Menoufia Medical Journal

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 33  |  Issue : 3  |  Page : 1059--1062

8-hydroxy-2-deoxyguanosine as a new biomarker of oxidative stress in patients with acne vulgaris


Magda M Hagag1, Nesreen G Elhelbawy2, Eman F. Abd Elfadil Albarqi3,  
1 Department of Dermatology, Andrology and STDs, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Dermatology, Andrology and STDs, Kom Hamada General Hospital, El-Behira, Egypt

Correspondence Address:
Eman F. Abd Elfadil Albarqi
Kom Hamada, El-Behira
Egypt

Abstract

Objectives To evaluate the serum level of 8-hydroxy-2-deoxyguanosine (8-OHdG) in patients with acne vulgaris and also to detect relation between serum level of 8-OHdG and acne vulgaris severity. Background Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized mainly by comedones. The precise mechanisms of acne are not known. Oxidative stress within the pilosebaceous unit are considered an important initiating step in the pathogenesis of acne. 8-OHdG is considered to be one of the main biomarkers of oxidative stress. Patients and methods This cross-sectional study was carried out on 75 patients with mild, moderate, and severe acne vulgaris, along with 15 age-matched and sex-matched healthy individuals. Acne severity was assessed by using the global acne score. Blood samples were taken for measuring serum 8-OHdG levels in patients and controls by using commercial enzyme-linked immunosorbent assay kit. Results The serum levels of 8-OHdG were significantly higher in patients with acne vulgaris when compared with healthy individuals (P = 0.005). A strong positive correlation between serum levels of 8-OHdG and acne severity was found (P < 0.001, r = 0.53). Conclusion Oxidative stress has an important role in acne pathogenesis represented by elevated 8-OHdG levels.



How to cite this article:
Hagag MM, Elhelbawy NG, Elfadil Albarqi EF. 8-hydroxy-2-deoxyguanosine as a new biomarker of oxidative stress in patients with acne vulgaris.Menoufia Med J 2020;33:1059-1062


How to cite this URL:
Hagag MM, Elhelbawy NG, Elfadil Albarqi EF. 8-hydroxy-2-deoxyguanosine as a new biomarker of oxidative stress in patients with acne vulgaris. Menoufia Med J [serial online] 2020 [cited 2021 Jan 18 ];33:1059-1062
Available from: http://www.mmj.eg.net/text.asp?2020/33/3/1059/296654


Full Text



 Introduction



Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit, which is characterized by formation of noninflammatory open and closed comedones and inflammatory papules, pustules, nodules, and cysts [1].

Although acne does not cause any serious health threat, it may cause significant psychological and social problems, depression, low self-esteem, disfigurement, and scarring that can persist for a life time [2].

The precise mechanisms of acne are not known but there are four major pathophysiologic factors including excessive sebum production, follicular hyperkeratinization, and proliferation of Propionibacterium acnes with direct or indirect inflammation [3].

Oxidative stress within the pilosebaceous unit is considered an important initiating step in the pathogenesis of acne, because it contributes to the formation of free radicals which may be released from the affected damaged follicular walls; at the same time, it is thought that this may be the reason for the progress of inflammation in the pathogenesis of acne [4].

8-hydroxy-2-deoxyguanosine (8-OHdG), continuously produced in living cells as an oxidized form of guanine in DNA by reactive oxygen species, was first reported in 1984[5].

Previous studies have demonstrated that 8-OHdG level increases in many diseases, such as diabetes, cancer, and cardiovascular diseases [5],[6].

Although it is widely used as an oxidative stress biomarker, 8-OHdG levels in patients with acne vulgaris had not been evaluated until 2018 [7].

Aim

The aim of this study was to evaluate serum level of 8-OHdG in patients with acne vulgaris and also to detect relation between serum level of 8-OHdG and acne vulgaris severity.

 Patients and Methods



This cross-sectional study was carried out at Dermatology and STDs and Biochemistry and Molecular Biology Departments, Faculty of Medicine, Menoufia University. This study included 90 patients: 75 patients with acne vulgaris divided into three groups (groups I, II, and III) according to global acne score (GAS) and 15 age-matched and sex-matched healthy controls (group IV). All patients were recruited from Dermatology Outpatient Clinic, Menoufia University Hospitals, during the period from October 2018 to December 2018. Written informed consent was taken from every patient who participated in the study. The study was approved by the ethical committee of medical research, Faculty of Medicine, Menoufia University.

Exclusions criteria

Patients with any dermatological disease other than acne vulgaris, systemic autoimmune or inflammatory diseases, pregnancy, and usage of any medication within the previous month before assessment were excluded from the study.

