Evaluation of biomarkers of oxidant–antioxidant balance in patients with acne vulgaris

Background: There have been controversial arguments and conflicting research results on whether oxidative stress plays a role in the etiopathogenesis of acne vulgaris, or it is just a consequence of the disease. Objectives: The aim of this study was to explore the effect of oxidative stress burden, mainly lipid peroxidation, on the oxidant–antioxidant balance and on the development of acne by studying the activity of some oxidative stress markers. Patients and methods: This study was conducted on 40 acne vulgaris patients and 36 age-matched and sexmatched healthy controls. Patients were classified into mild, moderate, severe, and very severe on the basis of the Global Acne Grading System. Venous blood samples taken from both patients and controls were analyzed to determine the activity of the antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT), and glucose-6- phosphate dehydrogenase (G6PD); the levels of malondialdehyde (MDA), a major byproduct and an important marker of lipid peroxidation, were also determined. Different laboratory techniques suitable for each marker were used and the results were read spectrophotometrically. Results: A highly significant decrease in the mean blood G6PD, CAT, and SOD enzyme activities (P 0.001) and a highly significant increase in the mean MDA (P 0.001) blood levels were detected in acne patients compared with controls. None of the measured markers (G6PD, SOD, CAT, and MDA) was found to correlate with patients’ age, disease duration, or severity (P 0.05). Conclusion: The significant decrease in the antioxidant enzyme biomarkers, as well as the significant increase in the lipid peroxidation marker, indicates the compromised oxidant–antioxidant balance in patients with acne vulgaris. This justifies adding antioxidants to acne therapy and calls for finding a multibiomarker scoring system for a better evaluation and monitoring of oxidative stress and its consequences.