Reappraisal of Acne vulgaris Pathogenesis: The Role of TIMP-2

Abstract Background A persistent inflammatory condition affecting the pilosebaceous unit is acne vulgaris. An endogenic inhibitor of matrix metalloproteinase-2 (MMP-2) that has been linked to the control of MMP-2 proteolytic activity is a tissue inhibitor of metalloproteinase-2 (TIMP-2). This work is designed to evaluate serum and gene expression levels of TIMP-2 in cases with acne vulgaris compared with healthy controls and to correlate the results with the available clinical data. Subjects and methods: This case-control study has 83 cases of acne vulgaris and 83 normal controls. Disease severity was estimated by the Global Acne Grading System (GAGS). Real-time polymerase chain reaction (PCR) was used to determine the expression level of the TIMP-2 gene and serum TIMP-2 presence was assessed by enzyme-linked immunosorbent assay (ELISA). Results Comparison between cases and controls regarding mean serum and mean expression levels of TIMP-2 showed statistically significant differences between both groups being higher in cases than controls (P < 0.001 for both). Also; there were significant positive correlations between mean serum TIMP-2 and GAGS score, NAST classification, and TIMP-2 gene expression level (P < 0.001 for all). Significant positive correlations existed between TIMP-2 gene expression and GAGS score and NAST classification (P < 0.001 for both). Conclusion TIMP-2 could be considered a potential diagnostic biomarker for acne vulgaris.