title: Effect of isotretinoin on serum levels of precursor and peripherally derived androgens in patients with acne.
abstract: Sebaceous glands are stimulated by androgens and can convert them to more active forms. Isotretinoin, however, has a profound inhibitory effect on sebaceous gland size and function. This study evaluated the effect of isotretinoin on serum levels of precursor and tissue-derived androgens. Twenty-four subjects (15 men and nine women) were treated for 20 weeks with 1 mg/kg/d of isotretinoin. Serum samples were obtained at baseline, 8, 16, and 24 weeks, and assayed for precursor androgens--total testosterone (TT), free testosterone (free T), dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEA-S); and tissue androgens--dihydrotestosterone (DHT), and its metabolite, 3 alpha-androstanediol glucuronide (3 alpha-diol G). Isotretinoin had no meaningful effects on precursor androgens, except for producing an elevation of free T in women. In contrast, isotretinoin produced depressions in the serum levels of DHT and 3 alpha-diol G in women and in 3 alpha-diol G in men. These decreases are believed to be the result, rather than the cause, of a reduction in the size of the sebaceous glands: The magnitude of the observed decreases may represent the amount of tissue-derived androgens that sebaceous glands normally contribute to the circulating pool.
authors.affiliation: Department of Medicine, College of Medicine, Pennsylvania State University, Hershey.
authors.forename: D P
authors.initials: DP
authors.lastname: Lookingbill
authors.forename: L M
authors.initials: LM
authors.lastname: Demers
authors.forename: R E
authors.initials: RE
authors.lastname: Tigelaar
authors.forename: A R
authors.initials: AR
authors.lastname: Shalita
mesh_terms: D000152:Acne Vulgaris / Q000097:blood / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood*; D015113:Androstane-3,17-diol / Q000031:analogs & derivatives / Q000378:metabolism; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D013196:Dihydrotestosterone / Q000378:metabolism; D005260:Female; D006801:Humans; D015474:Isotretinoin; D008297:Male; D012627:Sebaceous Glands / Q000187:drug effects; D013739:Testosterone / Q000097:blood; D014212:Tretinoin / Q000494:pharmacology*
chemical_list: D000728:Androgens; D013196:Dihydrotestosterone; D015113:Androstane-3,17-diol; C028895:androstane-3,17-diol glucuronide; D013739:Testosterone; D003687:Dehydroepiandrosterone; D014212:Tretinoin; D019314:Dehydroepiandrosterone Sulfate; D015474:Isotretinoin