151
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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: 109] [Impact Index Per Article: 13.6] [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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152
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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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153
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Bakhlykova EA, Filimonkova NN, Matusevich SL. Systemic therapy in patients with severe rosacea. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-4-68-74] [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
Rosacea is a polietiologic disease with a complex pathogenesis, resulting in the problem is the selection of therapeutic tactics, especially in severe disease. The result of the study revealed that the isotretinoin treatment for rosacea had a positive result, even in the absence of the effect of previous systemic antibiotic therapy. Aim of the study. To study the effect and tolerability of systemic isotretinoin treatment for severe rosacea that is resistant to antibiotic therapy. Materials and methods. Under the supervision and treatment were 16 patients with severe course of rosacea, 14 of them had pustules and papules and 2 - fimatodes subtype. The severity was estimated by the method a 4-point scale proposed by V.P. Adaskevich, and was in average 18.6 points. All patients had a duration of 3 ± 1.2 years for systemic antibacterial therapy (clarithromycin, Ornidazole) with insufficient effect in the past. All patients (n = 16) was conducted therapy with isotretinoin (using Aknekutan). Daily dose was calculated on body weight, the initial dose was 0.2-0.3 mg/ kg, with subsequent dose reduction. Topically patients received clindamycin phosphate gel 1% treatment (5-7 days), then metronidazole 1% cream (Rosamet) 1-2 times a day. The duration of therapy ranged from 3 to 5 months. Results. After the course of therapy using Aknekutan remission or significant improvement was achieved in 87.5% of cases. The severity of the disease fell to 6.5 points, i.e. 2.8 times. Conclusion. Aknekutan showed a high therapeutic effect in severe rosacea, so it can be recommended to patients with resistance to conventional therapy. As external therapy, and supportive treatment patients are recommended - cream metronidazole 1% (Rosamet) and adequate skin care, photoprotective creams.
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154
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Daniel MC, O’Gallagher M, Hingorani M, Dahlmann-Noor A, Tuft S. Challenges in the management of pediatric blepharokeratoconjunctivis / ocular rosacea. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1080/17469899.2016.1209408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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155
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Sun XK, Chen JF, Shen H. Immunohistochemical study of toll-like receptors 2, 4, and 9 expressions in pemphigus and bullous pemphigoid lesions. Arch Dermatol Res 2016; 308:429-36. [PMID: 27221282 DOI: 10.1007/s00403-016-1656-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 04/17/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
Abstract
Pemphigus and bullous pemphigoid (BP) are severe autoimmune skin diseases. Whether innate immunity could be a trigger or a part of the pathogeneses is unknown. Toll-like receptors (TLRs) are important components of the innate immune system, with no previous evaluation of TLRs in autoimmune bullous diseases. This work aims to investigate TLRs 2, 4, and 9 expressions in pemphigus and bullous pemphigoid. Thirty-six patients with pemphigus vulgaris (PV), pemphigus foliaceus (PF), bullous pemphigoid (BP), and six healthy controls were studied. Skin biopsies from the patients and the controls were examined immunohistochemically for TLR2, 4, and 9 expressions. The TLR4 expressed mainly at the basal layer of epidermis in controls, but in the cases with autoimmune bullous diseases, TLR4 staining located at basal layer and suprabasal layer, even superficial layer of epidermis. The immunostaining-intensity-distribution (IID) index of TLR4 in patients with PF (13.83, P = 0.001), PV (13.08, P = 0.003), and BP (11.42, P = 0.042) were significantly higher than that of the controls (6.17). TLR2 and TLR9 showed no significantly changes at epidermal expression (P > 0.05) compared with controls. There was no correlation found between the expressions of these TLRs. This work, thus, shows a re-localization of TLR4 expression sites with increased expression in pemphigus and bullous pemphigoid lesions. Targeting TLR4 signaling is expected to be a novel treatment strategy for autoimmune bullous diseases.
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Affiliation(s)
- Xiu-Kun Sun
- Department of Dermatology, The Third People's Hospital of Hangzhou, No.38, XiHu Street, Hangzhou, 310009, Zhejiang, China.
