Pharmacogenomics and Personalized Medicine (Dec 2021)
Isotretinoin Induced Hyperlipidemia and Impact of Leptin Gene rs 7799039 Polymorphism in Safety of Acne Patients
Abstract
Amal A Mohamed,1 Alshymaa Hassnine,2 Amr Elsayed,2 Mahmoud Montaser,3 Yasmeen Ismail,4 Ahmed El-Demery,5 Eman Sultan,6 Rania S Abdel Aziz,7 Eman Eldemiry,8 Radwa Hagag,9 Amal A El-Kholy,10 Eman Salah11 1Biochemistry and Molecular Biology Department, National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt; 2Gastroenterology and Tropical Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt; 3Department of Dermatology, Andrology and STDs, Faculty of Medicine, Minia University, Minia, Egypt; 4Clinical Pharmacology Department, Faculty of Medicine, Benha University, Benha, Egypt; 5Biochemistry Department, Faculty of Medicine, October 6 University, 6th of October City, Egypt; 6Clinical Nutrition Department, National Nutrition Institute, Cairo, Egypt; 7Clinical and Chemical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt; 8Faculty of Pharmacy, Fellow of Clinical Pharmacology, Cairo University Hospitals, Giza, Egypt; 9Pharmacy Practice and Clinical Pharmacy Department, Faculty of Pharmacy, Egyptian Russian University, Badr City, Egypt; 10Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt; 11Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, EgyptCorrespondence: Amal A El-KholyClinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, EgyptTel +201060355448Email [email protected]: Acne vulgaris (AV) is a chronic inflammatory disease that affects the pilosebaceous unit. Leptin (LEP) gene polymorphisms is associated with higher risk of multiple disorders. Insulin-like growth factor-1 (IGF-1) exerts comedogenic effect by stimulating the sebaceous glands. Isotretinoin is an effective oral therapy for AV with many side effects including hyperlipidemia and increased serum levels of liver enzymes.Purpose: To evaluate the impact of LEP gene rs7799039 polymorphism in acne patients’ clinical response lipid profile and liver enzymes following 6 months oral isotretinoin therapy in Egyptian AV patients.Methods: One hundred eligible AV patients received 0.5 mg/kg oral isotretinoin for 6 months. Patients’ demographics and clinical data were obtained. Body mass index (BMI), lipid profile, liver enzymes and IGF-1 were measured at baseline and after 6 months of therapy. Genotyping was done for LEP gene rs 7799039.Results: Six month administration of oral isotretinoin in Egyptian AV patients is associated with significantly elevated aspartate transaminase (AST) in CC and AC genotypes (P< 0.001). Significant alanine aminotransferase (ALT) elevation was observed in CC, AC and AA genotypes (P < 0.001, 0.004, 0.002, respectively). Total cholesterol (TC), triglycerides (TG) and low density lipoprotein (LDL) were elevated significantly P< 0.001) in the three genotypes. IGF-1 was decreased significantly in CC and AC genotypes (P< 0.001). CC genotype is associated with highest response (P< 0.001).Conclusion: LEP rs7799039 gene had an impact on the clinical response, lipid profile and liver enzymes in AV patients treated with oral isotretinoin. LEP rs7799039 CC genotype is predicted to be the treatment candidate for 6 month oral isotretinoin.Keywords: leptin, IGF-1, lipid, isotretinoin, liver enzymes, LEP, insulin-like growth factor-1
