Interleukin-1 Alpha Expression In Men With Comedonal, Papulopustular, And Nodular Acne Vulgaris Lesions

Abstract

Introduction : Acne vulgaris (AV) is a chronic, multifactorial pilosebaceous unit disorder, which generally appears in
adolescence.1 This condition causes non-inflammatory lesions, including: closed comedones or whiteheads and open
comedones or blackheads and inflammatory lesions, such as papules, pustules, and nodules.2 The main hypotheses
regarding the pathophysiology of acne include: keratinization of the follicles in the sebum unit of hair follicles,
colonization of Cutibacterium acnes (C. acnes) and follicle activation, hormone action, sebum production and release
of inflammatory mediators.6 Mechanisms of the inflammatory response against C. acnes will induce monocytes and
other cells to produce interleukin (IL) namely IL-1α, IL-1β, IL-6, IL-8, IL-12, interferons (IFN), chemotactic factor, β- defensin, tumor necrosis factor alpha (TNF-α), and other polypeptides and cytokines that can trigger an
inflammatory response.7
Interleukin-1 alpha (IL-1α) and TNF- are involved in the initiation and maintenance of inflammation and immune
responses in AV disorders.8
Purpose of the Study: This study aims at proving whether the expression of IL-1α in acne vulgaris lesions is directly
proportional to the degree of acne vulgaris.
Methods: This study was an observational study with an analytical cross-sectional design to determine the
expression of IL-1α in acne vulgaris lesions. Measurements were carried out once with a sample of 33 using
purposive sampling technique. Punch biopsy was performed on the AV lesion area and then examined using
immunohistochemistry with IL-1α primary antibody. The interpretation of the results of the immunohistochemistry
examination was carried out by Anatomical Pathologists with 4 scales of brownish color intensity in the tissue,
namely negative, weak, moderate, and strong. The data were analyzed using the Chi Square test.
Results and Discussion: The minimum IL-1α value for comedonal lesions was 3.04%, the maximum was 55.96%, the
median value was 31.89% and the mean±SD was 32.81±17.70%. In papulopustular lesions, the minimum value was
18.77%, the maximum value was 63.11% with a median of 50.84% while the mean value was 47.16±14.77. For
nodular lesions, the minimum value was 17.13%, the maximum value was 64.28%, with a median value of 34.61%
and a mean value of 34.81±13.85%. The value of IL-1α expression by immunohistochemistry examination was weak
(<25%) in 4 samples (30.8%) of comedonal AV lesions, 1 sample of moderate IL-1α expression (10.0%) and strong IL1α expression were found in 3 samples (23.1 %). In AV papulopustular lesions, IL-1α was weakly displayed in 1 sample
(10%), moderate IL-1α expression was displayed in 4 samples (40%) and IL-1α was strongly displayed in 5 samples
(50.0%). As for nodular lesions, 2 samples (20.0%) showed weak IL-1α, 7 samples (70%) moderately displayed and 1
sample (10%). P value = 0.085> 0.05 which means there is no significant difference between IL-1α expression and
AV lesions. Conclusion: There is no significant difference in the expression of IL-1α that appears in various degrees
of acne vulgaris lesions.