{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:45:30Z","timestamp":1760060730991,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010621","name":"Medical University of Lublin","doi-asserted-by":"publisher","award":["PBmb95"],"award-info":[{"award-number":["PBmb95"]}],"id":[{"id":"10.13039\/501100010621","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Acne vulgaris can be non-inflammatory lesions, i.e., closed comedones, open comedones, inflammatory lesions, i.e., papules, pustules, cysts, and post-acne lesions. This study aimed to evaluate the expression of TLR2 and TLR4 receptors on classical, intermediate, and non-classical monocyte subpopulations in 38 women with acne vulgaris and to correlate the results with clinical features of the disease and selected skin parameters. Methods: The skin parameters were assessed: level of oiliness, hydration, pH, skin pigmentation (phototype, erythema) using a special diagnostic device (Scientific multi-probe system MPA 6, Courage + Khazaka) with simultaneous determination of monocyte subpopulations in peripheral blood expressing TLR2 and TLR4 using a CytoflexLX flow cytometer (Beckman Coulter). Results: In the study group, the percentage of non-classical monocytes expressing TLR2 was statistically significantly lower than the classical and intermediate monocytes expressing TLR2 (p &lt; 0.001). However, the level of TLR2 receptor expression (MFI) was significantly higher on intermediate monocytes compared to the level of TLR2 expression on classical and non-classical monocytes. In the group of patients with post-acne lesions, a statistically significantly higher percentage of non-classical monocytes with TLR4 expression was observed compared to patients without post-acne lesions (p = 0.009). A statistically significant negative correlation was also observed between the percentage of intermediate and non-classical monocytes with TLR4 expression and the results of the mexameter measurements. Acne has a significant impact on the percentage of monocyte subpopulations expressing TLR2 and TLR4. A higher percentage of non-classical monocytes TLR4+ in the blood is associated with a higher incidence of post-acne lesions. Conclusions: The positive correlation between the degree of skin hydration and the level of TLR2 expression on classical monocytes suggests that these cells play an important role in skin homeostasis and defense against C. acnes. Proper acne care is not only important for aesthetic aspects, but may also have a positive impact on immunological phenomena.<\/jats:p>","DOI":"10.3390\/jcm14186449","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T11:51:43Z","timestamp":1757937103000},"page":"6449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Percentage of Monocyte Subpopulations with TLR2 and TLR4 Expression About Selected Skin Functional Parameters in Patients with Acne Vulgaris\u2014Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Ewelina","family":"Firlej","sequence":"first","affiliation":[{"name":"Department of Cosmetology and Aesthetic Medicine, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0930-5874","authenticated-orcid":false,"given":"Wioleta","family":"Grzegorzewska","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Jastrz\u0119bska-Paw\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariola","family":"Janiszewska","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Statistics with e-Health Lab, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilona","family":"G\u0105bka-Flis","sequence":"additional","affiliation":[{"name":"Department of Cosmetology and Aesthetic Medicine, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Makarska-Bia\u0142okoz","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Vincent Pol University in Lublin, 20-816 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Roli\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Bartosi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Cosmetology and Aesthetic Medicine, Medical University of Lublin, 20-093 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Topical Clascoterone for Acne Vulgaris","volume":"27","author":"Burma","year":"2022","journal-title":"Skin Ther. Lett."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rao, A., Douglas, S.C., and Hall, J.M. (2021). Endocrine Disrupting Chemicals, Hormone Receptors, and Acne Vulgaris: A Connecting Hypothesis. Cells, 10.","DOI":"10.3390\/cells10061439"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chilicka, K., Rogowska, A.M., Szygu\u0142a, R., Dzie\u0144dziora-Urbi\u0144ska, I., and Taradaj, J. (2020). A comparison of the effectiveness of azelaic and pyruvic acid peels in the treatment of female adult acne: A randomized controlled trial. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-69530-w"},{"key":"ref_4","first-page":"27","article-title":"The role of inflammation in the pathology of acne","volume":"6","author":"Tanghetti","year":"2013","journal-title":"J. Clin. Aesthetic Dermatol."},{"key":"ref_5","unstructured":"Noszczyk, M. (2018). Kosmetologia Piel\u0119gnacyjna i Lekarska, PZWL Medical Publishing House. [1st ed.]."