by increased MPV and MHR.
• MHR serves as a potential indicator of subclinical inflammation following ISO therapy.
• The observed lipid profile changes warrant consideration during isotretinoin treatment.