101
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Clinical and Histologic Effects of Fractional Microneedling Radiofrequency Treatment on Rosacea. Dermatol Surg 2017; 42:1362-1369. [PMID: 27608206 DOI: 10.1097/dss.0000000000000888] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fractional microneedling radiofrequency (FMR) is an emerging treatment modality, but its effect on rosacea has not been studied yet. OBJECTIVE To investigate the potential impact of FMR treatment on clinical improvement and histologic changes in rosacea patients. MATERIALS AND METHODS A 12-week, prospective, randomized, split-face clinical trial was conducted. Two sessions of FMR were performed on one side of the cheeks with 4-week interval and the other side remained untreated. Erythema index from DermaSpectrometer and a* value from Spectrophotometer CM-2002 were measured at each visit for the objective measurement of erythema. Histologic analysis of skin samples was also carried out. RESULTS Clinical evaluation and photometric measurement revealed the reduction of redness in the treated side compared with untreated side and baseline. Erythema index decreased 13.6% and a* value decreased 6.8% at Week 12 compared with baseline. Reduced expression of markers related to inflammation, innate immunity, and angiogenesis was observed in immunohistochemical staining of tissue obtained after FMR treatment. CONCLUSION Fractional microneedling radiofrequency treatment showed modest clinical and histologic improvement of rosacea, and it might be used as an alternative or in combination with other treatment methods.
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102
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Wang G, Wang K. The Ca2+-Permeable Cation Transient Receptor Potential TRPV3 Channel: An Emerging Pivotal Target for Itch and Skin Diseases. Mol Pharmacol 2017; 92:193-200. [DOI: 10.1124/mol.116.107946] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/31/2017] [Indexed: 12/15/2022] Open
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103
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Abstract
Acne, one of the most common skin diseases, affects approximately 85% of the adolescent population, and occurs most prominently at skin sites with a high density of sebaceous glands such as the face, back, and chest. Although often considered a disease of teenagers, acne is occurring at an increasingly early age. Rosacea is a chronic facial inflammatory dermatosis characterized by flushing (or transient facial erythema), persistent central facial erythema, inflammatory papules/pustules, and telangiectasia. Both acne and rosacea have a multifactorial pathology that is incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and altered bacterial colonization with Propionibacterium acnes are considered to be the underlying disease mechanisms in acne, while the multifactorial pathology of rosacea is thought to involve both vasoactive and neurocutaneous mechanisms. Several advances have taken place in the past decade in the research field of acne and rosacea, encompassing pathogenesis and epidemiology, as well as the development of new therapeutic interventions. In this article, we provide an overview of current perspectives on the pathogenesis and treatment of acne and rosacea, including a summary of findings from recent landmark pathophysiology studies considered to have important implications for future clinical practice. The advancement of our knowledge of the different pathways and regulatory mechanisms underlying acne and rosacea is thought to lead to further advances in the therapeutic pipeline for both conditions, ultimately providing a greater array of treatments to address gaps in current management practices.
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Affiliation(s)
| | | | - Jerry Tan
- University of Western Ontario, Windsor, ON, Canada
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104
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Tan J, Almeida LMC, Bewley A, Cribier B, Dlova NC, Gallo R, Kautz G, Mannis M, Oon HH, Rajagopalan M, Steinhoff M, Thiboutot D, Troielli P, Webster G, Wu Y, van Zuuren EJ, Schaller M. Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea COnsensus (ROSCO) panel. Br J Dermatol 2017; 176:431-438. [PMID: 27718519 DOI: 10.1111/bjd.15122] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rosacea is currently diagnosed by consensus-defined primary and secondary features and managed by subtype. However, individual features (phenotypes) can span multiple subtypes, which has implications for clinical practice and research. Adopting a phenotype-led approach may facilitate patient-centred management. OBJECTIVES To advance clinical practice by obtaining international consensus to establish a phenotype-led rosacea diagnosis and classification scheme with global representation. METHODS Seventeen dermatologists and three ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and severity evaluation. All voting was electronic and blinded. RESULTS Consensus was achieved for transitioning to a phenotype-based approach to rosacea diagnosis and classification. The following two features were independently considered diagnostic for rosacea: (i) persistent, centrofacial erythema associated with periodic intensification; and (ii) phymatous changes. Flushing, telangiectasia, inflammatory lesions and ocular manifestations were not considered to be individually diagnostic. The panel reached agreement on dimensions for phenotype severity measures and established the importance of assessing the patient burden of rosacea. CONCLUSIONS The panel recommended an approach for diagnosis and classification of rosacea based on disease phenotype.
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Affiliation(s)
- J Tan
- Department of Medicine, University of Western Ontario, Windsor, ON, Canada
| | - L M C Almeida
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - A Bewley
- Whipps Cross University Hospital, London, U.K.,Royal London Hospital, London, U.K
| | - B Cribier
- Department of Dermatology, Hopitaux Universitaires de Strasbourg, Strasbourg, Alsace, France
| | - N C Dlova
- Department of Dermatology, University of KwaZulu-Natal College of Health Sciences, Durban, South Africa
| | - R Gallo
- Department of Dermatology, University of California San Diego, La Jolla, CA, U.S.A
| | - G Kautz
- Haut- und Laserklinik, Konz, Germany
| | - M Mannis
- Department of Ophthalmology and Vision Science, University of California Davis, Davis, CA, U.S.A
| | - H H Oon
- National Skin Centre, Singapore, Singapore
| | - M Rajagopalan
- Department of Dermatology, Apollo Hospitals Enterprise, Chennai, Tamil Nadu, India
| | - M Steinhoff
- Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| | - D Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, PA, U.S.A
| | - P Troielli
- Faculty of Dermatology, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - G Webster
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, U.S.A
| | - Y Wu
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - E J van Zuuren
- Department of Dermatology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M Schaller
- Department of Dermatology, Universitatsklinikum Tubingen, Tubingen, Baden-Württemberg, Germany
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105
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Anderson MS, Nadkarni A, Cardwell LA, Alinia H, Feldman SR. Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptability. Patient Prefer Adherence 2017; 11:1143-1150. [PMID: 28740369 PMCID: PMC5505675 DOI: 10.2147/ppa.s115708] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Brimonidine tartrate is a highly selective alpha 2 agonist that induces direct vasoconstriction of small arteries and veins, thereby reducing vasodilation and edema. OBJECTIVE To review the current literature regarding the safety, efficacy, and patient acceptability of brimonidine 0.33% gel. METHODS A PubMed search was performed using the terms brimonidine 0.33% gel, rosacea, safety, efficacy, and acceptability. Peer-reviewed clinical trials and case reports from 2012 to 2016 were screened for inclusion of safety, efficacy, and/or patient acceptability data. RESULTS Brimonidine topical gel 0.33% is associated with mild, transient skin-related adverse reactions. Efficacy may be achieved within 30 minutes of administration with maximal reductions in erythema 3-6 hours after administration. Patient satisfaction with use of brimonidine topical gel is superior to vehicle gel for facial appearance, treatment effect, facial redness, and daily control of facial redness. LIMITATIONS Studies were typically limited to 1-year follow-up. Only one study has examined the use of brimonidine topical gel in combination with other rosacea and acne medications. DISCUSSION Brimonidine topical gel 0.33% is a safe, effective, and patient-accepted treatment for facial erythema of rosacea.