},{"key":"ref_6","first-page":"155","article-title":"Tr\u0105dzik pospolity i jego leczenie","volume":"2","author":"Biegaj","year":"2017","journal-title":"Kosmetologia Estetyczna"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"adv26002","DOI":"10.2340\/actadv.v104.26002","article-title":"Efficacy of Spironolactone Compared with Doxycycline in Moderate Acne in Adult Females: Results of the Multicentre, Controlled, Randomized, Double-blind Prospective and Parallel Female Acne Spironolactone vs doxyCycline Efficacy (FASCE) Study","volume":"104","author":"Nguyen","year":"2024","journal-title":"Acta Derm.-Venereol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1468-3083.2011.04384.x","article-title":"Facial sebum affects the development of acne, especially the distribution of inflammatory acne","volume":"27","author":"Choi","year":"2013","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/dtb.2023.000051","article-title":"Managing acne vulgaris: An update","volume":"62","author":"Santer","year":"2023","journal-title":"Drug Ther. Bull."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s10103-023-03855-6","article-title":"Fractional CO2 laser versus 1064-nm long-pulsed Nd: YAG laser for inflammatory acne vulgaris treatment: A randomized clinical trial","volume":"38","author":"Hammoda","year":"2023","journal-title":"Lasers Med. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"131","DOI":"10.2147\/PROM.S451537","article-title":"Validation and Cultural Adaptation of the Sinhala Translation of the Cardiff Acne Disability Index (CADI)","volume":"15","author":"Liyanage","year":"2024","journal-title":"Patient Relat. Outcome Meas."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Baroud, S., Wu, J., and Zouboulis, C.C. (2021). Acne Syndromes and Mosaicism. Biomedicines, 9.","DOI":"10.3390\/biomedicines9111735"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"adv00310","DOI":"10.2340\/00015555-3666","article-title":"Combination Treatment with Human Adipose Tissue Stem Cell-derived Exosomes and Fractional CO2 Laser for Acne Scars: A 12-week Prospective, Double-blind, Randomized, Split-face Study","volume":"100","author":"Kwon","year":"2020","journal-title":"Acta Derm.-Venereol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s13555-021-00552-6","article-title":"Updated Treatment for Acne: Targeted Therapy Based on Pathogenesis","volume":"11","author":"Kurokawa","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Kulthanan, K., Trakanwittayarak, S., Tuchindaet, P., Chularojanamontri, L., Limphoka, P., and Varothai, S. (2020). A Double-Blinded, Randomized, Vehicle-Controlled Study of the Efficacy of Moisturizer Containing Licochalcone A, Decanediol, L-Carnitine, and Salicylic Acid for Prevention of Acne Relapse in Asian Population. Biomed Res. Int., 2020.","DOI":"10.1155\/2020\/2857812"},{"key":"ref_16","first-page":"649","article-title":"Tr\u0105dzik zwyczajny: Patogeneza i leczenie. Konsensus Polskiego Towarzystwa Dermatologicznego","volume":"99","author":"Szepietowski","year":"2012","journal-title":"Prz. Dermatol."},{"key":"ref_17","first-page":"6","article-title":"Tr\u0105dzik pospolity\u2014Najcz\u0119stsza dermatoza os\u00f3b m\u0142odych","volume":"2","year":"2019","journal-title":"Wiad. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/exd.14172","article-title":"Endocrinology and immunology of acne: Two sides of the same coin","volume":"29","author":"Zouboulis","year":"2020","journal-title":"Exp. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1182\/blood-2010-02-258558","article-title":"Nomenclature of monocytes and dendritic cells in blood","volume":"116","author":"Ancuta","year":"2010","journal-title":"Blood"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1111\/exd.14394","article-title":"Cutibacterium acnes: Much ado about maybe nothing much","volume":"30","author":"Goh","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Huang, L., Yang, S., Yu, X., Fang, F., Zhu, L., Wang, L., Zhang, X., Yang, C., Qian, Q., and Zhu, T. (2024). Association of different cell types and inflammation in early acne vulgaris. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1275269"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Eliasse, Y., Leveque, E., Garidou, L., Battut, L., McKenzie, B., Nocera, T., Redoules, D., and Espinosa, E. (2021). IL-17+ Mast Cell\/T Helper Cell Axis in the Early Stages of Acne. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.740540"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/jocd.13485","article-title":"Tissue expression of IL-17A and FOXP3 in acne vulgaris patients","volume":"20","author":"Farag","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_24","first-page":"e101449","article-title":"Proteomic Analysis Reveals an Increase of Neutrophils and TH17-related Proteins Expression in Severe Nodular Acne Lesions of the Back","volume":"6","author":"Carlavan","year":"2020","journal-title":"J. Skin Stem Cell"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Yu, H., Zhang, B., Zhan, Y., Yi, Y., Jiang, Q., Zhang, Q., Wu, Y., and Wu, M. (2024). Neutrophil extracellular trap-related mechanisms in acne vulgaris inspire a novel treatment strategy with adipose-derived stem cells. