Skip to main content Skip to main navigation menu Skip to site footer

A Randomised Controlled Trial: The effect of oral astaxanthin as an anti-inflammatory agent on serum level of e-selectin in acne vulgaris

  • Muhammad Eko irawanto ,
  • Harijono Kariosentono ,
  • Bambang Purwanto ,
  • Eti Poncorini Pamungkasari ,


Background: E-selectin plays a pivotal role in the inflammatory response of acne. Astaxanthin (AST), an supplement claimed having anti-inflammatory and antioxidant properties, has potential in inflammatory skin therapy. This study aims to determine the effect of oral AST as an anti-inflammatory agent on the serum level of e-selectin in acne vulgaris. 

Methods: This is a double-blind, randomized controlled trial study with a pretest and posttest control group design. The participants were 34 acne vulgaris patients with inflammatory lesions (papulopustular acne). The participants are randomly assigned to the treatment or control group to receive oral tablet of 4 mg of AST or placebo in addition to standard acne therapy of tretinoin cream 0.025% and clindamycin cream 1.2%. Each group was measured for the serum level of E-selectin before therapy (pretest) and after one month of therapy (posttest). 

Results: The pretest and posttest level of the mean serum e-selectin in the treatment  group were 50.21 ± 21.12 ng/ml and 50.04 ± 22.99 ng/ml, respectively. There is no significant difference between the pretest and posttest of the mean e-selectin level in the treatment group (p=0.943). While, the pretest and posttest of mean serum e-selectin level in control group were 57.84 ± 20.71 ng/ml and 55.87 ± 15.98 ng/ml, respectively. There is no significant difference between the pretest and posttest of the mean e-selectin level in the control group (p=0.453). There was a decrease in the mean serum e-selectin level of the treatment and control groups one month after therapy. However, the decrease of the mean e-selectin level between treatment and control group is not significantly different (p=0.547).

Conclusion: The addition of oral AST to standard acne therapy shows no significant difference in reducing the serum e-selectin level compared to placebo.


  1. Korkmaz S, Fıçıcıoğlu SK. Calprotectin can play an inflammatory role in acne vulgaris. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2018;35(4):397.
  2. Agak GW, Qin M, Nobe J, Kim M-H, Krutzik SR, Tristan GR, et al. Propionibacterium acnes induces an IL-17 response in acne vulgaris that is regulated by vitamin A and vitamin D. Journal of Investigative Dermatology. 2014;134(2):366-73.
  3. Bhat YJ, Latief I, Hassan I. Update on etiopathogenesis and treatment of Acne. Indian Journal of Dermatology, Venereology, and Leprology. 2017;83(3):298.
  4. Mochtar M, Murasmita A, Irawanto ME, Julianto I, Kariosentono H, Waskito F. The Difference in Interleukin-19 Serum on Degrees of Acne Vulgaris Severity. International journal of inflammation. 2018;2018.
  5. Szabó K, Tax G, Teodorescu-Brinzeu D, Koreck A, Kemény L. TNFα gene polymorphisms in the pathogenesis of acne vulgaris. Archives of dermatological research. 2011;303(1):19-27.
  6. Liu T, Zhang L, Joo D, Sun S-C. NF-κB signaling in inflammation. Signal transduction and targeted therapy. 2017;2:17023.
  7. Lee S, Bai S. Lee Ks, Namkng s, Na Hj, Ha KS, et al. Astaxanthin Inhibits Nitric Oxide Production and Inflammatory Gene Expression by Suppressing I (kappa) B Kinase-dependent NF-(kappa) B Activation. Mol Cells. 2003;16(1):97-105.
  8. Zouboulis C, Jourdan E, Picardo M. Acne is an inflammatory disease and alterations of sebum composition initiate acne lesions. Journal of the European Academy of Dermatology and Venereology. 2014;28(5):527-32.
  9. Chew W, Mathison BD, Kimble LL, Mixter PF, Chew BP. Astaxanthin decreases inflammatory biomarkers associated with cardiovascular disease in human umbilical vein endothelial cells. Am J Adv Food Sci Technol. 2013;1:1-17.
  10. Zhong L, Simard MJ, Huot J. Endothelial microRNAs regulating the NF-κB pathway and cell adhesion molecules during inflammation. The FASEB Journal. 2018;32(8):4070-84.
  11. Maria AG, Graziano R, Nicolantonio DO. Carotenoids: potential allies of cardiovascular health? Food & nutrition research. 2015;59(1):26762.
  12. Abbas AK, Lichtman AH, Pillai S. Cellular and molecular immunology E-book: Elsevier Health Sciences; 2014.
  13. Layton A, Morris C, Cunliffe W, Ingham E. Immunohistochemical investigation of evolving inflammation in lesions of acne vulgaris. Experimental dermatology. 1998;7(4):191-7.
  14. Park JH, Yeo IJ, Han JH, Suh JW, Lee HP, Hong JT. Antiâ€inflammatory effect of astaxanthin in phthalic anhydrideâ€induced atopic dermatitis animal model. Experimental dermatology. 2018;27(4):378-85.
  15. Farruggia C, Kim M-B, Bae M, Lee Y, Pham TX, Yang Y, et al. Astaxanthin exerts anti-inflammatory and antioxidant effects in macrophages in NRF2-dependent and independent manners. The Journal of nutritional biochemistry. 2018;62:202-9.
  16. Priyadarshini L, Aggarwal A. Astaxanthin inhibits cytokines production and inflammatory gene expression by suppressing IκB kinase-dependent nuclear factor κB activation in pre and postpartum Murrah buffaloes during different seasons. Veterinary world. 2018;11(6):782.
  17. Davinelli S, Nielsen ME, Scapagnini G. Astaxanthin in skin health, repair, and disease: A comprehensive review. Nutrients. 2018;10(4):522.
  18. Gerondakis S, Fulford TS, Messina NL, Grumont RJ. NF-κB control of T cell development. Nature immunology. 2014;15(1):15.
  19. Dispenza MC, Wolpert EB, Gilliland KL, Dai JP, Cong Z, Nelson AM, et al. Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients. Journal of Investigative Dermatology. 2012;132(9):2198-205.
  20. Dreno B, Gollnick H, Kang S, Thiboutot D, Bettoli V, Torres V, et al. Understanding innate immunity and inflammation in acne: implications for management. Journal of the European Academy of Dermatology and Venereology. 2015;29:3-11.
  21. Kurokawa I, Danby FW, Ju Q, Wang X, Xiang LF, Xia L, et al. New developments in our understanding of acne pathogenesis and treatment. Experimental dermatology. 2009;18(10):821-32.

How to Cite

irawanto, M. E., Kariosentono, H., Purwanto, B., & Pamungkasari, E. P. (2020). A Randomised Controlled Trial: The effect of oral astaxanthin as an anti-inflammatory agent on serum level of e-selectin in acne vulgaris. Bali Medical Journal, 9(1), 41–43.




Search Panel

Muhammad Eko irawanto
Google Scholar
BMJ Journal

Harijono Kariosentono
Google Scholar
BMJ Journal

Bambang Purwanto
Google Scholar
BMJ Journal

Eti Poncorini Pamungkasari
Google Scholar
BMJ Journal