| | - Jun-Fan Chen
- Department of Dermatology, The Third People's Hospital of Hangzhou, No.38, XiHu Street, Hangzhou, 310009, Zhejiang, China
| | - Hong Shen
- Department of Dermatology, The Third People's Hospital of Hangzhou, No.38, XiHu Street, Hangzhou, 310009, Zhejiang, China
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156
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Hotz C, Boniotto M, Guguin A, Surenaud M, Jean-Louis F, Tisserand P, Ortonne N, Hersant B, Bosc R, Poli F, Bonnabau H, Thiébaut R, Godot V, Wolkenstein P, Hocini H, Lévy Y, Hüe S. Intrinsic Defect in Keratinocyte Function Leads to Inflammation in Hidradenitis Suppurativa. J Invest Dermatol 2016; 136:1768-1780. [PMID: 27206704 DOI: 10.1016/j.jid.2016.04.036] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 03/17/2016] [Accepted: 04/08/2016] [Indexed: 01/06/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating, follicular disease of the skin. Despite a high prevalence in the general population, the physiopathology of HS remains poorly understood. The use of antibiotics and immunosuppressive agents for therapy suggests a deregulated immune response to microflora. Using cellular and gene expression analyses, we found an increased number of infiltrating CD4(+) T cells secreting IL-17 and IFN-γ in perilesional and lesional skin of patients with HS. By contrast, IL-22-secreting CD4(+) T cells are not enriched in HS lesions contrasting with increased number of those cells in the blood of patients with HS. We showed that keratinocytes isolated from hair follicles of patients with HS secreted significantly more IL-1β, IP-10, and chemokine (C-C motif) ligand 5 (RANTES) either constitutively or on pattern recognition receptor stimulations. In addition, they displayed a distinct pattern of antimicrobial peptide production. These findings point out a functional defect of keratinocytes in HS leading to a balance prone to inflammatory responses. This is likely to favor a permissive environment for bacterial infections and chronic inflammation characterizing clinical outcomes in patients with HS.
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Affiliation(s)
- Claire Hotz
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Michele Boniotto
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Aurélie Guguin
- Plateforme de Cytométrie en flux, IMRB, UFR de Médecine, Créteil, France
| | - Mathieu Surenaud
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Francette Jean-Louis
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Pascaline Tisserand
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Nicolas Ortonne
- Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Pathology Department, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France; Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France
| | - Barbara Hersant
- Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France; Plastic, Reconstructive and Aesthetic Surgery Department, Henri Mondor Hospital, Créteil, France
| | - Romain Bosc
- Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France; Plastic, Reconstructive and Aesthetic Surgery Department, Henri Mondor Hospital, Créteil, France
| | - Florence Poli
- Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France; Dermatology Department, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
| | - Henri Bonnabau
- Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France; INSERM U897, INRIA SISTM, Univ. Bordeaux Segalen ISPED, Bordeaux, France
| | - Rodolphe Thiébaut
- Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France; INSERM U897, INRIA SISTM, Univ. Bordeaux Segalen ISPED, Bordeaux, France
| | - Véronique Godot
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Pierre Wolkenstein
- Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France; Dermatology Department, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
| | - Hakim Hocini
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France
| | - Yves Lévy
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France; Service d'Immunologie Clinique, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France.
| | - Sophie Hüe
- INSERM U955, Team 16, Créteil, France; Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Université Paris Est Créteil, Faculté de Médecine, Créteil, France; Assistance publique, Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris Est Créteil, Val-de Marne (UPEC), Créteil, France; Service d'Immunologie Biologique, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
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157
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Dorschner RA, Williams MR, Gallo RL. Rosacea, the face of innate immunity. Br J Dermatol 2016; 171:1282-4. [PMID: 25523247 DOI: 10.1111/bjd.13446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R A Dorschner
- Division of Dermatology, University of California San Diego, 9500 Gillman Drive, #0869, San Diego, CA, 92093, U.S.A
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158
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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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159
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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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160
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The role of altered cutaneous immune responses in the induction and persistence of rosacea. J Dermatol Sci 2016; 82:3-8. [DOI: 10.1016/j.jdermsci.2015.12.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 12/04/2015] [Accepted: 12/16/2015] [Indexed: 12/29/2022]
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161
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Sato E, Muto J, Zhang LJ, Adase CA, Sanford JA, Takahashi T, Nakatsuji T, Usdin TB, Gallo RL. The Parathyroid Hormone Second Receptor PTH2R and its Ligand Tuberoinfundibular Peptide of 39 Residues TIP39 Regulate Intracellular Calcium and Influence Keratinocyte Differentiation. J Invest Dermatol 2016; 136:1449-1459. [PMID: 27000502 DOI: 10.1016/j.jid.2016.02.814] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 02/22/2016] [Accepted: 02/29/2016] [Indexed: 01/02/2023]
Abstract
Genes related to the parathyroid hormone (PTH) influence cutaneous immune defense and development, but the full functions of the PTH family in cutaneous biology remain incompletely understood. In this study, we examined the expression and potential functions of the PTH second receptor (PTH2R) and its ligand, the tuberoinfundibular peptide of 39 residues (TIP39), in the skin. TIP39 and PTH2R mRNA and protein were detectable in both human and mouse skin, and in cultured keratinocytes and adipocytes. TIP39 was observed in the basal layer of human skin, whereas PTH2R was detected in the spinous to granular layer. The subcellular localization of TIP39 in keratinocytes changed during calcium-induced differentiation and shifted to colocalize with PTH2R at the membrane. The addition of recombinant TIP39 to normal human keratinocytes in culture induced an increase in intercellular calcium and triggered aspects of terminal differentiation including decreased keratin-14 and increased involucrin expression. Consistent with these observations, PTH2R(-/-) mice were observed to have increased epidermal thickness. In summary, identification of TIP39 and its receptor in the epidermis reveals an additional PTH family member that is expressed in the skin and may influence keratinocyte function.
