Calprotectin may be positively associated with the severity of acne vulgaris


  • Shireen A. Al-tameemi Department of Chemistry, College of Science, University of Diyala, Baqubah 32001, Iraq
  • Zainab S. Abid Miqdadiyah Primary Healthcare Sector, Diyala Health Directorate, Iraqi Ministry of Health, Miqdadiyah 32003, Iraq
  • WenChieh Chen Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
  • Fawwaz Alshammri Department of Dermatology, College of Medicine, University of Hail, Hail, Saudi Arabia
  • Hussein Abid Medical Laboratory Technology Department, Technical Institute of Baquba, Middle Technical University, Baqubah 32001, Iraq



acne vulgaris, calgranulin, inflammatory, copper, zinc


Background and objective: Acne vulgaris (AV) is a common skin disease of sebaceous hair follicles. Many factors are associated with the occurrence and severity of acne, while the exact etiology remains incompletely understood. The current study was aimed to investigate the association between the severity of acne and serum zinc, copper, and calprotectin.

Methods: Fifty patients with AV were recruited in the study as well as 25 healthy age and sex-matched individuals as controls. The acne severity was classified into mild (n=21), moderate (n=16), and severe acne (n=14) according to the global acne grading system (GAGS). Serum levels of zinc, acne and calprotectin were evaluated by enzyme-linked immunosorbent assay (ELISA). The gained data were analyzed using GraphPad Prism software.

Results: Insignificant difference was found in zinc and copper levels between controls and AV patients, except in severe AV, where the patients displayed significant elevation in serum copper level (p<0.05) as compared to that of mild AV. The calprotectin concentration was significantly higher (p<0.001) in all AV patients, when compared with healthy subjects, which was positively correlated with the disease severity. No gender difference was noted for all measured biomarkers.

Conclusions: Our study suggests a possible association between calprotectin and acne inflammation, which requires validation in large-scale studies.


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A De Ponti, L Wiechert, A Stojanovic, et al. “Chronic liver inflammation and hepatocellular carcinogenesis are independent of S100A9”. International Journal of Cancer 136 (2015), pp. 2458–63. DOI: 10.1002/ijc.29282.

A Di Landro, S Cazzaniga, F Parazzini, et al. “Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults”. Journal of the American Academy of Dermatology (2012). DOI: 10.1016/j.jaad.2012.02.018.

A Doshi, A Zaheer, and M J Stiller. “A comparison of current acne grading systems and proposal of a novel system”. International Journal of Dermatology 36 (1997), pp. 416–424. DOI: 10.1046/j.1365-4362.1997.00099.x.

A H T Jeremy, D B Holland, S G Roberts, et al. “Inflammatory events are involved in acne lesion initiation”. The Journal of Investigative Dermatology 121 (2003), pp. 20–27. DOI: 10.1046/j.1523-1747.2003.12321.x.

A M Layton, C Morris, W J Cunliffe, et al. “Immunohistochemical investigation of evolving inflammation in lesions of acne vulgaris”. Experimental Dermatology 7 (1998), pp. 191–198. DOI: 10.1111/j.1600-0625.1998.tb00323.x.

B D Corbin, E H Seeley, and A Raab. “Metal chelation and inhibition of bacterial growth in tissue abscesses”. Science 319 (2008), pp. 962–967. DOI: 10.1126/science.1152449.

B Dreno, P Foulc, and A Reynaud. “Effect of zinc gluconate on propionibacterium acnes resistance to erythromycin in patients with inflammatory acne: in vitro and in vivo study”. European journal of dermatology : EJD 15 (2005), pp. 152–157.

B Dreno, R Martin, D Moyal, et al. “Skin microbiome and acne vulgaris: Staphylococcus, a new actor in acne”. Experimental dermatology 26 (2017), pp. 798–803. DOI: 10.1111/exd.13296.

B E Yee, P Richards, J Y Sui, et al. “Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta-analysis”. Dermatologic Therapy (2020). DOI: 10.1111/dth.14252.

C El Haddad, N. -E Gerbaka, S Hallit, et al. “Association between exposure to ambient air pollution and occurrence of inflammatory acne in the adult population”. BMC Public Health 21 (2021). DOI: 10.1186/s12889-021-11738-0.

C Gebhardt, J Németh, P Angel, et al. “S100A8 and S100A9 in inflammation and cancer”. Biochemical Pharmacology 72 (2006), pp. 1622–1653. DOI: 10.1016/j.bcp.2006.05.017.

C I Ikaraoha, N C Mbadiwe, C J Anyanwu, et al. “The role of blood lead, cadmium, zinc and copper in development and severity of acne vulgaris in a nigerian population”. Biological Trace Element Research 176 (2017), pp. 251–257. DOI: 10.1007/s12011-016-0839-4.

D. Benet Bosco Dhas, Ballambattu Vishnu Bhat, and Dawn Gane. “Role of calprotectin in infection and inflammation”. Current Pediatric Research 83 (2012), pp. 94–94.

E A Tanghetti. “The role of inflammation in the pathology of acne”. The Journal of Clinical and Aesthetic Dermatology 6 (2013), pp. 27–35.

E Ingham, E A Eady, C E Goodwin, et al. “Pro-inflammatory levels of interleukin-1 alpha-like bioactivity are present in the majority of open comedones in acne vulgaris”. The Journal of Investigative Dermatology 98 (1992), pp. 895–901. DOI: 10.1111/1523-1747.ep12460324.

