title: Comparison of TLR-2, TLR-4, and antimicrobial peptide levels in different lesions of acne vulgaris.
abstract: BACKGROUND
  Recent studies have shown that tolls like receptors (TLRs) and antimicrobial peptides (hBD-1, cathelicidin) play an important role in the pathogenesis of acne vulgaris (AV).
  
  
  OBJECTIVE
  To evaluate and report the expression of TLR-2, TLR-4, hBD-1 and cathelicidin in different regions of skin in AV.
  
  
  METHODS
  This study was performed in 80 patients with AV and a control group of 20 healthy individuals.
  
  
  METHODS
  Skin biopsies were performed from 20 papular, 20 pustular, 20 comedonal and 20 nodular lesions of patients and 20 healthy volunteers. Expression levels of TLR-2, TLR-4, hBD-1 and cathelicidin in four separate areas (epidermis, dermis, inflammation region and skin appendages) were evaluated by immunohistochemical method. Further, these parameters were compared between different skin lesions.
  
  
  RESULTS
  A significant difference was found between the levels of staining of TLR-2, TLR-4 and hBD-1 from the epidermis, inflammation region, dermis and skin appendages (p < 0.05). Levels of cathelicidin were different in only the inflammation region (p < 0.05). The level of TLR-2 in the epidermis with nodules was lower than the papules and comedones (p < 0.05). Levels of TLR-2 in the inflammation and dermis of the cases with papules were significantly higher when compared to pustules (p < 0.05). The levels of staining of TLR-4 in the dermis with comedones were significantly lower compared to the cases with papules (p < 005). The level of hBD-1 in the epidermis region of comedones was significantly higher compared to nodules (p < 0.05). The expression of cathelicidin in the inflammation region of comedones was significantly low (p < 0.05).
  
  
  CONCLUSIONS
  It is thought that TLR-2, TLR-4, hBD-1 and cathelicidin play an important role in the pathogenesis of AV and in the development of different acne types. We think that, better results could be obtained in treatment of AV with different treatment options targeted in regulation of TLR-2, TLR-4, hBD-1 and cathelicidin release.
authors.affiliation: a Department of Dermatology and.
authors.forename: Emin
authors.initials: E
authors.lastname: Ozlu
authors.affiliation: a Department of Dermatology and.
authors.forename: Ayse Serap
authors.initials: AS
authors.lastname: Karadag
authors.affiliation: b Department of Pathology , Istanbul Medeniyet University, School of Medicine, Goztepe Research and Training Hospital , Istanbul , Turkey .
authors.forename: Seyma
authors.initials: S
authors.lastname: Ozkanli
authors.affiliation: c Department of Biology , Kırıkkale University, Kırıkkale , Turkey , and.
authors.forename: Serpil
authors.initials: S
authors.lastname: Oguztuzun
authors.affiliation: d Department of Pharmacy Service , Biology Unit, Vocational School of Health Service, Ankara University , Ankara , Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kilic
authors.affiliation: b Department of Pathology , Istanbul Medeniyet University, School of Medicine, Goztepe Research and Training Hospital , Istanbul , Turkey .
authors.forename: Ebru
authors.initials: E
authors.lastname: Zemheri
authors.affiliation: a Department of Dermatology and.
authors.forename: Ozge
authors.initials: O
authors.lastname: Akbulak
authors.affiliation: a Department of Dermatology and.
authors.forename: Necmettin
authors.initials: N
authors.lastname: Akdeniz
mesh_terms: D000152:Acne Vulgaris / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D023181:Antimicrobial Cationic Peptides / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D012867:Skin / Q000378:metabolism*; D051195:Toll-Like Receptor 2 / Q000378:metabolism*; D051197:Toll-Like Receptor 4 / Q000378:metabolism*; D055815:Young Adult; D023083:beta-Defensins / Q000378:metabolism*; D054804:Cathelicidins
chemical_list: D023181:Antimicrobial Cationic Peptides; C406407:DEFB1 protein, human; C495342:TLR2 protein, human; C495345:TLR4 protein, human; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4; D023083:beta-Defensins; D054804:Cathelicidins
keywords: Acne; antimicrobial peptides; toll-like receptors