The molecular pathology of rosacea

Abstract

Rosacea is a common and chronic inflammatory skin disease that affects over 10 million Americans. Although the phenotypes of rosacea are clinically heterogeneous, they are all related by the presence of chronic facial skin inflammation. Until recently, the pathophysiology of this disease has been poorly understood and limited to descriptions of factors that exacerbate or improve this disorder. Recent molecular studies suggest that an altered innate immune response is involved in the pathogenesis of the vascular and inflammatory disease seen in patients with rosacea. These findings may help explain the benefits of current treatments and suggest new therapeutic strategies helpful for alleviating this disease. This article discusses the possible molecular mechanisms for the pathogenesis of rosacea from current clinical observations and laboratory research.

Ocular rosacea: a review

“…Based on the observation of a single molecule that presents both vasoactive and pro-inflammatory actions, researchers decided to study the behavior of such molecule in rosacea. As hypothesized, these peptides were found in greater levels in the skin of individuals with rosacea than in normal facial skin (25,27,28) . Moreover, the cathelicidin peptides found in rosacea patients were not only more abundant but were different from those found in normal individuals (25) .…”

“…As hypothesized, these peptides were found in greater levels in the skin of individuals with rosacea than in normal facial skin (25,27,28) . Moreover, the cathelicidin peptides found in rosacea patients were not only more abundant but were different from those found in normal individuals (25) . These forms of cathelicidin peptides are known for its role in natural host defense against infections and in promoting leukocyte chemotaxis, angiogenesis, and extracellular matrix component expression (27) .…”

“…Recently, studies have shown that disease exacerbation is stimulated by normal external environmental factors, leading to unique activation of pro-inflammatory systems as well as innate immune responses (23,25,26) . Molecular studies propose that the enhanced sensitivity of patients with rosacea may be caused by abnormal recognition of common environmental stimuli.…”

“…Molecular studies propose that the enhanced sensitivity of patients with rosacea may be caused by abnormal recognition of common environmental stimuli. Factors that trigger the innate immune system lead to an increase in the expression of certain cytokines and anti-microbial molecules in the skin (25,27) . Cathelicidin, one of these antimicrobial peptides, has both vasoactive and pro-inflammatory actions and is implicated in the pathogenesis of this disorder.…”

Blushing in rosacea sufferers

“…Yamasaki and Gallo [25] proposed recently that the innate immune system triggers an abnormal inflammatory reaction that mediates the symptoms of rosacea [26,27]. If so, erythema may be due to chronic inflammation.…”