E Mcneill and N Hogg. “S100A9 has a protective role in inflammation-induced skin carcinogenesis”. International Journal of Cancer 135 (2014), pp. 798–808. DOI: 10.1002/ijc.28725.

F F Alshammrie, R Alshammari, R Alharbi, et al. “Epidemiology of acne vulgaris and its association with lifestyle among adolescents and young adults in Hail, Kingdom of Saudi Arabia: A community-based study”. Cureus (2020). DOI: 10.7759/cureus.9277.

F Fiedler, G I Stangl, E Fiedler, et al. “Acne and nutrition: A systematic review”. Acta Dermato-venereologica 97 (2017), pp. 7–9. DOI: 10.2340/00015555-2450.

I Fouda, Z M Obaid, and S F Hegazy. “Calprotectin in acne vulgaris: A possible contributory role”. Journal of Cosmetic Dermatology 20 (2021), pp. 621–625. DOI: 10.1111/jocd.13574.

K Fischer, R Tschismarov, and A Pilz. “Cutibacterium acnes infection induces type I interferon synthesis through the cGAS-STING pathway”. Frontiers in immunology 11 (2020). DOI: 10.3389/fimmu.2020.571334.

L El-Saaiee, H Abdel-Aal, H El-Mahdy, et al. “Serum copper, iron and zinc in cases of acne vulgaris”. Journal of Medicine 14 (1983), pp. 125–136.

M J Kaplan and M Radic. “Neutrophil extracellular traps: double-edged swords of innate immunity”. Journal of Immunology 189 (1950), pp. 2689–95. DOI: 10.4049/jimmunol.1201719.

M P Philpott. “Defensins and acne”. Molecular immunology 40(03) (2003), pp. 154–162. DOI: 10.1016/s0161-5890(03)00154-8.

P G Sohnle, M J Hunter, and B Hahn. “Zinc-reversible antimicrobial activity of recombinant calprotectin (migration inhibitory factor-related proteins 8 and 14)”. Journal of Infectious Diseases (2000). DOI: 10.1086/315810.

R Chitturi, V R Baddam, and L Prasad. “A review on role of essential trace elements in health and disease”. Journal of Dr. NTR University of Health Sciences 4 (2015), pp. 75–75.

R J Hay, N E Johns, and H C Williams. “The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions”. The Journal of Investigative Dermatology 134 (2014), pp. 1527–1534. DOI: 10.1038/jid.2013.446.

R M Walter, J Y Uriu-Hare, and K L Olin. “Copper, zinc, manganese, and magnesium status and complications of diabetes mellitus”. Diabetes Care 14 (1991), pp. 1050–1056. DOI: 10.2337/diacare.14.11.1050.

S Chen, M Jiang, T Ding, et al. “Calprotectin is a potential prognostic marker for polycystic ovary syndrome”. Annals of Clinical Biochemistry 54 (2017), pp. 253–257. DOI: 10.1177/0004563216653762.

S E Kelly, D B Jones, and S Fleming. “Calgranulin expression in inflammatory dermatoses”. The Journal of Pathology (1989). DOI: 10.1002/path.1711590107.

S Korkmaz and S K Fıçıcıog˘lu. “Calprotectin can play an inflammatory role in acne vulgaris”. Advances in Dermatology and Allergology 35 (2018), pp. 397–399. DOI: 10.5114/ada.2017.71286.

S M Yaseen, H A Abid, and M A Al-Obaidi. “Disturbed levels of non-enzymatic antioxidants and malondialdehyde among makeup users”. Journal of Techniques 2 (2020), pp. 42–48. DOI: 10.51173/jt.v2i1.166.

S Moradi Tuchayi, T Alexander, A Nadkarni, et al. “Interventions to increase adherence to acne treatment”. Patient Preference and Adherence 10 (2016), pp. 2091–2096. DOI: 10.2147/PPA.S117437.

S N Mahmood and W P Bowe. “Diet and acne update: carbohydrates emerge as the main culprit”. Journal of Drugs in Dermatology: JDD 13 (2014), pp. 428–463.

S Nasiri, F Ghalamkarpour, and M Yousefi. “Serum zinc levels in Iranian patients with acne”. Clinical and experimental dermatology 34 (2009), pp. 446–446.

S Yui, Y Nakatani, and M Mikami. “Calprotectin (S100A8/S100A9), an inflammatory protein complex from neutrophils with a broad apoptosis-inducing activity”. Biological & Pharmaceutical Bulletin 26 (2003), pp. 753–60. DOI: 10.1248/bpb.26.753.

T Nakatsuji, M C Kao, L Zhang, et al. “Sebum free fatty acids enhance the innate immune defense of human sebocytes by upregulating β-defensin-2 expression”. Journal of Investigative Dermatology (2010). DOI: 10.1038/jid.2009.384.

T Vos, A D Flaxman, M Naghavi, et al. “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study”. Lancet 380 (2010), pp. 61729–61731. DOI: 10.1016/S0140-6736(12)61729-2.

W El-Rifai, C A Moskaluk, and M K Abdrabbo. “Gastric cancers overexpress S100A calcium-binding proteins”. Cancer research 62 (2002), pp. 6823–6829.




How to Cite

Al-tameemi, S., Abid, Z., Chen, W., Alshammri, F., & Abid, H. (2022). Calprotectin may be positively associated with the severity of acne vulgaris. Baghdad Journal of Biochemistry and Applied Biological Sciences, 3(02), 145–155.