Association between intestinal fatty acid-binding protein and acne severity: evidence for gut barrier dysfunction in...

Acne vulgaris is a common inflammatory dermatosis with a multifactorial pathogenesis. Recent research suggests that alterations in the gut-skin axis and impaired intestinal barrier function may contribute to acne pathogenesis; however, direct evaluation of gut barrier integrity in acne patients remains limited. The objective of this study was to assess intestinal barrier integrity in patients with acne vulgaris by measuring serum intestinal fatty acid-binding protein (I-FABP) levels and to evaluate the association between I-FABP levels and acne severity.

This single-center, prospective case-control study included 77 patients with acne vulgaris and 77 age- and sex-matched controls without acne. Acne severity was assessed using the Global Acne Grading System. Serum I-FABP levels were measured using an enzyme-linked immunosorbent assay.

Median serum I-FABP levels were significantly higher in patients with acne vulgaris than in controls (32.03 [7-107] pg/ml vs. 22.81 [12-189] pg/ml, p = 0.002). I-FABP levels differed significantly across acne severity grades (p < 0.001), with progressively higher levels observed from mild to very severe acne. A strong positive correlation was identified between acne severity and serum I-FABP levels (Spearman r = 0.797, p < 0.001). No significant association was found between I-FABP levels and body mass index.

Serum I-FABP levels are significantly elevated in patients with acne vulgaris and correlate strongly with disease severity. These findings support the hypothesis that impaired intestinal barrier function may contribute to both the development and progression of acne vulgaris, highlighting the potential role of the gut-skin axis in acne pathogenesis.