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Affiliation(s)
- Emi Sato
- Department of Dermatology, University of California San Diego, La Jolla, California, USA
| | - Jun Muto
- Department of Dermatology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Ling-Juan Zhang
- Department of Dermatology, University of California San Diego, La Jolla, California, USA
| | - Christopher A Adase
- Department of Dermatology, University of California San Diego, La Jolla, California, USA
| | - James A Sanford
- Department of Dermatology, University of California San Diego, La Jolla, California, USA
| | - Toshiya Takahashi
- Department of Dermatology, University of California San Diego, La Jolla, California, USA
| | - Teruaki Nakatsuji
- Department of Dermatology, University of California San Diego, La Jolla, California, USA
| | - Ted B Usdin
- Section on Fundamental Neuroscience, NIMH National Institute of Mental Health, Bethesda, Maryland, USA
| | - Richard L Gallo
- Department of Dermatology, University of California San Diego, La Jolla, California, USA.
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162
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Avgeris M, Scorilas A. Kallikrein-related peptidases (KLKs) as emerging therapeutic targets: focus on prostate cancer and skin pathologies. Expert Opin Ther Targets 2016; 20:801-18. [PMID: 26941073 DOI: 10.1517/14728222.2016.1147560] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Tissue kallikrein and the kallikrein-related peptidases (KLKs) constitute a family of 15 homologous secreted serine proteases with trypsin- or chymotrypsin-like activities, which participate in a broad spectrum of physiological procedures. Deregulated expression and/or activation of the majority of the family members have been reported in several human diseases, thereby making KLKs ideal targets for therapeutic intervention. AREAS COVERED In the present review, we summarize the role of KLKs in normal human physiology and pathology, focusing on prostate cancer and skin diseases. Furthermore, we discuss the recent advances in the development of KLK-based therapies. A great number of diverse engineered KLKs inhibitors with improved potency, selectivity and immunogenicity have been synthesized by redesigning examples that are endogenous and naturally occurring. Moreover, encouraging results have been documented using KLKs-based vaccines and immunotherapies, as well as KLKs-mediated activation of pro-drugs. Finally, KLKs-targeting aptamers and KLKs-based imaging tools represent novel approaches towards the exploitation of KLKs' therapeutic value. EXPERT OPINION The central/critical roles of KLK family in several human pathologies highlight KLKs as attractive molecular targets for developing novel therapeutics.
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Affiliation(s)
- Margaritis Avgeris
- a Department of Biochemistry and Molecular Biology, Faculty of Biology , University of Athens , Athens , Greece
| | - Andreas Scorilas
- a Department of Biochemistry and Molecular Biology, Faculty of Biology , University of Athens , Athens , Greece
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163
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The role of antimicrobial peptides in chronic inflammatory skin diseases. Postepy Dermatol Alergol 2016; 33:6-12. [PMID: 26985172 PMCID: PMC4793058 DOI: 10.5114/pdia.2015.48066] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 11/12/2014] [Indexed: 11/17/2022] Open
Abstract
Antimicrobial peptides (AMPs) are effector molecules of the innate immune system of the skin. They present an activity against a broad spectrum of Gram-positive and Gram-negative bacteria as well as some fungi, parasites and enveloped viruses. Several inflammatory skin diseases including psoriasis, atopic dermatitis, acne vulgaris and rosacea are characterized by a dysregulated expression of AMPs. Antimicrobial peptides are excessively produced in lesional psoriatic scales or rosacea in contrast to the atopic skin that shows lower AMP levels when compared with psoriasis. The importance of the AMPs contribution to host immunity is indisputable as alterations in the antimicrobial peptide expression have been associated with various pathologic processes. This review discusses the biology and clinical relevance of antimicrobial peptides expressed in the skin and their role in the pathogenesis of inflammatory skin diseases.
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164
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165
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Lacey N, Russell-Hallinan A, Powell F. Study of Demodex
mites: Challenges and Solutions. J Eur Acad Dermatol Venereol 2015; 30:764-75. [DOI: 10.1111/jdv.13517] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/13/2015] [Indexed: 12/12/2022]
Affiliation(s)
- N. Lacey
- The Charles Institute of Dermatology; University College Dublin; Belfield Dublin 4 Ireland
| | - A. Russell-Hallinan
- The Charles Institute of Dermatology; University College Dublin; Belfield Dublin 4 Ireland
| | - F.C. Powell
- The Charles Institute of Dermatology; University College Dublin; Belfield Dublin 4 Ireland
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166
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La photothérapie dynamique antimicrobienne en dermatologie. Partie I : les infections bactériennes et fongiques. Ann Dermatol Venereol 2015; 142:782-8. [DOI: 10.1016/j.annder.2015.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 01/30/2015] [Accepted: 02/06/2015] [Indexed: 11/18/2022]
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167
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Matin N, Tabatabaie O, Mohammadinejad P, Rezaei N. Therapeutic targeting of Toll-like receptors in cutaneous disorders. Expert Opin Ther Targets 2015; 19:1651-63. [DOI: 10.1517/14728222.2015.1069275] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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168
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Kubanova AA, Makhakova YUB. Rosacea: prevalence, pathogenesis, particular features of clinical manifestations. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-3-36-45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
This literature review examines principal aspects of rosacea prevalence in the Russian Federation and abroad, shows present-day opinions about the pathogenesis and histological picture of rosacea and presents actual classification and a number of key clinical forms of the disease.
