الفهرس 
ACNE VULGARIS
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Abstract
Acne Vulgaris is a common cutaneous disorder of the pilosebaceous follicle, which has a multifactorial pathogenesis involving abnormal hyperkeratinization, increased sebum production, hormones, cutaneous microbes and immunological mechanisms.
Interleukin 8 belongs to the family of low molecular weight cytokines that are potent chemoattractants for leukocytes, termed chemokines. They are now called as chemokines (chemotactic cytokine).
The accumulation of neutrophil leukocytes in a tissue is the hallmark of inflammation, a defense reaction to infection or other injury, with participation of blood, blood vessel and tissue elements. The neutrophils are recruited from the blood by chemotactic stimuli that direct their migration through the vessel wall to the affected site.
The aim of this study is to evaluate the expression of IL-8 in skin biopsies of non-inflammatory and inflammatory acne vulgaris by immunohistochemical methods in an attempt to understand its potential role in disease pathogenesis.
This study included 15 patients with acne vulgaris with their ages ranging from 18-25 years. Patients were classified according to the clinical severity of acne into 3 groups: mild, moderate and severe. Punch biopsies were taken from the non-lesional and lesional skin of patients where the non-lesional biopsies act as control. All are stained and examined under light microscope. The immunoreactivity of IL-8 in the epidermal layers was studied. Its expression in the pilosebaceous follicles and the dermis was also evaluated. The relation between the intensity of IL-8 expression and the severity of acne were studied.
It was found that in lesional inflammatory skin of acne patients, all samples showed immunostaing staining in the basal layer, the majority showed strong staining while few samples showed moderate pattern of staining. Regarding suprabasal layer the majority showed strong staining while others showed from mild to moderate staining. The dermis showed mild to strong staining of inflammatory cells and infiltrate around the pilosebaceous follicles. The pilosebaceous follicles showed mild to strong staining in the upper and lower part of the follicle in the majority of the samples while in 1 sample there was no stain.
As for lesional non-inflammatory skin of acne patients, all samples showed positive immunostaining for IL-8in the basal layer of epidermis , the majority showed strong staining while others showed moderate staining. Regarding the dermis, few samples only showed immunoreactivity to dermal infiltrate. The pilosebaceous follicles all samples showed immunoreactivity in the upper part of the follicle only sparing the lower part where most of the samples showed strong staining.
Regarding non-lesional normal skin of acne patients, IL-8 immunostaning was seen in the basal layer of the epidermis of all samples ranging from mild to moderate staining. The suprabasal cell layer on the other hand showed no IL-8 immunoreactivity. IL-8 was not immunohistochemically detected in the pilosebaceous follicles and the dermis of normal samples.
This study has also shown that there is no significant correlation between IL-8 expression and the severity of acne.
¬In conclusion, the present study has shown that IL-8 is expressed in the epidermis of the normal skin. Moreover, expression of IL-8 has been demonstrated in skin lesions of acne where IL-8 is expressed in the suprabasal , basal layer and pilosebaceous follicles more than normal skin. These findings suggest that IL-8 may play an essential role in the pathogenesis of acne. Being a very strong pro-inflammatory chemokine , this suggest a strong evidence about the inflammatory nature of the comedone.
Finally, further research on a larger scale of patients studying the role of IL-8 in normal skin as well as in the clinical variants of acne is recommended, also Further studies are needed to investigate the kinetics of cytokine production by keratinocytes in response to P acnes and to decipher the signaling pathways involved. This will help in better understanding the pathogenesis of acne, and thus open the way for the design of new and efficient drugs to treat this disease.