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Affiliation(s)
| | - Anish Nadkarni
- Department of Dermatology, Center for Dermatology Research
| | - Leah A Cardwell
- Department of Dermatology, Center for Dermatology Research
- Correspondence: Leah A Cardwell, Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA, Tel +1 313 790 5469, Fax +1 336 716 7732, Email
| | - Hossein Alinia
- Department of Dermatology, Center for Dermatology Research
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research
- Department of Pathology
- Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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106
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Blume-Peytavi U, Tan J, Tennstedt D, Boralevi F, Fabbrocini G, Torrelo A, Soares-Oliveira R, Haftek M, Rossi AB, Thouvenin MD, Mangold J, Galliano MF, Hernandez-Pigeon H, Aries MF, Rouvrais C, Bessou-Touya S, Duplan H, Castex-Rizzi N, Mengeaud V, Ferret PJ, Clouet E, Saint Aroman M, Carrasco C, Coutanceau C, Guiraud B, Boyal S, Herman A, Delga H, Biniek K, Dauskardt R. Fragility of epidermis in newborns, children and adolescents. J Eur Acad Dermatol Venereol 2016; 30 Suppl 4:3-56. [PMID: 27062556 DOI: 10.1111/jdv.13636] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/10/2016] [Accepted: 02/17/2016] [Indexed: 12/18/2022]
Abstract
Within their first days of life, newborns' skin undergoes various adaptation processes needed to accommodate the transition from the wet uterine environment to the dry atmosphere. The skin of newborns and infants is considered as a physiological fragile skin, a skin with lower resistance to aggressions. Fragile skin is divided into four categories up to its origin: physiological fragile skin (age, location), pathological fragile skin (acute and chronic), circumstantial fragile skin (due to environmental extrinsic factors or intrinsic factors such as stress) and iatrogenic fragile skin. Extensive research of the past 10 years have proven evidence that at birth albeit showing a nearly perfect appearance, newborn skin is structurally and functionally immature compared to adult skin undergoing a physiological maturation process after birth at least throughout the first year of life. This article is an overview of all known data about fragility of epidermis in 'fragile populations': newborns, children and adolescents. It includes the recent pathological, pathophysiological and clinical data about fragility of epidermis in various dermatological diseases, such as atopic dermatitis, acne, rosacea, contact dermatitis, irritative dermatitis and focus on UV protection.
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Affiliation(s)
- U Blume-Peytavi
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité-Universitätsmedizin, Berlin, Germany
| | - J Tan
- Department of Medicine, Faculty of Medicine, Schulich School of Medicine and Dentistry, Western University, Windsor campus, Windsor, ON, Canada.,Windsor Clinical Research Inc., Windsor campus, Windsor, ON, Canada
| | - D Tennstedt
- Department of Dermatology, Saint-Luc University Clinics, Brussels, Belgium
| | - F Boralevi
- Pediatric Dermatology, Pellegrin Hospital, Bordeaux, France
| | - G Fabbrocini
- Department of Dermatology, University Hospital of Naples, Naples, Italy
| | - A Torrelo
- Pediatric Dermatology, Hospital del Niño Jesús, Madrid, Spain
| | | | - M Haftek
- University Lyon 1, Lyon, France.,University Lyon 1, EA4169, "Fundamental, clinical and therapeutic aspects of the skin barrier function", Lyon, France
| | - A B Rossi
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Department of Dermatology, Toulouse University hospital, France
| | - M D Thouvenin
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - J Mangold
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - M F Galliano
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - H Hernandez-Pigeon
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - M F Aries
- Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - C Rouvrais
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - S Bessou-Touya
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Medical Department, Pierre Fabre Research and Laboratoires Dermatologiques A-Derma, Lavaur, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - H Duplan
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - N Castex-Rizzi
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - V Mengeaud
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France
| | - P J Ferret
- Pierre Fabre Dermo-Cosmétique Research & Development, Toxicology Division, Vigoulet-Auzil, France.,Pierre Fabre Dermo-Cosmétique Research & Developement Center, Toxicology division, Vigoulet, France
| | - E Clouet
- Pierre Fabre Dermo-Cosmétique Research & Development, Toxicology Division, Vigoulet-Auzil, France.,Pierre Fabre Dermo-Cosmétique Research & Developement Center, Toxicology division, Vigoulet, France
| | | | - C Carrasco
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique Research and Development Center, Pharmacology Division, Toulouse, France.,Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - C Coutanceau
- Medical Department, Pierre Fabre Research and Laboratoires Dermatologiques A-Derma, Lavaur, France
| | - B Guiraud
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - S Boyal
- Windsor Clinical Research Inc., Windsor campus, Windsor, ON, Canada
| | - A Herman
- Department of Dermatology, Saint-Luc University Clinics, Brussels, Belgium
| | - H Delga
- Pierre Fabre Dermo-Cosmétique, Pierre Fabre Research and Development Center, Pharmacology Division, Toulouse, France
| | - K Biniek
- Department of Materials Science and Engineering, Stanford University hospital, Stanford, CA, USA
| | - R Dauskardt
- Department of Materials Science and Engineering, Stanford University hospital, Stanford, CA, USA
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107
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Baltabaev MK, Shakirova AT, Baltabaev AM. Clinical efficasy of L-arginine and ursodeoxycholic acid in the complex treatment of rosacea. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-6-34-42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Under clinical observation were 77 patients suffered from different clinical forms of acne rosacea that using L-arginin and Ursodeoxycholic acid had treated All patients have functional and organic disturbances of hepatobiliary system before treatment. Complex treatment including L-arginin and Ursodeoxycholic acid led to improvement of balance of liver enzymes and lipid fractions in peripheric blood of investigated patients.
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108
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TRP Channels in Skin Biology and Pathophysiology. Pharmaceuticals (Basel) 2016; 9:ph9040077. [PMID: 27983625 PMCID: PMC5198052 DOI: 10.3390/ph9040077] [Citation(s) in RCA: 334] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 11/17/2022] Open
Abstract
Ion channels of the Transient Receptor Potential (TRP) family mediate the influx of monovalent and/or divalent cations into cells in response to a host of chemical or physical stimuli. In the skin, TRP channels are expressed in many cell types, including keratinocytes, sensory neurons, melanocytes, and immune/inflammatory cells. Within these diverse cell types, TRP channels participate in physiological processes ranging from sensation to skin homeostasis. In addition, there is a growing body of evidence implicating abnormal TRP channel function, as a product of excessive or deficient channel activity, in pathological skin conditions such as chronic pain and itch, dermatitis, vitiligo, alopecia, wound healing, skin carcinogenesis, and skin barrier compromise. These diverse functions, coupled with the fact that many TRP channels possess pharmacologically accessible sites, make this family of proteins appealing therapeutic targets for skin disorders.
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109
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Mascarenhas NL, Wang Z, Chang YL, Di Nardo A. TRPV4 Mediates Mast Cell Activation in Cathelicidin-Induced Rosacea Inflammation. J Invest Dermatol 2016; 137:972-975. [PMID: 27908695 DOI: 10.1016/j.jid.2016.10.046] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/10/2016] [Accepted: 10/10/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Nicholas L Mascarenhas
- Department of Dermatology, School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Zhenping Wang
- Department of Dermatology, School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Yu-Ling Chang
- Department of Dermatology, School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Anna Di Nardo
- Department of Dermatology, School of Medicine, University of California, San Diego, La Jolla, California, USA.
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110
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Multidisciplinary Consideration of Potential Pathophysiologic Mechanisms of Paradoxical Erythema with Topical Brimonidine Therapy. Adv Ther 2016; 33:1885-1895. [PMID: 27562835 PMCID: PMC5083782 DOI: 10.1007/s12325-016-0404-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Indexed: 01/14/2023]
Abstract
Rosacea is a chronic inflammatory disease with transient and non-transient redness as key characteristics. Brimonidine is a selective α2-adrenergic receptor (AR) agonist approved for persistent facial erythema of rosacea based on significant efficacy and good safety data. The majority of patients treated with brimonidine report a benefit; however, there have been sporadic reports of worsening erythema after the initial response. A group of dermatologists, receptor physiology, and neuroimmunology scientists met to explore potential mechanisms contributing to side effects as well as differences in efficacy. We propose the following could contribute to erythema after application: (1) local inflammation and perivascular inflammatory cells with abnormally functioning ARs may lead to vasodilatation; (2) abnormal saturation and cells expressing different AR subtypes with varying ligand affinity; (3) barrier dysfunction and increased skin concentrations of brimonidine with increased actions at endothelial and presynaptic receptors, resulting in increased vasodilation; and (4) genetic predisposition and receptor polymorphism(s) leading to different smooth muscle responses. Approximately 80% of patients treated with brimonidine experience a significant improvement without erythema worsening as an adverse event. Attention to optimizing skin barrier function, setting patient expectations, and strategies to minimize potential problems may possibly reduce further the number of patients who experience side effects. FUNDING Galderma International S.A.S., Paris, France.