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169
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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: 163] [Impact Index Per Article: 18.1] [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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170
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Salzer S, Ruzicka T, Schauber J. Face-to-face with anti-inflammatory therapy for rosacea. Exp Dermatol 2015; 23:379-81. [PMID: 24684602 DOI: 10.1111/exd.12401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2014] [Indexed: 12/17/2022]
Abstract
In the past, our understanding of rosacea has been inadequate and limited to descriptions of factors that exacerbate and improve the disease. While the pathophysiology of rosacea is complex and multifactorial, cathelicidin peptides have emerged as key players in the pathogenesis of this common dermatological disorder. This article correlates recent findings in abnormal cathelicidin production and proteolytic processing in rosacea with therapeutic actions of current treatment options and, in this way, highlights potential points of intervention for the development of efficient therapeutic alternatives.
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Affiliation(s)
- Suzanna Salzer
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany
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171
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Prassas I, Eissa A, Poda G, Diamandis EP. Unleashing the therapeutic potential of human kallikrein-related serine proteases. Nat Rev Drug Discov 2015; 14:183-202. [DOI: 10.1038/nrd4534] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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172
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Assessment of the genetic basis of rosacea by genome-wide association study. J Invest Dermatol 2015; 135:1548-1555. [PMID: 25695682 PMCID: PMC4434179 DOI: 10.1038/jid.2015.53] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 12/30/2014] [Accepted: 01/22/2015] [Indexed: 02/06/2023]
Abstract
Rosacea is a common, chronic skin disease that is currently incurable. Although environmental factors influence rosacea, the genetic basis of rosacea is not established. In this genome-wide association study, a discovery group of 22,952 individuals (2,618 rosacea cases and 20,334 controls) was analyzed, leading to identification of two significant single-nucleotide polymorphisms (SNPs) associated with rosacea, one of which replicated in a new group of 29,481 individuals (3,205 rosacea cases and 26,262 controls). The confirmed SNP, rs763035 (P=8.0 × 10−11 discovery group; P=0.00031 replication group), is intergenic between HLA-DRA and BTNL2. Exploratory immunohistochemical analysis of HLA-DRA and BTNL2 expression in papulopustular rosacea lesions from six individuals, including one with the rs763035 variant, revealed staining in the perifollicular inflammatory infiltrate of rosacea for both proteins. In addition, three HLA alleles, all MHC class II proteins, were significantly associated with rosacea in the discovery group and confirmed in the replication group: HLA-DRB1*03:01 (P=1.0 × 10−8 discovery group; P=4.4 × 10−6 replication group), HLA-DQB1*02:01 (P=1.3 × 10−8 discovery group; P=7.2 × 10−6 replication group), and HLA-DQA1*05:01 (P=1.4 × 10−8 discovery group; P=7.6 × 10−6 replication group). Collectively, the gene variants identified in this study support the concept of a genetic component for rosacea, and provide candidate targets for future studies to better understand and treat rosacea.
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173
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Abokwidir M, Fleischer AB. An emerging treatment: Topical ivermectin for papulopustular rosacea. J DERMATOL TREAT 2015; 26:379-80. [DOI: 10.3109/09546634.2014.991672] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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174
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Abstract
The imbalance and/or the perturbation of the microbial populations that colonize the skin and that contribute to its defense may represent one of the causes of the development of noninfectious skin diseases. Atopic dermatitis, psoriasis, acne, and rosacea can be listed among these kinds of pathologies. In particular, considering that microbes have been long addressed as having a role in rosacea, this common dermatosis can be an interesting model to evaluate the correlation between microbiome alterations and the occurrence of clinical manifestations. Different microorganisms have been suggested to have a role in rosacea, but no direct correlation with the incidence of the pathology has been clearly defined. Skin microbiome composition is crucial for the correct skin immune functions and recent findings indicate an abnormal activation of innate immune system associated with the rosacea. The enhanced expression of toll-like receptor 2 in the epidermis of rosacea patients can represent a possible explanation for the amplified inflammatory response to external stimuli observed during the disease. In addition, significantly higher small intestinal bacterial overgrowth prevalence in rosacea subjects has been found and its eradication has been associated with a regression of the skin lesions. In conclusion, both skin and gut microbiome seem to have a role, even if synergistic with other factors, in the pathogenesis of rosacea. A deeper knowledge of human microbiome composition and microbe-host interactions will contribute to clarify the mechanism of development of rosacea and possibly will provide innovative therapeutic approaches.
