Cited by 541Acne and Rosacea Treatments and EffectsDermatology and Skin DiseasesPsoriasis: Treatment and Pathogenesis

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Inflammatory Events Are Involved in Acne Lesion Initiation

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Jeremy, Anthony H.T., Holland, Diana B., Roberts, Susan G., Thomson, Kathryn F., Cunliffe, William J.·2003·Journal of Investigative Dermatology

DOI 10.1046/j.1523-1747.2003.12321.x

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Abstract

The earliest subclinical acne "lesion" is a microcomedone, of which hyperproliferation of the follicular epithelium is a characteristic feature. Inflammatory cells have been observed at the periphery of these "lesions". This study investigated whether inflammatory events occur pre or post hyperproliferative changes. Cellular, vascular, and proliferative markers were examined by immunohistochemical techniques on biopsies of clinically normal follicles from uninvolved skin and early inflamed lesions from acne patients. Control follicles were obtained from non-acne subjects. Follicles from uninvolved skin exhibited no microcomedonal features. Proliferation in the epithelium was comparable to controls and was significantly lower than in inflamed lesions. Numbers of CD3+, CD4+ T cells were elevated in the perifollicular and papillary dermis although levels were not equivalent to those in papules. The number of macrophages was also greatly increased and similar to those in papules. There were no changes in blood vessel numbers or vascular intercellular adhesion molecule 1 expression but E-selectin expression was increased to levels found in papules and vascular adhesion molecule 1 levels were upregulated. Levels of the pro-inflammatory cytokine interleukin-1 were also upregulated perifollicularly. Moreover, aberrant integrin expression was demonstrated in the epidermis around these uninvolved follicles and inflamed lesions whereas the basement membrane was still intact. These results provide novel evidence for vascular endothelial cell activation and involvement of inflammatory responses in the very earliest stages of acne lesion development.