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111
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Misery L, Loser K, Ständer S. Sensitive skin. J Eur Acad Dermatol Venereol 2016; 30 Suppl 1:2-8. [PMID: 26805416 DOI: 10.1111/jdv.13532] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 12/15/2022]
Abstract
Sensitive skin is a clinical condition defined by the self-reported facial presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus. Sensitive skin may occur in individuals with normal skin, with skin barrier disturbance, or as a part of the symptoms associated with facial dermatoses such as rosacea, atopic dermatitis and psoriasis. Although experimental studies are still pending, the symptoms of sensitive skin suggest the involvement of cutaneous nerve fibres and neuronal, as well as epidermal, thermochannels. Many individuals with sensitive skin report worsening symptoms due to environmental factors. It is thought that this might be attributed to the thermochannel TRPV1, as it typically responds to exogenous, endogenous, physical and chemical stimuli. Barrier disruptions and immune mechanisms may also be involved. This review summarizes current knowledge on the epidemiology, potential mechanisms, clinics and therapy of sensitive skin.
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Affiliation(s)
- L Misery
- Department of Dermatology, University Hospital, Brest, France
| | - K Loser
- Department of Dermatology, University of Münster, Münster, Germany
| | - S Ständer
- Center for Chronic Pruritus (KCP), University of Münster, Münster, Germany
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112
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Abstract
Recent studies about the cutaneous barrier demonstrated consistent evidence that
the stratum corneum is a metabolically active structure and also has adaptive
functions, may play a regulatory role in the inflammatory response with
activation of keratinocytes, angiogenesis and fibroplasia, whose intensity
depends primarily on the intensity the stimulus. There are few studies
investigating the abnormalities of the skin barrier in rosacea, but the existing
data already show that there are changes resulting from inflammation, which can
generate a vicious circle caused a prolongation of flare-ups and worsening of
symptoms. This article aims to gather the most relevant literature data about
the characteristics and effects of the state of the skin barrier in rosacea.
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113
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Yadav M, Goswami C. TRPV3 mutants causing Olmsted Syndrome induce impaired cell adhesion and nonfunctional lysosomes. Channels (Austin) 2016; 11:196-208. [PMID: 27754757 DOI: 10.1080/19336950.2016.1249076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
TRPV3 is a non-selective cationic channel and is important for several physiological functions. It can be activated by physiological temperature and selective endogenous and exogenous compounds. TRPV3 is one of the key ion channel involved in Ca2+-signaling in keratinocyte and thus involved in skin-related functions. Recently, naturally occurring mutations in TRPV3, namely G573A, G573S, G573C and W692G have been detected which are linked with the development of pathophysiological conditions such as Olmsted Syndrome (OS) and other skin disorders. Our qualitative and quantitative data suggests that these naturally occurring TRPV3 mutants are mainly restricted in the ER. Expression of OS-mutants cause impaired vesicular trafficking resulting reduced surface localization of these mutants and other membrane proteins too. OS-mutants also cause reduced cell adhesion, altered distribution and less number of lysosomes. Our data confirms that TRPV3 is a lysosomal protein suggesting that Olmsted Syndrome is a lysosomal disorder. These findings may have a broad implication in the context of keratinocyte functions, skin-degeneration and in skin-cancer.
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Affiliation(s)
- Manoj Yadav
- a National Institute of Science Education and Research, Institute of Physics Campus , Bhubaneswar , Orissa , India.,b Homi Bhabha National Institute, Training School Complex , Mumbai , India
| | - Chandan Goswami
- a National Institute of Science Education and Research, Institute of Physics Campus , Bhubaneswar , Orissa , India.,b Homi Bhabha National Institute, Training School Complex , Mumbai , India
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114
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Holmes AD, Steinhoff M. Integrative concepts of rosacea pathophysiology, clinical presentation and new therapeutics. Exp Dermatol 2016; 26:659-667. [DOI: 10.1111/exd.13143] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2016] [Indexed: 12/13/2022]
Affiliation(s)
| | - Martin Steinhoff
- Department of Dermatology; UCD Charles Institute for Translational Dermatology; University College Dublin; Dublin Ireland
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115
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Woo YR, Lim JH, Cho DH, Park HJ. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition. Int J Mol Sci 2016; 17:ijms17091562. [PMID: 27649161 PMCID: PMC5037831 DOI: 10.3390/ijms17091562] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/23/2016] [Accepted: 09/07/2016] [Indexed: 01/21/2023] Open
Abstract
Rosacea is a chronic cutaneous inflammatory disease that affects the facial skin. Clinically, rosacea can be categorized into papulopustular, erythematotelangiectatic, ocular, and phymatous rosacea. However, the phenotypic presentations of rosacea are more heterogeneous. Although the pathophysiology of rosacea remains to be elucidated, immunologic alterations and neurovascular dysregulation are thought to have important roles in initiating and strengthening the clinical manifestations of rosacea. In this article, we present the possible molecular mechanisms of rosacea based on recent laboratory and clinical studies. We describe the genetic predisposition for rosacea along with its associated diseases, triggering factors, and suggested management options in detail based on the underlying molecular biology. Understanding the molecular pathomechanisms of rosacea will likely aid toward better comprehending its complex pathogenesis.
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Affiliation(s)
- Yu Ri Woo
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
| | - Ji Hong Lim
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
| | - Dae Ho Cho
- Department of Life Science, Sookmyung Women's University, Seoul 04310, Korea.
| | - Hyun Jeong Park
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
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116
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Broad LM, Mogg AJ, Eberle E, Tolley M, Li DL, Knopp KL. TRPV3 in Drug Development. Pharmaceuticals (Basel) 2016; 9:E55. [PMID: 27618069 PMCID: PMC5039508 DOI: 10.3390/ph9030055] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/19/2016] [Accepted: 08/31/2016] [Indexed: 02/01/2023] Open
Abstract
Transient receptor potential vanilloid 3 (TRPV3) is a member of the TRP (Transient Receptor Potential) super-family. It is a relatively underexplored member of the thermo-TRP sub-family (Figure 1), however, genetic mutations and use of gene knock-outs and selective pharmacological tools are helping to provide insights into its role and therapeutic potential. TRPV3 is highly expressed in skin, where it is implicated in skin physiology and pathophysiology, thermo-sensing and nociception. Gain of function TRPV3 mutations in rodent and man have enabled the role of TRPV3 in skin health and disease to be particularly well defined. Pre-clinical studies provide some rationale to support development of TRPV3 antagonists for therapeutic application for the treatment of inflammatory skin conditions, itch and pain. However, to date, only one compound directed towards block of the TRPV3 receptor (GRC15300) has progressed into clinical trials. Currently, there are no known clinical trials in progress employing a TRPV3 antagonist.
