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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Isotretinoin therapy induces DNA oxidative damage

Sophia Georgala1 / Ioannis Papassotiriou2 / Catherina Georgala3 / Elisabeth Demetriou4 / Kleopatra H. Schulpis5






Corresponding author: Ioannis Papassotiriou, PhD, Department of Clinical Biochemistry, “Aghia Sophia” Children's Hospital, 115 27 Athens, Greece Phone: +30-210-7467931, Fax: +30-210-7467171, ,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 43, Issue 11, Pages 1178–1182, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2005.204, October 2005

Publication History

June 13, 2005
August 29, 2005
Published Online:


Background: Isotretinoin (Iso) is currently indicated for the treatment of cystic acne (CA) and is related to marked teratogenicity.

Aim: The aim of the study was to evaluate the relationship between total antioxidant status (TAS) and a serum marker of DNA oxidative damage, 8-hydroxy-2-desoxyguanosine (8-OHdG), in patients on Iso treatment.

Patients and methods: Patients with CA (n=18) were evaluated before and 45 days after Iso (0.5mg/kg per day) treatment and non-diseased controls (n=22) were tested only once. Plasma TAS levels and 8-OHdG were measured spectrophotometrically and with an immunoassay, respectively. Liver biochemical parameters and muscle enzymes were measured on a blood chemistry analyzer.

Results: TAS levels were significantly (p<0.0001) lower in patients before treatment (921±124 μmol/L) compared with those after treatment (1335±93 μmol/L) and in controls (1536±126 μmol/L). In contrast, 8-OHdG serum levels were two-fold higher in patients after treatment (0.21±0.03 ng/mL) than before treatment (0.11±0.02 ng/mL) and three-fold higher than in controls (0.07±0.01 ng/mL; p<0.0001). Negative correlations were found between TAS and 8-OHdG (r=−0.754, p<0.0001) in patients before therapy and positive correlations were found between creatine kinase (CK) and 8-OHdG (r=0.488, p<0.001) and liver enzymes after Iso treatment.

Conclusions: High serum levels of 8-OHdG in patients on Iso therapy may be due to a direct effect of Iso on liver, muscle and skin epidermal cells. Regular evaluation of 8-OHdG in sera of patients, especially of women of reproductive age, on Iso treatment could be a sensitive follow-up biomarker of DNA oxidation.

Keywords: cystic acne; DNA damage; free radicals; 8-hydroxy-2-desoxyguanosine (8-OhdG); isotretinoin

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