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175
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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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176
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Salzer S, Kresse S, Hirai Y, Koglin S, Reinholz M, Ruzicka T, Schauber J. Cathelicidin peptide LL-37 increases UVB-triggered inflammasome activation: possible implications for rosacea. J Dermatol Sci 2014; 76:173-9. [PMID: 25306296 DOI: 10.1016/j.jdermsci.2014.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/22/2014] [Accepted: 09/09/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND In patients with rosacea, environmental stressors, especially UVB radiation, trigger disease flares that are characterized by inflammation and vascular hyperactivity. An altered innate immune detection and response system, modulated to a large extent by the aberrant production and processing of human cathelicidin LL-37, is thought to play a central role in disease pathogenesis. OBJECTIVE To investigate whether the proinflammatory and proangiogenic effects of UV radiation are enhanced in the presence of cathelicidin LL-37. METHODS Human skin ex vivo and epidermal keratinocytes in vitro were exposed to UVB irradiation. The proinflammatory effects of UVB exposure in the presence and absence of LL-37 were characterized using immunoblot, transfection, qPCR, and a cell-based second messenger assay. ELISA was used to assess cytokine release and the angiogenic potential of endothelial cells was evaluated using an in vitro angiogenesis assay. RESULTS UVB irradiation triggered the inflammasome-mediated processing and release of IL-1β. LL-37 augmented this UV-induced IL-1β secretion by acting on the P2X7 receptor on keratinocytes. P2X7 receptor activation by UVB and LL-37 resulted in an increase in intracellular calcium concentrations, which enhances inflammasome activation and subsequent IL-1β release. Furthermore, IL-1β and LL-37 worked synergistically to increase the angiogenic potential of endothelial cells. CONCLUSION Cathelicidin LL-37 modulates the proinflammatory and proangiogenic effects of UV radiation and thereby contributes to enhanced sensitivity to sun exposure in rosacea.
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Affiliation(s)
- Suzanna Salzer
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany
| | - Sonja Kresse
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany
| | - Yoji Hirai
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany
| | - Sarah Koglin
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany
| | - Jürgen Schauber
- Department of Dermatology and Allergy, Ludwig-Maximilian-University, Frauenlobstr. 9-11, Munich 80337, Germany.
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177
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Fischer K, Walton S. Parasitic mites of medical and veterinary importance--is there a common research agenda? Int J Parasitol 2014; 44:955-67. [PMID: 25218570 DOI: 10.1016/j.ijpara.2014.08.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 08/22/2014] [Accepted: 08/23/2014] [Indexed: 01/31/2023]
Abstract
There are an estimated 0.5-1 million mite species on earth. Among the many mites that are known to affect humans and animals, only a subset are parasitic but these can cause significant disease. We aim here to provide an overview of the most recent work in this field in order to identify common biological features of these parasites and to inform common strategies for future research. There is a critical need for diagnostic tools to allow for better surveillance and for drugs tailored specifically to the respective parasites. Multi-'omics' approaches represent a logical and timely strategy to identify the appropriate mite molecules. Recent advances in sequencing technology enable us to generate de novo genome sequence data, even from limited DNA resources. Consequently, the field of mite genomics has recently emerged and will now rapidly expand, which is a particular advantage for parasitic mites that cannot be cultured in vitro. Investigations of the microbiota associated with mites will elucidate the link between parasites and pathogens, and define the role of the mite in transmission and pathogenesis. The databases generated will provide the crucial knowledge essential to design novel diagnostic tools, control measures, prophylaxes, drugs and immunotherapies against the mites and associated secondary infections.
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Affiliation(s)
- Katja Fischer
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, Biology Department, Brisbane, Queensland, Australia.
| | - Shelley Walton
- Inflammation and Healing Research Cluster, School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
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178
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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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179
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Lowry MB, Guo C, Borregaard N, Gombart AF. Regulation of the human cathelicidin antimicrobial peptide gene by 1α,25-dihydroxyvitamin D3 in primary immune cells. J Steroid Biochem Mol Biol 2014; 143:183-91. [PMID: 24565560 PMCID: PMC4127358 DOI: 10.1016/j.jsbmb.2014.02.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 02/12/2014] [Accepted: 02/15/2014] [Indexed: 01/08/2023]
Abstract
Production of the human cathelicidin antimicrobial peptide gene (hCAP18/LL-37), is regulated by 1α,25-dihydroxyvitamin D3 (1,25D3) and is critical in the killing of pathogens by innate immune cells. In addition, secreted LL-37 binds extracellular receptors and modulates the recruitment and activity of both innate and adaptive immune cells. Evidence suggests that during infections activated immune cells locally produce increased levels of 1,25D3 thus increasing production of hCAP18/LL-37. The relative expression levels of hCAP18/LL-37 among different immune cell types are not well characterized. The aim of this study was to determine the relative levels of hCAP18/LL-37 in human peripheral blood immune cells and determine to what extent 1,25D3 increased its expression in peripheral blood-derived cells. We show for the first time, a hierarchy of expression of hCAP18 in freshly isolated cells with low levels in lymphocytes, intermediate levels in monocytes and the highest levels found in neutrophils. In peripheral blood-derived cells, the highest levels of hCAP18 following treatment with 1,25D3 were in macrophages, while comparatively lower levels were found in GM-CSF-derived dendritic cells and osteoclasts. We also tested whether treatment with parathyroid hormone in combination with 1,25D3 would enhance hCAP18 induction as has been reported in skin cells, but we did not find enhancement in any immune cells tested. Our results indicate that hCAP18 is expressed at different levels according to cell type and lineage. Furthermore, potent induction of hCAP18 by 1,25D3 in macrophages and dendritic cells may modulate functions of both innate and adaptive immune cells at sites of infection.
