Downregulation of KLF2 Gene Reflects Inflammation and Scarring in Acne Vulgaris

acne scar atrophic scar
acne scar atrophic scar
Decreased serum level of Kruppel-like factor 2 (KLF2) gene in patients with acne vulgaris may serve as an indicator for degree of acne severity and outcome.

Downregulation of the Kruppel-like factor 2 (KLF2) gene may be predictive of acne severity and scar formation in patients with acne vulgaris, study research published in the Journal of Cosmetic Dermatology suggests.

A total of 100 patients with acne, including 50 patients with inflammatory acne (age, 22.50±3.62 years) and 50 patients with noninflammatory acne (age, 26.08±4.91 years), as well as 50 age- and sex-matched healthy control patients (age, 25.84±4.89 years) were enrolled in this case-control study. Venous blood samples were obtained from each participant, and quantitative real-time polymerase chain reaction was used to measure serum levels of KLF2 mRNA.

Compared with the healthy control group, the mean value of KLF2 mRNA was significantly lower in the patients with acne (1.0 vs 0.61, respectively; P <.001). In addition, patients with inflammatory acne grades 3, 4, and 5 had significantly lower mean KLF2 mRNA values (0.48±0.24, 0.29±0.15, and 0.22±0.10, respectively) compared with patients with noninflammatory acne grades 1 and 2 (0.96±0.08 and 0.93±0.11, respectively).

The highest value of KLF2 mRNA was observed in the control group relative to the inflammatory acne group (P <.001). Serum levels of KLF2 mRNA decreased significantly with increasing acne severity grade (P <.001). In addition, the researchers observed a lower mean KLF2 mRNA value in patients who had healed by scars vs patients healed by postinflammatory hyperpigmentation (0.23 vs 0.37, respectively; P =.016), which the investigators suggest indicates a continuous process of inflammation in patients with scarring.

The investigators concluded that their findings suggest “that KLF2 could serve as a marker of inflammation and scaring in acne vulgaris.”


Ibrahim MA, Mohammed SA, Elhabak DM. Role of KLF2: New insight in inflammatory acne pathogenesis [published online July 5, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13595