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Affiliation(s)
- Lisa M Broad
- Lilly Research Centre, Eli Lilly and Company Ltd., Erl Wood Manor, Windlesham, Surrey GU20 6PH, UK.
| | - Adrian J Mogg
- Lilly Research Centre, Eli Lilly and Company Ltd., Erl Wood Manor, Windlesham, Surrey GU20 6PH, UK.
| | - Elizabeth Eberle
- Covance Greenfield Laboratories, Greenfield, Indianapolis, IN 46140, USA.
| | - Marcia Tolley
- Covance Greenfield Laboratories, Greenfield, Indianapolis, IN 46140, USA.
| | - Dominic L Li
- Lilly Research Laboratories, Eli Lilly and Company Inc., Indianapolis, IN 46285, USA.
| | - Kelly L Knopp
- Lilly Research Laboratories, Eli Lilly and Company Inc., Indianapolis, IN 46285, USA.
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117
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Topical Ivermectin 10 mg/g and Oral Doxycycline 40 mg Modified-Release: Current Evidence on the Complementary Use of Anti-Inflammatory Rosacea Treatments. Adv Ther 2016; 33:1481-501. [PMID: 27432381 PMCID: PMC5020118 DOI: 10.1007/s12325-016-0380-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Indexed: 12/21/2022]
Abstract
Rosacea is a common, chronic inflammatory skin disease that can present with a variety of signs and symptoms. The potentially simultaneous occurrence of different signs and symptoms is due to different underlying inflammatory pathways, emphasizing the need for complementary treatment approaches. Topical ivermectin cream (10 mg/g) and systemic, oral anti-inflammatory doxycycline (40 mg modified-release) are both approved for the treatment of papulopustular rosacea (PPR). Whether or not a combined therapeutic approach may be more beneficial than monotherapy for patients with PPR remains to be tested. Here, we summarize underlying inflammatory pathways implicated in rosacea and clarify the impact of these two agents on selective pathways during inflammation, due to specific characteristics of their individual mechanisms of action (MoA). Based on the complementary MoA of doxycycline modified-release and ivermectin, a scientific rationale for a combined therapy targeting inflammatory lesions in rosacea is given. We propose that topical ivermectin cream is a promising new candidate as first-line treatment to target the inflammatory lesions of rosacea, which can be used in combination with systemic doxycycline modified-release to provide an optimal treatment approach considering all inflammatory pathways involved in PPR. Funding Galderma.
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118
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Asai Y, Tan J, Baibergenova A, Barankin B, Cochrane CL, Humphrey S, Lynde CW, Marcoux D, Poulin Y, Rivers JK, Sapijaszko M, Sibbald RG, Toole J, Ulmer M, Zip C. Canadian Clinical Practice Guidelines for Rosacea. J Cutan Med Surg 2016; 20:432-45. [PMID: 27207355 DOI: 10.1177/1203475416650427] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used as a source of clinical trial evidence on which to base the recommendations.
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Affiliation(s)
- Yuka Asai
- Division of Dermatology, Queen's University, Kingston, ON, Canada
| | - Jerry Tan
- University of Western Ontario, Windsor, ON, Canada
| | | | | | | | - Shannon Humphrey
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | | | - Danielle Marcoux
- CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | | | - Jason K Rivers
- Bearing Biomedical Consulting, Vancouver, BC, Canada Pacific DermAesthetics, Vancouver, BC, Canada
| | - Mariusz Sapijaszko
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - John Toole
- University of Manitoba, Winnipeg, MB, Canada
| | - Marcie Ulmer
- Bearing Biomedical Consulting, Vancouver, BC, Canada Carruthers & Humphrey, Vancouver, BC, Canada
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119
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Abstract
Itch is a unique sensation associated with the scratch reflex. Although the scratch reflex plays a protective role in daily life by removing irritants, chronic itch remains a clinical challenge. Despite urgent clinical need, itch has received relatively little research attention and its mechanisms have remained poorly understood until recently. The goal of the present review is to summarize our current understanding of the mechanisms of acute as well as chronic itch and classifications of the primary itch populations in relationship to transient receptor potential (Trp) channels, which play pivotal roles in multiple somatosensations. The convergent involvement of Trp channels in diverse itch signaling pathways suggests that Trp channels may serve as promising targets for chronic itch treatments.
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Affiliation(s)
- Shuohao Sun
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, Johns Hopkins University, School of Medicine, Baltimore, MD, 21205, USA
| | - Xinzhong Dong
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, Johns Hopkins University, School of Medicine, Baltimore, MD, 21205, USA.
- Howard Hughes Medical Institute, Johns Hopkins University, School of Medicine, Baltimore, MD, 21205, USA.
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120
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Del Rosso JAMESQ. Cutaneous rosacea: a thorough overview of pathogenesis, clinical presentations, and current recommendations on management. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-2-32-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The review summarizes and systemizes available international data on the pathogenesis, clinical manifestations and current recommendations for the management of rosacea patients.
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121
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Del Rosso JAMESQ. Cutaneous rosacea: a thorough overview of pathogenesis, clinical presentations, and current recommendations on management. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-2-21-31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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122
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Adaskevich VP, Saprykova VV, Adaskevich MV. Erythemato-telangiectatic rosacea: analysis of effectivity of treatment by flavonoid-rich topical agents. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-1-73-80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Rosacea is a common non-infectious disease with intricate aetiology involving endogenous, systemic or local, and environmental factors. Vascular changes may play a major role in rosacea pathogenesis. Chrysanthellum indicum extract contains a unique combination of component which has a beneficial effect on vascular wall permeability and increases the mechanical resistance of capillaries. The aim of the study is to investigate clinical and epidemiologic features of rosacea as well as to evaluate the efficacy and tolerability of external medication - flavonoid-rich plant extract-based cream Ruboril - in patients with erythemato-telangiectatic subtype of rosacea. Material and methods. We observed 52 patients (16 male and 36 female) aged from 23 to 69 with erythemato-telangiectatic subtype of rosacea. The diagnosis was established on the base of clinical presentation with regard to major and minor diagnostic criteria. In order to evaluate the efficacy of topical therapy with Ruboril cream a scale from 0 to 3 was used assessing the severity grade of erythema and teleangiectasias before treatment and after the 4th, 8th and 12th week of therapy. Results. Women were more often affected than men (69%). Patients of the age group from 40 years prevailed (75%). Fitzpatrick skin phototype II was revealed in 30 (58%) of patients. The most common provoking factors were meteorological (77%), emotional stress (67%), sauna/hot baths or alcohol (66%), hot drinks (48%). The prevailing areas of affection were cheeks (98%), forehead (54%), chin (48%), nose (52%). Moderate erythema was observed in 29 (56%) of patients, severe erythema in 15 (29%). Moderate grade of telangiectasias was registered in 30 (58%) of patients, numerous telangiectasias in 16 (31%). Topical application of cream Ruboril allowed to achieve good immediate results: the severity of erythema was reduced by 63%, the manifestation of telangiectasias decreased by 63%. Conclusion. Clinico-epidemiologic features of patients with erythemato-telangiectatic subtype of rosacea are as follows: erythematous and telangiectatic eruption on the cheeks, nose, and chin, weather and emotional influences, predominance of the female gender, skin phototype II, age > 40 years. The external medication Ruboril showed its high efficacy and safety in the treatment of patients with erythemato-telangiectatic subtype of rosacea which allowed to achieve good immediate results with erythema severity reduction of 63% and the decrease in the manifestation of telangiectasias of 63%.