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Affiliation(s)
- Malcolm B Lowry
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; Department of Microbiology, Oregon State University, Corvallis, OR 97331, USA
| | - Chunxiao Guo
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; Department of Biochemistry and Biophysics, Oregon State University, Corvallis, OR 97331, USA
| | - Niels Borregaard
- Department of Hematology, Rigshospitalet-4042, University of Copenhagen, Copenhagen DK-1200, Denmark
| | - Adrian F Gombart
- Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA; Department of Biochemistry and Biophysics, Oregon State University, Corvallis, OR 97331, USA.
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180
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181
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[Morbihan disease as a special form of rosacea: review of pathogenesis and new therapeutic options]. Hautarzt 2014; 64:884-6. [PMID: 24201653 DOI: 10.1007/s00105-013-2642-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Morbihan disease is classified as a special form of rosacea, which presents with persistent facial erythema and solid edema because of marked involvement of the lymphatic vessels. The cheeks, nose and forehead are particularly affected. Currently, the treatment options of this cosmetically very disturbing disease are limited. However, every attempt should be made to provide treatment because of the great emotional suffering of the patients. We review some new currently available therapeutic options for Morbihan disease. In our patient, we were able to achieve a significant improvement with systemic isotretinoin 30 mg/day over a period of 12 months.
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182
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Awais M, Anwar MI, Iftikhar R, Iqbal Z, Shehzad N, Akbar B. Rosacea – the ophthalmic perspective. Cutan Ocul Toxicol 2014; 34:161-6. [DOI: 10.3109/15569527.2014.930749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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183
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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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184
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Ferrer L, Ravera I, Silbermayr K. Immunology and pathogenesis of canine demodicosis. Vet Dermatol 2014; 25:427-e65. [PMID: 24910252 DOI: 10.1111/vde.12136] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2014] [Indexed: 12/31/2022]
Abstract
Demodex mites colonized the hair follicles and sebaceous glands of mammals millions of years ago and have remained relatively unchanged in this protected ecologic niche since then. The host immune system detects and tolerates their presence. Toll-like receptor-2 of keratinocytes has been demonstrated to recognize mite chitin and to elicit an innate immune response. The subsequent acquired immune response is poorly understood at present, but there is experimental and clinical evidence that this is the main mechanism in the control of mite proliferation. A transgenic mouse model (STAT(-/-) /CD28(-/-) ) has demonstrated that the immune response is complex, probably involving both cellular and humoral mechanisms and requiring the role of co-stimulatory molecules (CD28). It is known that a genetic predisposition for developing canine juvenile generalized demodicosis exists; however, the primary defect leading to the disease remains unknown. Once the mite proliferation is advanced, dogs show a phenotype that is similar to the T-cell exhaustion characterized by low interleukin-2 production and high interleukin-10 and transforming growth factor-β production by lymphocytes, as described in other viral and parasitic diseases. Acaricidal treatment (macrocyclic lactones) decreases the antigenic load and reverses T-cell exhaustion, leading to a clinical cure. Although in recent years there have been significant advances in the management and understanding of this important and complex canine disease, more research in areas such as the aetiology of the genetic predisposition and the immune control of the mite populations is clearly needed.
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Affiliation(s)
- Lluis Ferrer
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA
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185
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Murillo N, Aubert J, Raoult D. Microbiota of Demodex mites from rosacea patients and controls. Microb Pathog 2014; 71-72:37-40. [PMID: 24768927 DOI: 10.1016/j.micpath.2014.04.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 03/28/2014] [Accepted: 04/08/2014] [Indexed: 12/27/2022]
Abstract
Proliferation of Demodex mites is associated with rosacea. Furthermore, Demodex-associated bacteria were suggested to play a role in the pathogenesis of rosacea. We decided to analyze Demodex microbiota. Mites were collected by standardized skin surface biopsies from patients with erythematotelangiectatic, papulopustular rosacea or from control subjects. The microbiota from each mite was characterized by 16S rRNA clone library approach. The 16S rRNA clone library consisted of 367 clones obtained from 73 extracts originating from 5 samples per study group (ETR, PPR or healthy subjects). A total of 86 species were identified with 36 as Demodex-specific microbiota. In the papulopustular group, proportions of Proteobacteria and Firmicutes increased whereas proportion of Actinobacteria decreased. Here, we report preliminary results on the microbiota of Demodex mites based on a molecular approach showing an unexpected diversity. Differences according to the host status need to be confirmed but open new perspectives for diagnostic of rosacea.