Each of the patient with acne was subjected to the following: full history taking and clinical examination to identify any excluding factors. Dermatological examination was performed, and Global Acne Grading System (GAGS) was used to assess acne severity [8]. Those with GAGS of 1–18 were accepted as mild, those with GAGS of 19–30 were accepted as moderate, whereas those with GAGS more than 30 were accepted as severe acne vulgaris.

Sample taking

Overall, 3 ml of venous blood was taken and transferred into a plain tube, left to stand for 30 min, and then centrifuged. The serum separated was kept frozen at −80°C until determination of 8-OHdG.

The concentrations were measured using commercial enzyme-linked immunosorbent assay kits (Shanghai Sunred Biological Technology Co. Ltd, Shanghai, China) according to the manufacturer's recommendations.

Statistical analysis

The data collected were tabulated and analyzed by SPSS (statistical package for the social science software), statistical package version 20, on IBM compatible computer (New York, USA).

Descriptive statistics were expressed as percentage (%), mean, and SD. Analytic statistics included χ2 test to compare between qualitative data, Mann–Whitney (U test) to compare between two groups not normally distributed, and Spearman correlation (r) to measure the association between two not normally distributed quantitative variables or one quantitative and one qualitative ordinal variable. P value of less than 0.05 was considered statistically significant. Student t test was used for comparison between two independent groups of normally distributed quantitative variables.

 Results



The mean age of patients with acne vulgaris was 19.21 ± 5.05 years. Approximately 46.6% of patients had a positive family history of acne vulgaris. Regarding smoking, there was a significant statistical difference between patients and controls (P = 0.025) [Table 1].{Table 1}

The mean age of onset of acne vulgaris was 17.21 ± 2.15 years. The mean value of GAS in patients with acne vulgaris was 25.57 ± 16.38, and there was no significant difference between males and females regarding GAS (P = 0.598). The 8-OHdG levels in those with acne vulgaris were found to be higher compared with the healthy control group (P = 0.005) [Table 2]. In patients with acne vulgaris, there was a strong positive correlation identified between GAS and 8-OHdG (P < 0.001, r = 0.53; [Figure 1]). Regarding age, there was a positive correlation between serum levels of 8-OHdG and age. Moreover, 8-OHdG was positively associated with smoking (P = 0.005).{Table 2}{Figure 1}

 Discussion



Oxidative stress occurs when there is an imbalance between the formation and removal of reactive species because of an overproduction, impaired ability to neutralize them, or to repair the resulting damage [9]. Oxidative stress plays a role in acne vulgaris [10],[11], because it contributes to the formation of free radicals which may be released from the affected damaged follicular walls; at the same time, it is thought that this may be the reason for the progress of inflammation in the pathogenesis of acne [12].

Emerging studies indicate that low blood superoxide dismutase and glutathione peroxidase with elevated level of MDA are characteristics of acne versus healthy control [13]. Furthermore, it has been concluded that decline in antioxidant activity manifested by a decrease in glutathione quantity may play an important role in pathogenesis of acne vulgaris [10]. In another study, there was evidence of increased oxidative stress as reflected by higher thiobarbituric acid reactive substance [14]. All the aforementioned evidences may support the existence of oxidative stress in patients with acne compared with controls [15].

8-OHdG is the most representative product of oxidative modifications of DNA, and urinary 8-OHdG is potentially the best noninvasive biomarker of oxidative damage to DNA [16].

Many studies and improvements in the quantitative estimation of 8-OHdG by various analytical techniques in blood cells or in urine have established it as a very important biomarker not only for carcinogenesis but also for aging and degenerative diseases[17].

Korkmaz and Ozgun [7] found that in cases with mild and moderate acne, the serum 8-OHdG levels increased and showed a positive correlation with GAS. They were the first to estimate 8-OHdG in patients with acne vulgaris. They believed that DNA damage begins even in the early period of the disease; therefore, prevention of progression of the disease in the comedonal period may contribute to preventing further DNA damage.

In this study, 8-OHdG levels were high in patients with acne vulgaris and were correlated with the severity of the disease. Our study found that there was a positive correlation between serum levels of 8-OHdG and age. This is similar to the study by Black et al. [18], as 8-OHdG was higher with age, suggesting the accumulation of oxidative damage with increasing age. This lends support to the hypothesis that oxidative damage accumulates with time and so contributes to aging and age-related diseases [19].

Black et al. [18] reported that 8-OHdG was positively associated with smoking, and this is similar to our study. Ellegaard and Henrik reported a significant reduction in oxidative stress to DNA after smoking cessation [20].

 Conclusion



Oxidative stress has an important role in acne pathogenesis represented by elevated 8-OHdG levels. Further studies with a larger sample size are recommended to confirm our results and indicate new treatment targets.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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