Arginine, Albumin, and Vitamin A and E Levels in Patients With Acne

The importance of oxidative stress and antioxidants in patients with acne is examined.

Patients with acne have significantly higher levels of asymmetric dimethylarginine (ADMA), LNG-monomethyl-L-arginine (L-NMMA), symmetric dimethylarginine (SDMA), and ischemia-modified albumin (IMA), suggesting that the IMA and L-arginine nitric oxide pathway associated with both ischemia and oxidative stress represent a role in the pathogenesis and progression of acne, according to study research published in the Journal of Cosmetic Dermatology.

A total of 90 patients with acne vulgaris (mean age, 18.67±3.36 years) and 30 healthy control patients (mean age, 19.7±2.49 years) from the Konya Training and Research Hospital dermatology outpatient clinic in Turkey were enrolled in this study. Only patients who had not been using systemic treatment in the last 3 months or topical acne therapy in the last month were included.

Blood samples were collected after a 12-hour fast in both patients with acne and control participants. The investigators measured serum levels of L-arginine, ADMA, SDMA, IMA, L-NMMA, and vitamins A and E.

Compared with the control group, patients with acne had significantly higher levels of ADMA (0.37±0.12 vs 0.48±0.15 μmol/L, respectively; P =.001), L-NMMA (0.06±0.02 vs 0.07±0.03 μmol/L; P = .030), SDMA (0.41 ± 0.12 vs 0.48 ± 0.19 μmol/L; P =.020), and IMA (1.1±0.33 vs 1.45±0.22; P =.001).

Healthy control patients had significantly higher levels of vitamin A (660.34±17.66 vs 560.33±12.3 μg/L; P =.010), citrulline (55.07±21.29 vs 36.03±11.02 μmol/L; P =.001), and arginine/ADMA ratio (975.3±474.22 vs 666.72±373.81; P =.001). The plasma levels of ADMA and IMA increased in parallel with severity of disease (P <.05). As disease became severe, the plasma levels of L-arginine/ADMA ratio, L-arginine, citrulline, and vitamin A decreased (P ˂.05).

Limitations of the study included the small sample size as well as the lack of information on participants’ dietary habits.

According to these findings, the researchers suggest that “the requirements for supplements such as antioxidant vitamins and amino acids to be given in acne treatment can be predicted.”


Tuncez Akyurek F, Saylam Kurtipek G, Kurku H, et al. Assessment of ADMA, IMA, vitamin A and E levels in patients with acne vulgaris [published online July 5, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13590