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Affiliation(s)
- Nathalia Murillo
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France
| | - Jérome Aubert
- Galderma R&D, Sophia Antipolis, SNC Les Templiers, 2400 route des Colles, 06410 Biot, France
| | - Didier Raoult
- Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France.
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186
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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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187
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de Veer SJ, Furio L, Harris JM, Hovnanian A. Proteases: common culprits in human skin disorders. Trends Mol Med 2014; 20:166-78. [DOI: 10.1016/j.molmed.2013.11.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/24/2013] [Accepted: 11/25/2013] [Indexed: 12/17/2022]
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188
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Vieira AC, Mannis MJ. Ocular rosacea: common and commonly missed. J Am Acad Dermatol 2014; 69:S36-41. [PMID: 24229635 DOI: 10.1016/j.jaad.2013.04.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 04/21/2013] [Indexed: 12/23/2022]
Abstract
Rosacea is a prevalent disorder that may be disfiguring and cause significant ocular morbidity, if not diagnosed and managed appropriately. Ocular rosacea, in particular, is often left undiagnosed as no specific test is available to confirm the diagnosis. Accurate diagnosis is further complicated because symptoms of ocular rosacea are not always specific to the disorder alone. Other ophthalmic disorders may present with similar findings. Further challenges exist because the severity of ocular symptoms is often not related to the severity of cutaneous findings in rosacea. Isolating a disease marker may facilitate earlier diagnosis and treatment, and could also contribute to better understanding of disease pathogenesis. The glycomics of tear fluid and saliva in patients with rosacea shows promise as an initial step in the search for a biomarker specific to the disease. We have previously found potentially important disease biomarkers in roseatic tear and saliva samples. Further investigation should prove important in the early stages of developing a set of markers for accurate disease identification.
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189
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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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190
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Del Rosso JQ. Management of facial erythema of rosacea: what is the role of topical α-adrenergic receptor agonist therapy? J Am Acad Dermatol 2014; 69:S44-56. [PMID: 24229637 DOI: 10.1016/j.jaad.2013.06.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/11/2013] [Accepted: 06/16/2013] [Indexed: 12/19/2022]
Abstract
Several more recent advances have led to a better understanding of the pathophysiologic mechanisms involved in rosacea and therapeutic modalities used for treatment. Although the clinical features may vary among patients, there are some unifying mechanisms that appear to relate to the more common presentations of rosacea. Both neurovascular dysregulation and augmented immune detection and response appear to play central roles that lead to many of the signs and symptoms of rosacea. Diffuse central facial erythema is a very common finding that intensifies during flares and persists to varying degrees between flares. This background of facial redness occurs secondary to vasodilation and fixed vascular changes that develop over time. Physical modalities are commonly used to treat the erythema that persists as a result of fixed changes in superficial cutaneous vasculature that do not remit after treatment with agents whose mechanisms are active primarily against some of the inflammatory processes operative in rosacea (ie metronidazole, azelaic acid, tetracyclines). As enlarged superficial cutaneous vessels that contribute to the fixed background facial redness of rosacea remain vasoactive to sympathetic nervous system innervation, topical α-adrenergic receptor agonists, namely brimonidine and oxymetazoline, are currently under evaluation for the treatment of facial erythema of rosacea. This article focuses on the clinical differentiation of facial erythema of rosacea and its management.
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Affiliation(s)
- James Q Del Rosso
- Dermatology Residency Program, Valley Hospital Medical Center Las Vegas, Las Vegas, Nevada; Dermatology, Touro University College of Osteopathic Medicine, Henderson, Nevada; Dermatology and Cutaneous Surgery, Las Vegas Skin and Cancer Clinics, Las Vegas and Henderson, Nevada.
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191
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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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192
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Roby KD, Nardo AD. Innate immunity and the role of the antimicrobial peptide cathelicidin in inflammatory skin disease. ACTA ACUST UNITED AC 2013; 10:e79-e82. [PMID: 24489580 DOI: 10.1016/j.ddmec.2013.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cathelicidin antimicrobial peptide is an important mediator of the innate immune response. In addition to its potent antimicrobial activity, cathelicidin has been shown to have chemoattractant and angiogenic properties. Recent research has demonstrated that, in addition to its aforementioned functions, cathelicidin plays an important role in the complex pathogenesis of several chronic inflammatory skin diseases. This review will present a concise overview of the role of cathelicidin in infection and in the development of atopic dermatitis, psoriasis, and rosacea. This understanding will direct future research efforts to identify therapeutic approaches that use cathelicidin as a novel drug itself, or aim to modify its expression and regulation.