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Li C, Ma W, Yin S, Liang X, Shu X, Pei D, Egan TM, Huang J, Pan A, Li Z. Sorting Nexin 11 Regulates Lysosomal Degradation of Plasma Membrane TRPV3. Traffic 2016; 17:500-14. [DOI: 10.1111/tra.12379] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 01/21/2016] [Accepted: 01/21/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Caiyue Li
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
| | - Wenbo Ma
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
| | - Shikui Yin
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
| | - Xin Liang
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
| | - Xiaodong Shu
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
| | - Duanqing Pei
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
| | - Terrance M. Egan
- Pharmacological and Physiological Science, School of Medicine; Saint Louis University; St. Louis MO USA
| | - Jufang Huang
- Department of Anatomy and Neurobiology, Xiangya School of Medicine; Central South University; Changsha China
| | - Aihua Pan
- Department of Anatomy and Neurobiology, Xiangya School of Medicine; Central South University; Changsha China
| | - Zhiyuan Li
- Key Laboratory of Regenerative Biology, Chinese Academy of Sciences and Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences; Guangzhou China
- Department of Anatomy and Neurobiology, Xiangya School of Medicine; Central South University; Changsha China
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Ehnis-Pérez A, Torres-Álvarez B, Cortés-García D, Hernández-Blanco D, Fuentes-Ahumada C, Castanedo-Cázares JP. Relationship between transient receptor potential vanilloid-1 expression and the intensity of sensitive skin symptoms. J Cosmet Dermatol 2015; 15:231-7. [PMID: 26695734 DOI: 10.1111/jocd.12204] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sensitive skin (SS) is a hyper-reactive condition of the skin secondary to external factors, without objective signs of lesion. Its pathogenesis is still under investigation. Transient receptor potential vanilloid-1 (TRPV1) is a cation channel that responds to low pH and is related to nociception, neurogenic inflammation, and pruritus. AIMS To determine the expression of TRPV1 in subjects with SS and correlate it with the degree of symptoms and skin pigmentation. PATIENTS/METHODS We included 31 subjects self-diagnosed as having SS. Colorimetric values were obtained for assessment of skin phototype, and the lactic acid stinging test (LAST) was performed. Two skin biopsies from the nasolabial fold of each volunteer were obtained. Qualitative analysis of TRPV1 was carried out with immunohistochemistry. Quantitative analysis of TRPV1 was carried out with qRT-PCR. RESULTS LAST was positive in 74% of the subjects, 56% of those having tan and brown skin. Immunohistochemistry staining for TRPV1 was greater in positive subjects (P = 0.03), but showed no correlation with the intensity of symptoms. Positive subjects also had higher TRPV1 mRNA expression compared to negative subjects (P < 0.001). This expression showed a positive correlation with the intensity of referred symptoms (R = 0.75, P < 0.001) and skin pigmentation (R = 0.63, P < 0.001). CONCLUSIONS TRPV1 expression is upregulated in subjects with sensitive skin, and it correlates with the intensity of the symptoms. Our findings suggest a role for this receptor in the pathogenesis of sensitive skin syndrome.
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Affiliation(s)
- Adriana Ehnis-Pérez
- Department of Dermatology, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Bertha Torres-Álvarez
- Department of Dermatology, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Diego Cortés-García
- Laboratory of Immunology, Cellular and Molecular Biology, Chemical Sciences Faculty, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Diana Hernández-Blanco
- Department of Dermatology, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Cornelia Fuentes-Ahumada
- Department of Dermatology, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Juan Pablo Castanedo-Cázares
- Department of Dermatology, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
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125
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Abstract
The skin epidermis is densely innervated by peripheral sensory nerve endings. Nociceptive neurons, whose terminals are in close contact with epidermal keratinocytes, can be activated directly by noxious physical and chemical stimuli to trigger pain. However, whether keratinocytes can signal acutely to sensory nerve terminals to initiate pain in vivo remains unclear. Here, using the keratin 5 promoter to selectively express the capsaicin receptor TRPV1 in keratinocytes of TRPV1-knockout mice, we achieved specific stimulation of keratinocytes with capsaicin. Using this approach, we found that keratinocyte stimulation was sufficient to induce strong expression of the neuronal activation marker, c-fos, in laminae I and II of the ipsilateral spinal cord dorsal horn and to evoke acute paw-licking nocifensive behavior and conditioned place aversion. These data provide direct evidence that keratinocyte stimulation is sufficient to evoke acute nociception-related responses.
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126
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Jackson JM, Knuckles M, Minni JP, Johnson SM, Belasco KT. The role of brimonidine tartrate gel in the treatment of rosacea. Clin Cosmet Investig Dermatol 2015; 8:529-38. [PMID: 26566370 PMCID: PMC4627400 DOI: 10.2147/ccid.s58920] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Rosacea is a chronic cutaneous condition with a prevalence rate ranging from 9.6% to 22% in recent studies. Facial erythema (transient and permanent) is considered a common denominator that is frequently observed in all subtypes of rosacea and is estimated to affect more than 40 million people worldwide. Brimonidine tartrate is a selective α2-adrenergic receptor agonist and is the first topical treatment approved for facial erythema of rosacea. Clinical trials have demonstrated that brimonidine tartrate provided significantly greater efficacy, compared to vehicle, for the treatment of moderate to severe erythema of rosacea. In addition, brimonidine tartrate has demonstrated a rapid onset of effect, duration of action throughout the day, and good safety profile in studies of up to 1 year. This review critically discusses the role of brimonidine tartrate for the treatment of facial erythema of rosacea by examining both clinical study data and real-world dermatologist experiences across a wide spectrum of treated patients, and concludes that it is a significant therapeutic option in the management of an unmet need of this chronic condition.
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Affiliation(s)
- J Mark Jackson
- Division of Dermatology, University of Louisville, Louisville, KY, USA
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127
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Bertin S, Raz E. Transient Receptor Potential (TRP) channels in T cells. Semin Immunopathol 2015; 38:309-19. [PMID: 26468011 DOI: 10.1007/s00281-015-0535-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 10/01/2015] [Indexed: 12/16/2022]
Abstract
The transient receptor potential (TRP) family of ion channels is widely expressed in many cell types and plays various physiological roles. Growing evidence suggests that certain TRP channels are functionally expressed in the immune system. Indeed, an increasing number of reports have demonstrated the functional expression of several TRP channels in innate and adaptive immune cells and have highlighted their critical role in the activation and function of these cells. However, very few reviews have been entirely dedicated to this subject. Here, we will summarize the recent findings with regards to TRP channel expression in T cells and discuss their emerging role as regulators of T cell activation and functions. Moreover, these studies suggest that beyond their pharmaceutical interest in pain management, certain TRP channels may represent potential novel therapeutic targets for various immune-related diseases.
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Affiliation(s)
- Samuel Bertin
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0663, USA.
| | - Eyal Raz
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0663, USA
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128
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129
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Lopes DM, McMahon SB. Ultraviolet Radiation on the Skin: A Painful Experience? CNS Neurosci Ther 2015; 22:118-26. [PMID: 26331607 PMCID: PMC4833175 DOI: 10.1111/cns.12444] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/21/2015] [Accepted: 07/22/2015] [Indexed: 12/31/2022] Open
Abstract
Excessive exposure of skin to ultraviolet radiation (UVR) has dramatic clinical effects in humans, and it is a significant public health concern. Discomfort and sensory changes caused by skin sunburn are the main common features experienced by many of us, a phenomena triggered by the combination of long and short wavelengths radiation (UVA and UVB, respectively). Although the biological processes underlying UVR exposure are not fully understood, in the last few years many studies have made significant progress in characterizing sunburn at the cellular and molecular levels, making use of both humans and laboratory animal models. Here we review and reason that UVR can be used as an excellent model of sensitization and inflammation for pain research. UVR, particularly UVB, produces a controllable and sterile inflammation that causes a robust dose‐dependent hypersensitivity with minimal confounding effects. Importantly, we show that UVR animal models precisely recapitulate the sensory, cellular, and molecular changes observed in human skin, giving it great confidence as a translational model. Furthermore, in this article, we give an overview of the pharmacology underlying UVB inflammation, the latest advances in the field, and potential new targets for inflammatory pain.