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“The increased blood flow and higher density of inflammatory cells in perilesional- and lesion-free skin of patients with higher acne severity are consistent with the theory that inflammatory events occur prior to development of acne lesions reported in multiple studies [7,9,28].”
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Bharti, S., & Vadlamudi, H. C. (2020) · Journal of Receptors and Signal Transduction · doi:10.1080/10799893.2020.1805626 · Cited by 43
Inflammasome Activation by Propionibacterium acnes: The Story of IL-1 in Acne Continues to Unfold
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“, 1998; Jeremy et al., 2003). Very little is known about the dynamics of myeloid cell infiltration into follicles at this early stage. Toyoda and Morohashi, (2001) published electron micrographs depicting macro-”
Background
HR-1 Mice: A New Inflammatory Acne Mouse Model
Jang, Y. H., Lee, K. C., Lee, S., Kim, D. W., & Lee, W. J. (2015) · Annals of Dermatology · doi:10.5021/ad.2015.27.3.257 · Cited by 33
“However, Jeremy et al.(3) show that inflammatory events occur in ad-”
Background
Fractional carbon dioxide laser: Optimizing treatment outcomes for pigmented atrophic acne scars in skin of color
Arsiwala, S., & Desai, S. R. (2019) · Journal of Cutaneous and Aesthetic Surgery · doi:10.4103/jcas.jcas_171_18 · Cited by 33
“Involvement of epidermis, upper, or deep reticular dermis defines the depth of acne scars and also the treatment choice.[5] Mild-to-moderate scars involving epidermis and papillary dermis respond to resurfacing laser or other technologies [Table 1], whereas the deep scars involving reticular dermis require more aggres…”
Background
Does inflammatory acne result from imbalance in the keratinocyte innate immune response?
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Oxidative stress in acne vulgaris: an important therapeutic target
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Li, L., Zhang, J., Cheng, W., Di, F., Wang, C., & An, Q. (2024) · Molecules · doi:10.3390/molecules29081793 · Cited by 35
“Rhizoma Paridis total saponins inhibits P. acnes NCTC737 and ATCC6919, S. epidermidis ATCC12228, S. aureus ATCC6538 (MIC = 2.5, 5.0, 5.0, 1.25 mg/mL), Polyphyllin I, II, III, V, VI, VII, H inhibits P. acnes NCTC737 (MIC = 0.6, 1.”
BackgroundInfluential
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Mills, O. H., Criscito, M. C., Schlesinger, T. E., Verdicchio, R., & Szoke, E. (2016) · PubMed Central · Cited by 31
Interleukin-10 secretion from CD14+ peripheral blood mononuclear cells is downregulated in patients with acne vulgaris
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Cicatrices d’acné : épidémiologie, physiopathologie, clinique, traitement
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Ex vivo demonstration of a synergistic effect of Adapalene and benzoyl peroxide on inflammatory acne lesions
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Androgens modulate keratinocyte differentiation indirectly through enhancing growth factor production from dermal fibroblasts
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Common Pathogenesis of Acne Vulgaris and Atherosclerosis
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Investigation of papulopustular eruptions caused by cetuximab treatment shows altered differentiation markers and increases in inflammatory cytokines
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Low‐level red LED light inhibits hyperkeratinization and inflammation induced by unsaturated fatty acid in an in vitro model mimicking acne
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“Inflammatory events occurring during early acne lesion development include interleukin-1a (IL-1a) bioactivity found in open comedones [12], aswell as in papules of knownduration less than 6 hours [13].”
Background
Plant Phenolics in the Prevention and Therapy of Acne: A Comprehensive Review
Koch, W., Zagórska, J., Michalak-Tomczyk, M., Karav, S., & Wawruszak, A. (2024) · Molecules · doi:10.3390/molecules29174234 · Cited by 28
“In addition, follicular hyperkeratinization may be preceded by the stimulation of the pilosebaceous vasculature resulting from immune-mediated inflammatory processes involving macrophages and CD4 + lymphocytes [44].”
Background
Management of Acne Vulgaris With Trifarotene
Tan, J. K. L., Chavda, R., Baldwin, H. E., & Dréno, B. (2023) · Journal of Cutaneous Medicine and Surgery · doi:10.1177/12034754231163542 · Cited by 28
Managing acne in the Middle East: consensus recommendations
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Macrophages in acne vulgaris: mediating phagocytosis, inflammation, scar formation, and therapeutic implications
Feng, Y., Li, J., Mo, X., & Ju, Q. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1355455 · Cited by 30
Explore the Anti-Acne Mechanism of Licorice Flavonoids Based on Metabonomics and Microbiome
Ruan, S.-F., Hu, Y., Wu, W., Du, Q., Wang, Z., Chen, T., Shen, Q., Liu, L., Jiang, C., Li, H., et al. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.832088 · Cited by 29
“The operational taxonomic units (OTUs) that reached a 97% nucleotide similarity level were subjected to alpha-diversity analyses using mothur software (Jeremy et al., 2003).”
Method
Microbiological effect of photodynamic therapy (PDT) in healthy volunteers: a comparative study using methyl aminolaevulinate and hexyl aminolaevulinate cream
Yung, A., Stables, G. I., Fernandez, C., Williams, J. V., Bojar, R. A., & Goulden, V. (2007) · Clinical and Experimental Dermatology · doi:10.1111/j.1365-2230.2007.02472.x · Cited by 27
Treatment of acne with special emphasis on herbal remedies
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Unveiling the mechanisms for the development of rosehip-based dermatological products: an updated review
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In vitro modeling of unsaturated free fatty acid-mediated tissue impairments seen in acne lesions
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Authors: Jeremy, A. H. T., Holland, D. B., Roberts, S. G., Thomson, K. F., & Cunliffe, W. J.
Affiliations: Leeds General Infirmary (GB)
Corresponding author: Holland, Diana B.
ORCID: Cunliffe, William J.
Venue: Journal of Investigative Dermatology
Publisher: Elsevier BV
Published: 2003-07
Volume: 121
Issue: 1
Pages: 20-27
ISSN: 0022-202X (ISSN-L)
DOI: 10.1046/j.1523-1747.2003.12321.x
OpenAlex: W2062768474
Cited by: 541
References: 34
Citations by year: 2026: 13 · 2025: 30 · 2024: 52 · 2023: 28 · 2022: 20 · 2021: 28 · 2020: 26 · 2019: 32 · 2018: 29 · 2017: 24 · 2016: 23 · 2015: 19 · 2014: 35 · 2013: 27 · 2012: 17
FWCI: 16.89
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 4537 d)
Locations: Journal of Investigative Dermatology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
Keywords: acne, microcomedones, inflammation, T cells, macrophages, endothelial activation, E-selectin, VCAM-1, interleukin-1, integrins, basement membrane, follicular epithelium, vascular adhesion molecules
MeSH terms: CD68 Molecule, Acne Vulgaris, Adolescent, Adult, Blood Vessels, Cell Differentiation, Cell Division, HLA-DR Antigens, Humans, Immunohistochemistry, Immunologic Memory, Interleukin-1, Laminin, Langerhans Cells, Macrophages, Neutrophils, Antigens, Differentiation, Myelomonocytic, Biomarkers, CD4-Positive T-Lymphocytes, Keratinocytes, Antigens, CD, CD3 Complex, Receptors, Interleukin-1, Leukocyte Common Antigens, CD8-Positive T-Lymphocytes, Hair Follicle, Antigens, CD1, Collagen Type IV, Integrin alpha6, Receptors, Interleukin-1 Type II

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Inflammatory Events Are Involved in Acne Lesion Initiation

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