New study cites abnormal immune response as possible cause of rosacea

Although the mechanisms of rosacea are still not fully understood, a study published in Nature Medicine in October 2007 suggests that rosacea may be caused in part by an abnormal immune response triggered by cathelicidin.¹

Cathelicidins are peptides (a type of protein) believed to function as natural antibiotics, working within the immune system to defend against bacterial infection and against some viruses.

The study shows that rosacea sufferers not only have an increased amount of cathelicidin present in their facial skin, but also process it abnormally. Study team member Dr. Richard Gallo observed that this aberration may explain why certain things that may pose no threat among non-rosacea sufferers can, in the rosacea sufferer, be interpreted as threats and cause cathelicidin to overreact to a perceived threat, triggering an excessive immune response and the inflammation that comes with it. Interestingly, other inflammatory diseases operate on the same principle. Patients with an inflammatory skin condition called atopic dermatitis also had more cathelicidin present on their skin.

While not conclusive, Dr. Gallo's study adds a new piece to the puzzle of what causes this disease. Nevertheless, the cause of rosacea remains unknown.

For treating the symptoms of rosacea (i.e., the flushing, blushing, pimples, and bumps), there are different medications currently available on the market. If you have rosacea or think you might have it, ask your dermatologist about the best treatment option for you.

1. Yamasaki K, Di Nardo, et al. Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nature Medicine.2007.

A new study uncovers a potential down side to ATPs

Researchers have found that one of the most common and hard-working substances in your body may have a darker side for rosacea patients.

The researchers have discovered that when adenosine 5'-triphosphate (ATP) — a transmitter in the body and carrier of chemical energy — is released into the skin by the nerves, a variety of microscopic events may occur in rosacea patients that are theorized to ultimately lead to the bumps and pimples.¹

"Sometimes too much of a good thing turns out to be bad," noted Dr. Richard Granstein, chairman of dermatology at Cornell University, lead investigator in the research funded by the National Rosacea Society (NRS). "The key to improving therapy is to identify those inflammatory pathways involved with rosacea so they can be better controlled."

While ATPs have many functions in the body, its role in the development of rosacea may be related to its job as a messenger for your nerves. Your nervous system regulates blood flow to the skin and uses ATP to prompt the dilation of blood vessels (in some cases this may occur after you've been exposed to rosacea triggers such as sunlight, emotional stress or alcohol). This process is thought to result in rosacea symptoms such as flushing and redness of the face.

"As we continue to learn more about the biochemical processes that lead to rosacea, we should increasingly be able to identify how signs and symptoms occur in order to develop appropriate means to prevent them," Dr. Granstein said.

1. Seiffert K, Ding W, Wagner JA, Granstein RD. ATP enhances the production of inflammatory mediators by a human dermal endothelial cell line via purinergic receptor signaling. Journal of Investigative Dermatology. 2006.