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-51931-w"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Feng, Y., Li, J., Mo, X., and Ju, Q. (2024). Macrophages in acne vulgaris: Mediating phagocytosis, inflammation, scar formation, and therapeutic implications. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1355455"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jdermsci.2021.08.008","article-title":"Multiple roles of macrophage in skin","volume":"104","author":"Nakai","year":"2021","journal-title":"J. Dermatol. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s42269-019-0227-2","article-title":"Toll-like receptors activation, signaling, and targeting: An overview","volume":"43","author":"Sibaii","year":"2019","journal-title":"Bull. Natl. Res. Cent."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mayslich, C., Grange, P.A., and Dupin, N. (2021). Cutibacterium acnes as an Opportunistic Pathogen: An Update of Its Virulence-Associated Factors. Microorganisms, 9.","DOI":"10.3390\/microorganisms9020303"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zhang, B., Choi, Y.M., Lee, J., An, I.S., Li, L., He, C., Dong, Y., Bae, S., and Meng, H. (2019). Toll-like receptor 2 plays a critical role in pathogenesis of acne vulgaris. Biomed. Dermatol., 3.","DOI":"10.1186\/s41702-019-0042-2"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1097\/MEG.0b013e328365a447","article-title":"In patients with liver cirrhosis, proinflammatory interleukins correlate with health-related quality of life irrespective of minimal hepatic encephalopathy","volume":"25","author":"Wunsch","year":"2013","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1128\/IAI.72.2.788-794.2004","article-title":"Role of Toll-Like Receptor 4 in Gram-Positive and Gram-Negative Pneumonia inMice","volume":"72","author":"Branger","year":"2004","journal-title":"Infect. Immun."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Noh, H.H., Shin, S.H., Roh, Y.J., Moon, N.J., Seo, S.J., and Park, K.Y. (2022). Particulate matter increases Cutibacterium acnes-induced inflammation in human epidermal keratinocytes via the TLR4\/NF-\u03baB pathway. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268595"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/(SICI)1097-0320(19990215)38:1<44::AID-CYTO8>3.0.CO;2-Q","article-title":"Mean Fluorescence Intensity of Dual Stained Cells","volume":"38","author":"Isaac","year":"1999","journal-title":"Cytometry"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Tang, T., Xu, Y., Wang, L., and Zhang, P. (2023). In vitro acne disease model from inertial focusing effect for studying the interactions between sebocyte glands and macrophages. Biotechnol. J., 18.","DOI":"10.1002\/biot.202300108"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1824624","DOI":"10.1155\/2019\/1824624","article-title":"The Role of Toll-like Receptors in Skin Host Defense, Psoriasis, and Atopic Dermatitis","volume":"2019","author":"Sun","year":"2019","journal-title":"J. Immunol. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s12016-013-8402-y","article-title":"TLR2 and TLR4 in autoimmune diseases: A comprehensive review","volume":"47","author":"Liu","year":"2014","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"76","DOI":"10.5507\/bp.2015.016","article-title":"TLR2 and TLR4 expression on CD14++ and CD14+ monocyte subtypes in adult-onset autoimmune diabetes","volume":"160","author":"Cejkova","year":"2016","journal-title":"Biomed. Pap. Med. Fac. Palacky Univ. Olomouc"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/10799893.2020.1805626","article-title":"A strategic review on the involvement of receptors, transcription factors and hormones in acne pathogenesis","volume":"41","author":"Bharti","year":"2021","journal-title":"J. Recept. Signal Transduct."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"645","DOI":"10.21037\/atm-21-5924","article-title":"A narrative review of research progress on the role of NLRP3 inflammasome in acne vulgaris","volume":"10","author":"Zhu","year":"2022","journal-title":"Ann. Transl. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"300","DOI":"10.3109\/15569527.2015.1120742","article-title":"Comparison of TLR-2, TLR-4, and antimicrobial peptide levels in different lesions of acne vulgaris","volume":"35","author":"Ozlu","year":"2016","journal-title":"Cutan. Ocul. Toxicol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Lee, H., Hwang, D., Lee, M., Lee, J., Cho, S., Kim, T.J., and Kim, H.S. (2022). Micro-Current Stimulation Suppresses Inflammatory Responses in Peptidoglycan-Treated Raw 264.7 Macrophages and Propionibacterium acnes-Induced Skin Inflammation via TLR2\/NF-\u03baB Signaling Pathway. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23052508"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1038\/jid.2012.111","article-title":"Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients","volume":"132","author":"Dispenza","year":"2012","journal-title":"J. Investig. Dermatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6449\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:44:51Z","timestamp":1760035491000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":43,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14186449"],"URL":"https:\/\/doi.org\/10.3390\/jcm14186449","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,9,12]]}}}