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Affiliation(s)
- Douglas M Lopes
- Neurorestoration group, Wolfson Centre for Age-Related Diseases, King's College London, London, UK
| | - Stephen B McMahon
- Neurorestoration group, Wolfson Centre for Age-Related Diseases, King's College London, London, UK
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130
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Rosacea: part I. Introduction, categorization, histology, pathogenesis, and risk factors. J Am Acad Dermatol 2015; 72:749-58; quiz 759-60. [PMID: 25890455 DOI: 10.1016/j.jaad.2014.08.028] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 08/01/2014] [Accepted: 08/18/2014] [Indexed: 11/22/2022]
Abstract
Rosacea is a chronic inflammatory skin condition that affects approximately 16 million Americans. Four distinct subtypes of rosacea have been recognized, with transient and nontransient facial flushing, telangiectasia, and inflammatory papules and pustules being among the more commonly recognized features. Although the exact pathogenesis of rosacea is unknown, dysregulation of the innate immune system, overgrowth of commensal skin organisms, and aberrant neurovascular signaling may all have a role in promoting the clinical features of rosacea.
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131
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Metzler-Wilson K, Toma K, Sammons DL, Mann S, Jurovcik AJ, Demidova O, Wilson TE. Augmented supraorbital skin sympathetic nerve activity responses to symptom trigger events in rosacea patients. J Neurophysiol 2015; 114:1530-7. [PMID: 26133800 DOI: 10.1152/jn.00458.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/30/2015] [Indexed: 12/30/2022] Open
Abstract
Facial flushing in rosacea is often induced by trigger events. However, trigger causation mechanisms are currently unclear. This study tested the central hypothesis that rosacea causes sympathetic and axon reflex-mediated alterations resulting in trigger-induced symptomatology. Twenty rosacea patients and age/sex-matched controls participated in one or a combination of symptom triggering stressors. In protocol 1, forehead skin sympathetic nerve activity (SSNA; supraorbital microneurography) was measured during sympathoexcitatory mental (2-min serial subtraction of novel numbers) and physical (2-min isometric handgrip) stress. In protocol 2, forehead skin blood flow (laser-Doppler flowmetry) and transepithelial water loss/sweat rate (capacitance hygrometry) were measured during sympathoexcitatory heat stress (whole body heating by perfusing 50°C water through a tube-lined suit). In protocol 3, cheek, forehead, forearm, and palm skin blood flow were measured during nonpainful local heating to induce axon reflex vasodilation. Heart rate (HR) and mean arterial pressure (MAP) were recorded via finger photoplethysmography to calculate cutaneous vascular conductance (CVC; flux·100/MAP). Higher patient transepithelial water loss was observed (rosacea 0.20 ± 0.02 vs. control 0.10 ± 0.01 mg·cm(-2)·min(-1), P < 0.05). HR and MAP changes were not different between groups during sympathoexcitatory stressors or local heating. SSNA during early mental (32 ± 9 and 9 ± 4% increase) and physical (25 ± 4 and 5 ± 1% increase, rosacea and controls, respectively) stress was augmented in rosacea (both P < 0.05). Heat stress induced more rapid sweating and cutaneous vasodilation onset in rosacea compared with controls. No axon reflex vasodilation differences were observed between groups. These data indicate that rosacea affects SSNA and that hyperresponsiveness to trigger events appears to have a sympathetic component.
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Affiliation(s)
- Kristen Metzler-Wilson
- Marian University College of Osteopathic Medicine, Indianapolis, Indiana; Ohio Musculoskeletal and Neurological Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| | - Kumika Toma
- Ohio Musculoskeletal and Neurological Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio; School of Kinesiology, College of Health Professions, Marshall University, Huntington, West Virginia; and
| | - Dawn L Sammons
- Department of Specialty Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio; Oakview Dermatology, Athens, Ohio
| | - Sarah Mann
- Ohio Musculoskeletal and Neurological Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| | - Andrew J Jurovcik
- Ohio Musculoskeletal and Neurological Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| | - Olga Demidova
- Ohio Musculoskeletal and Neurological Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| | - Thad E Wilson
- Marian University College of Osteopathic Medicine, Indianapolis, Indiana; Ohio Musculoskeletal and Neurological Institute, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio; Department of Specialty Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio; Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio;
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Mediators of Chronic Pruritus in Atopic Dermatitis: Getting the Itch Out? Clin Rev Allergy Immunol 2015; 51:263-292. [DOI: 10.1007/s12016-015-8488-5] [Citation(s) in RCA: 200] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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133
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Buhl T, Sulk M, Nowak P, Buddenkotte J, McDonald I, Aubert J, Carlavan I, Déret S, Reiniche P, Rivier M, Voegel JJ, Steinhoff M. Molecular and Morphological Characterization of Inflammatory Infiltrate in Rosacea Reveals Activation of Th1/Th17 Pathways. J Invest Dermatol 2015; 135:2198-2208. [PMID: 25848978 DOI: 10.1038/jid.2015.141] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/11/2015] [Accepted: 03/18/2015] [Indexed: 02/07/2023]
Abstract
Rosacea is a common chronic inflammatory skin disease of unknown etiology. Our knowledge about an involvement of the adaptive immune system is very limited. We performed detailed transcriptome analysis, quantitative real-time reverse-transcriptase-PCR, and quantitative immunohistochemistry on facial biopsies of rosacea patients, classified according to their clinical subtype. As controls, we used samples from patients with facial lupus erythematosus and healthy controls. Our study shows significant activation of the immune system in all subtypes of rosacea, characterizing erythematotelangiectatic rosacea (ETR) already as a disease with significant influx of proinflammatory cells. The T-cell response is dominated by Th1/Th17-polarized immune cells, as demonstrated by significant upregulation of IFN-γ or IL-17, for example. Chemokine expression patterns support a Th1/Th17 polarization profile of the T-cell response. Macrophages and mast cells are increased in all three subtypes of rosacea, whereas neutrophils reach a maximum in papulopustular rosacea. Our studies also provide evidence for the activation of plasma cells with significant antibody production already in ETR, followed by a crescendo pattern toward phymatous rosacea. In sum, Th1/Th17 polarized inflammation and macrophage infiltration are an underestimated hallmark in all subtypes of rosacea. Therapies directly targeting the Th1/Th17 pathway are promising candidates in the future treatment of this skin disease.
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Affiliation(s)
- Timo Buhl
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany; Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland; Department of Dermatology and Surgery, University of California, San Francisco, California, USA
| | - Mathias Sulk
- Department of Dermatology and Surgery, University of California, San Francisco, California, USA; Department of Dermatology, University of Münster, Münster, Germany
| | - Pawel Nowak
- Department of Dermatology, University of Münster, Münster, Germany
| | - Jörg Buddenkotte
- Department of Dermatology, University of Münster, Münster, Germany
| | - Ian McDonald
- Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| | - Jérôme Aubert
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Isabelle Carlavan
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Sophie Déret
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Pascale Reiniche
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Michel Rivier
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France
| | - Johannes J Voegel
- Molecular Dermatology, Research Department, Galderma R&D, Sophia Antipolis, France.
| | - Martin Steinhoff
- Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland; Department of Dermatology and Surgery, University of California, San Francisco, California, USA; Department of Dermatology, University of San Diego, USA.
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134
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Liedtke W, Zhang JY, Hall RP, Steinhoff M. Keratinocyte growth regulation TRP-ed up over downregulated TRPV4? J Invest Dermatol 2014; 134:2310-2312. [PMID: 25120148 DOI: 10.1038/jid.2014.250] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This commentary on an exciting new study (Fusi et al., 2014) puts the finding of TRPV4 downregulation in several nonmelanoma skin cancers into context. The original paper point toward possible use of TRPV4 as dermatopathologic marker, also toward the possibility that downregulated TRPV4 can affect biological properties of the cancer, by enhancing, but also regulating tumor growth. As calcium-permeable TRPV4 has recently been identified as UVB-receptor in skin keratinocytes, where it regulates skin tissue injury and pain after UVB overexposure, it is discussed whether TRPV4 downregulation can also be found in other non-UVB-exposed cancers.
