title: Effect of systemic isotretinoin therapy on mucociliary clearance and nasal surface mucosa in acne patients.
abstract: BACKGROUND
  Currently, there are no studies investigating the topical or systemic effects of retinoids on human nasal mucosa. We aimed to investigate the effect of systemic isotretinoin therapy on mucociliary transport and nasal surface mucosa using the saccharine test (ST) and nasal cytology techniques.
  
  
  METHODS
  A total of 30 patients with severe or moderate acne were enrolled in this study. The median prescribed dose of isotretinoin was 0.75 mg per kg per day. Clinical and biochemical examinations were carried out periodically. The ST and nasal cytology were performed before treatment and during the third month of therapy.
  
  
  RESULTS
  Of the 30 patients who initially agreed to participate in the research, 21 completed the study (18 female and 3 male, mean ± standard deviation (SD) aged 20.9 ± 4.7 years, range 15-32 years). There was a significant difference between the mucociliary clearance time for subjects in the pre- and post-treatment periods (173.8 ± 89.2 seconds vs 245.2 ± 191.6 seconds, respectively; P=.009). Cytological examination revealed that the squamous cell ratio was significantly lower and the reactive changes of the respiratory epithelium were significantly higher 3 months after isotretinoin therapy than before therapy (P=.010, P=.002, respectively). There were mild signs of inflammation according to the number of neutrophilic leukocytes (8.3% vs 26.6%, P=.06) after 3 months of isotretinoin therapy.
  
  
  CONCLUSIONS
  Systemic isotretinoin alters the mucociliary transport, decreases the squamous cell ratio, increases the reactive changes in the respiratory epithelium significantly, and increases neutrophils in the nasal surface mucosa in the third month of treatment
authors.forename: Zennure
authors.initials: Z
authors.lastname: Takci
authors.forename: Gulcin Guler
authors.initials: GG
authors.lastname: Simsek
authors.forename: Hayriye
authors.initials: H
authors.lastname: Karabulut
authors.forename: Yunus
authors.initials: Y
authors.lastname: Buran
authors.forename: Ayse Serap
authors.initials: AS
authors.lastname: Karadag
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy / Q000473:pathology; D000293:Adolescent; D000328:Adult; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009079:Mucociliary Clearance / Q000187:drug effects*; D009297:Nasal Mucosa / Q000187:drug effects*; D012439:Saccharin; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin; D012439:Saccharin