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Affiliation(s)
- Wolfgang Liedtke
- Departments of Neurology, Neurobiology and Anesthesiology, Duke University, Durham, North Carolina, USA.
| | - Jennifer Y Zhang
- Department of Dermatology, Duke University, Durham, North Carolina, USA
| | - Russell P Hall
- Department of Dermatology, Duke University, Durham, North Carolina, USA
| | - Martin Steinhoff
- University College of Dublin, Charles Institute of Translational Dermatology, Dublin, Ireland
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135
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Tóth BI, Oláh A, Szöllősi AG, Bíró T. TRP channels in the skin. Br J Pharmacol 2014; 171:2568-81. [PMID: 24372189 DOI: 10.1111/bph.12569] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/28/2013] [Accepted: 12/03/2013] [Indexed: 12/16/2022] Open
Abstract
Emerging evidence suggests that transient receptor potential (TRP) ion channels not only act as 'polymodal cellular sensors' on sensory neurons but are also functionally expressed by a multitude of non-neuronal cell types. This is especially true in the skin, one of the largest organs of the body, where they appear to be critically involved in regulating various cutaneous functions both under physiological and pathophysiological conditions. In this review, we focus on introducing the roles of several cutaneous TRP channels in the regulation of the skin barrier, skin cell proliferation and differentiation, and immune functions. Moreover, we also describe the putative involvement of several TRP channels in the development of certain skin diseases and identify future TRP channel-targeted therapeutic opportunities.
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Affiliation(s)
- Balázs I Tóth
- Laboratory of Ion Channel Research and TRP Research Platform Leuven (TRPLe), Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; DE-MTA 'Lendület' Cellular Physiology Research Group, Department of Physiology, University of Debrecen, Medical and Health Science Center, Research Center for Molecular Medicine, Debrecen, Hungary
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136
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Caterina MJ. TRP channel cannabinoid receptors in skin sensation, homeostasis, and inflammation. ACS Chem Neurosci 2014; 5:1107-16. [PMID: 24915599 PMCID: PMC4240254 DOI: 10.1021/cn5000919] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
![]()
In
the skin, cannabinoid lipids, whether of endogenous or exogenous
origin, are capable of regulating numerous sensory, homeostatic, and
inflammatory events. Although many of these effects are mediated by
metabotropic cannabinoid receptors, a growing body of evidence has
revealed that multiple members of the transient receptor potential
(TRP) ion channel family can act as “ionotropic cannabinoid
receptors”. Furthermore, many of these same TRP channels are
intimately involved in cutaneous processes that include the initiation
of pain, temperature, and itch perception, the maintenance of epidermal
homeostasis, the regulation of hair follicles and sebaceous glands,
and the modulation of dermatitis. Ionotropic cannabinoid receptors
therefore represent potentially attractive targets for the therapeutic
use of cannabinoids to treat sensory and dermatological diseases.
Furthermore, the interactions between neurons and other cell types
that are mediated by cutaneous ionotropic cannabinoid receptors are
likely to be recapitulated during physiological and pathophysiological
processes in the central nervous system and elsewhere, making the
skin an ideal setting in which to dissect general complexities of
cannabinoid signaling.
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Affiliation(s)
- Michael J. Caterina
- Departments of Neurosurgery,
Biological Chemistry, and Neuroscience, Neurosurgery Pain Research
Institute, Center for Sensory Biology, Johns Hopkins School of Medicine, 725 N. Wolfe St., Baltimore, Maryland 21205, United States
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137
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Melnik BC. Endoplasmic reticulum stress: key promoter of rosacea pathogenesis. Exp Dermatol 2014; 23:868-73. [DOI: 10.1111/exd.12517] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Bodo C. Melnik
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
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138
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Del Rosso JQ. Management of cutaneous rosacea: emphasis on new medical therapies. Expert Opin Pharmacother 2014; 15:2029-38. [DOI: 10.1517/14656566.2014.945423] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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139
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140
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Abstract
Rosacea is a chronic relapsing inflammatory facial dermatosis. There are several known triggers but the pathogenesis remains unknown. Recent achievements in understanding this disease point to the importance of skin-environmental interactions. This includes physical and chemical factors, but also microbial factors. The impairment of the skin barrier function and the activation of the innate immune defences are major and connected pathways contributing to an ongoing inflammatory response in the affected skin. This becomes modulated by endogenous factors like neurovascular, drugs, and psychological factors. These factors offer new therapeutic targets for rosacea treatment. There is a broader range of anti-inflammatory compounds available with a favourable safety record. Only recently have persistent erythema and flushing been addressed by new drug formulations.
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141
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Nilius B, Szallasi A. Transient Receptor Potential Channels as Drug Targets: From the Science of Basic Research to the Art of Medicine. Pharmacol Rev 2014; 66:676-814. [DOI: 10.1124/pr.113.008268] [Citation(s) in RCA: 348] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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142
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de Veer SJ, Furio L, Harris JM, Hovnanian A. Proteases and proteomics: Cutting to the core of human skin pathologies. Proteomics Clin Appl 2014; 8:389-402. [DOI: 10.1002/prca.201300081] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/22/2013] [Accepted: 11/07/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Simon J. de Veer
- Université Paris Descartes - Sorbonne Paris Cité; Paris France
- INSERM UMR 1163, Laboratory of Genetic Skin Diseases, Imagine Institute; Paris France
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
| | - Laetitia Furio
- Université Paris Descartes - Sorbonne Paris Cité; Paris France
- INSERM UMR 1163, Laboratory of Genetic Skin Diseases, Imagine Institute; Paris France
| | - Jonathan M. Harris
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Australia
| | - Alain Hovnanian
- Université Paris Descartes - Sorbonne Paris Cité; Paris France
- INSERM UMR 1163, Laboratory of Genetic Skin Diseases, Imagine Institute; Paris France
- Department of Genetics; Necker Hospital for Sick Children; Paris France
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143
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Transient receptor potential vanilloid 4 (TRPV4) is downregulated in keratinocytes in human non-melanoma skin cancer. J Invest Dermatol 2014; 134:2408-2417. [PMID: 24643128 DOI: 10.1038/jid.2014.145] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 01/29/2014] [Accepted: 02/18/2014] [Indexed: 01/17/2023]
Abstract
A subgroup of the transient receptor potential (TRP) channels, including vanilloid 1 (TRPV1), TRPV2, TRPV3, TRPV4, and TRP ankyrin 1 (TRPA1), is expressed in cutaneous peptidergic somatosensory neurons, and has been found in skin non-neuronal cells, such as keratinocytes. Different cancer cells express TRPs, where they may exert either pro- or antitumorigenic roles. Expression and function of TRPs in skin cancers have been, however, poorly investigated. Here, we have studied the distribution and expression of TRPs by immunohistochemistry and messenger RNA (mRNA) in human healthy skin and human keratinocytic tumors, including intraepidermal proliferative disorders (solar keratosis (SK) and Bowen's disease), and non-melanoma skin cancer (NMSC; basal cell and squamous cell carcinomas). Similar TRPV1, TRPV2, and TRPV3 staining was found in keratinocytes from healthy and tumor tissues. TRPA1 staining was increased solely in SK samples. However, the marked TRPV4 staining and TRPV4 mRNA expression, observed in healthy or inflamed skin, was abrogated both in premalignant lesions and NMSC. In a human keratinocyte cell line (HaCaT), TRPV4 stimulation released IL-8, which in turn downregulated TRPV4 expression. Selective reduction in TRPV4 expression could represent an early biomarker of skin carcinogenesis. Whether the cytokine-dependent, autocrine pathway that results in TRPV4 downregulation contributes to NMSC mechanism remains to be determined.
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144
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Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol 2014; 69:S15-26. [PMID: 24229632 DOI: 10.1016/j.jaad.2013.04.045] [Citation(s) in RCA: 203] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 04/21/2013] [Indexed: 02/06/2023]
Abstract
Rosacea is a common, chronic inflammatory skin disease of poorly understood origin. Based on its clinical features (flushing, chronic inflammation, fibrosis) and trigger factors, a complex pathobiology involving different regulatory systems can be anticipated. Although a wealth of research has shed new light over recent years on its pathophysiology, the precise interplay of the various dysregulated systems (immune, vascular, nervous) is still poorly understood. Most authors agree on 4 major clinical subtypes of rosacea: erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea, and ocular rosacea. Still, it needs to be elucidated whether these subtypes develop in a consecutive serial fashion or if any subtypes may occur individually as part of a syndrome. Because rosacea often affects multiple family members, a genetic component is also suspected, but the genetic basis of rosacea remains unclear. During disease manifestation and early stage, the innate immune system and neurovascular dysregulation seem to be driving forces in rosacea pathophysiology. Dissection of major players for disease progression and in advanced stages is severely hampered by the complex activation of the innate and adaptive immune systems, enhanced neuroimmune communication, profound blood vessel and possibly lymphatic vessel changes, and activation of almost every resident cell in the skin. This review discusses some of the recent findings and aims to build unifying hypotheses for a modern understanding of rosacea pathophysiology.
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Affiliation(s)
- Martin Steinhoff
- Department of Dermatology, University of California, San Francisco, California.
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145
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Nilius B, Bíró T, Owsianik G. TRPV3: time to decipher a poorly understood family member! J Physiol 2014; 592:295-304. [PMID: 23836684 PMCID: PMC3922494 DOI: 10.1113/jphysiol.2013.255968] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 06/15/2013] [Indexed: 11/08/2022] Open
Abstract
The vanilloid transient receptor potential channel TRPV3 differs in several aspects from other members of the TRPV subfamily. This Ca(2+)-, ATP- and calmodulin-regulated channel constitutes a target for many natural compounds and has a unique expression pattern as the most prominent and important TRP channel in keratinocytes of the skin. Although TRPV3 is considered as a thermosensitive channel, its function as a thermosensor in the skin is challenged. Nevertheless, it plays important roles in other skin functions such as cutaneous sensations, hair development and barrier function. More recently, mutations in TRPV3 were linked with a rare genodermatosis known as the Olmsted syndrome. This review gives an overview on properties of TRPV3 and its functions in the skin and skin diseases.
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Affiliation(s)
- Bernd Nilius
- Campus Gasthuisberg, Department of Physiology, KU Leuven, Campus Gasthuisberg, Herestraat 49, Leuven B-3000, Belgium.
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146
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Luo J, Walters ET, Carlton SM, Hu H. Targeting Pain-evoking Transient Receptor Potential Channels for the Treatment of Pain. Curr Neuropharmacol 2014; 11:652-63. [PMID: 24396340 PMCID: PMC3849790 DOI: 10.2174/1570159x113119990040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 06/19/2013] [Accepted: 06/19/2013] [Indexed: 02/06/2023] Open
Abstract
Chronic pain affects billions of lives globally and is a major public health problem in the United States. However, pain management is still a challenging task due to a lack of understanding of the fundamental mechanisms of pain. In the past decades transient receptor potential (TRP) channels have been identified as molecular sensors of tissue damage and inflammation. Activation/sensitization of TRP channels in peripheral nociceptors produces neurogenic inflammation and contributes to both somatic and visceral pain. Pharmacological and genetic studies have affirmed the role of TRP channels in multiple forms of inflammatory and neuropathic pain. Thus pain-evoking TRP channels emerge as promising therapeutic targets for a wide variety of pain and inflammatory conditions.
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Affiliation(s)
- Jialie Luo
- Department of Integrative Biology and Pharmacology, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030
| | - Edgar T Walters
- Department of Integrative Biology and Pharmacology, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030
| | - Susan M Carlton
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1069
| | - Hongzhen Hu
- Department of Integrative Biology and Pharmacology, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030
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147
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Two AM, Del Rosso JQ. Kallikrein 5-mediated inflammation in rosacea: clinically relevant correlations with acute and chronic manifestations in rosacea and how individual treatments may provide therapeutic benefit. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2014; 7:20-5. [PMID: 24563692 PMCID: PMC3930536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Rosacea is a chronic inflammatory condition of facial skin estimated to affect more than 16 million Americans. Although the pathogenesis of rosacea is not fully understood, recent evidence in vitro as well as in vivo has supported the role of increased levels of the trypsin-like serine protease, kallikrein 5, in initiating an augmented inflammatory response in rosacea. The increase in the quantity and magnitude of biological activity of kallikrein 5 leads to production of greater quantities of cathelicidin (LL-37), an antimicrobial peptide associated with increases in innate cutaneous inflammation, vasodilation, and vascular proliferation, all of which are characteristic features of rosacea. In this article, the authors review the literature supporting the role of kallikrein 5 in the pathophysiology of rosacea, including how therapeutic interventions modulate the effects of kallikrein 5, thus providing further support for this pathophysiological model that at least partially explains many of the clinical features of cutaneous rosacea.
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Affiliation(s)
- Aimee M. Two
- Division of Dermatology, Department of Medicine, University of California, San Diego, La Jolla, California
| | - James Q. Del Rosso
- Touro University College of Osteopathic Medicine, Henderson, Nevada; JDRx Dermatology LLC, Las Vegas Skin and Cancer Clinics/West Dermatology Group, Henderson, Nevada
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148
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Abstract
TRPV3 is a temperature-sensitive transient receptor potential (TRP) ion channel. The TRPV3 protein functions as a Ca(2+)-permeable nonselective cation channel with six transmembrane domains forming a tetrameric complex. TRPV3 is known to be activated by warm temperatures, synthetic small-molecule chemicals, and natural compounds from plants. Its function is regulated by a variety of physiological factors including extracellular divalent cations and acidic pH, intracellular adenosine triphosphate, membrane voltage, and arachidonic acid. TRPV3 shows a broad expression pattern in both neuronal and non-neuronal tissues including epidermal keratinocytes, epithelial cells in the gut, endothelial cells in blood vessels, and neurons in dorsal root ganglia and CNS. TRPV3 null mice exhibit abnormal hair morphogenesis and compromised skin barrier function. Recent advances suggest that TRPV3 may play critical roles in inflammatory skin disorders, itch, and pain sensation. Thus, identification of selective TRPV3 activators and inhibitors could potentially lead to beneficial pharmacological interventions in several diseases. The intent of this review is to summarize our current knowledge of the tissue expression, structure, function, and mechanisms of activation of TRPV3.
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Affiliation(s)
- Jialie Luo
- The Center for the Study of Itch, Washington University Pain Center, The Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Hongzhen Hu
- The Center for the Study of Itch, Washington University Pain Center, The Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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149
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Targeting TRP channels for pain relief. Eur J Pharmacol 2013; 716:61-76. [DOI: 10.1016/j.ejphar.2013.03.003] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 03/04/2013] [Indexed: 11/23/2022]
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150
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Nilius B, Bíró T. TRPV3: a ‘more than skinny’ channel. Exp Dermatol 2013; 22:447-52. [DOI: 10.1111/exd.12163] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 02/02/2023]
Affiliation(s)
- Bernd Nilius
- Department of Cellular and Molecular Medicine; Laboratory Ion Channel Research; KU Leuven; Leuven Belgium
| | - Tamás Bíró
- DE-MTA “Lendület” Cellular Physiology Research Group; Department of Physiology; University of Debrecen; Medical and Health Science Center; Research Center for Molecular Medicine; Debrecen Hungary
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