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Affiliation(s)
- Keith D Roby
- Department of Medicine, Division of Dermatology University of California, San Diego 9500 Gilman Drive # 0869 La Jolla, CA 92093-0869
| | - Anna Di Nardo
- Department of Medicine, Division of Dermatology University of California, San Diego 9500 Gilman Drive # 0869 La Jolla, CA 92093-0869
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193
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Schommer NN, Gallo RL. Structure and function of the human skin microbiome. Trends Microbiol 2013; 21:660-8. [PMID: 24238601 DOI: 10.1016/j.tim.2013.10.001] [Citation(s) in RCA: 238] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/07/2013] [Accepted: 10/11/2013] [Indexed: 01/22/2023]
Abstract
An abundant and diverse collection of bacteria, fungi, and viruses inhabits the human skin. These microorganisms vary between individuals and between different sites on the skin. The factors responsible for the unique variability of the skin microbiome are only partly understood, but results suggest that host genetic and environmental influences play a major role. Today, the steady accumulation of data describing the skin microbiome, combined with experiments designed to test the biological functions of surface microbes, has provided new insights into links between human physiology and skin microbiota. This review describes some of the current information regarding the skin microbiome and its impact on human health. Specifically, we summarize the present understanding of the function of microbe-host interactions on the skin and highlight some unique features that distinguish skin commensal organisms from pathogenic microbes.
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Affiliation(s)
- Nina N Schommer
- Division of Dermatology, University of California, San Diego, La Jolla, CA, USA
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194
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Darlenski R, Kazandjieva J, Tsankov N, Fluhr JW. Acute irritant threshold correlates with barrier function, skin hydration and contact hypersensitivity in atopic dermatitis and rosacea. Exp Dermatol 2013; 22:752-3. [DOI: 10.1111/exd.12251] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Razvigor Darlenski
- Department of Dermatology and Venereology; Tokuda Hospital; Sofia Bulgaria
| | - Jana Kazandjieva
- Department of Dermatology and Venereology; Medical Faculty; Medical University; Sofia Bulgaria
| | - Nikolai Tsankov
- Department of Dermatology and Venereology; Tokuda Hospital; Sofia Bulgaria
| | - Joachim W. Fluhr
- Department of Dermatology; Charité Universitaetsmedizin; Berlin Germany
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195
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Potential role of microorganisms in the pathogenesis of rosacea. J Am Acad Dermatol 2013; 69:1025-32. [PMID: 24011460 DOI: 10.1016/j.jaad.2013.08.006] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 07/30/2013] [Accepted: 08/02/2013] [Indexed: 02/07/2023]
Abstract
Rosacea is a skin condition of abnormal inflammation and vascular dysfunction. The active contribution of a microbial agent in the development or progression of rosacea continues to be debated. Research supports the presence of commensal Demodex folliculorum mites at increased density in the skin and associates Helicobacter pylori infection of the gut with rosacea. Fewer studies implicate Staphylococcus epidermidis, Chlamydophila pneumoniae, and the Demodex-associated bacteria Bacillus oleronius. No research, however, provides a mechanism by which colonization by a microorganism translates to manifestation of the condition. Prevailing and emerging principles in the biology of the microbiome and the pathophysiology of rosacea may help to reconcile these lingering questions. Here the microorganisms implicated in rosacea are reviewed and the reaction of the microbiome to inflammation and to changes in microenvironments and macroenvironments are discussed to explain potential roles for microorganisms in rosacea pathophysiology.
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196
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Coda AB, Hata T, Miller J, Audish D, Kotol P, Two A, Shafiq F, Yamasaki K, Harper JC, Del Rosso JQ, Gallo RL. Cathelicidin, kallikrein 5, and serine protease activity is inhibited during treatment of rosacea with azelaic acid 15% gel. J Am Acad Dermatol 2013; 69:570-7. [PMID: 23871720 DOI: 10.1016/j.jaad.2013.05.019] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 05/13/2013] [Accepted: 05/18/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Excess cathelicidin and kallikrein 5 (KLK5) have been hypothesized to play a role in the pathophysiology of rosacea. OBJECTIVE We sought to evaluate the effects of azelaic acid (AzA) on these elements of the innate immune system. METHODS Gene expression and protease activity were measured in laboratory models and patients with rosacea during a 16-week multicenter, prospective, open-label study of 15% AzA gel. RESULTS AzA directly inhibited KLK5 in cultured keratinocytes and gene expression of KLK5, Toll-like receptor-2, and cathelicidin in mouse skin. Patients with rosacea showed reduction in cathelicidin and KLK5 messenger RNA after treatment with AzA gel. Subjects without rosacea had lower serine protease activity (SPA) than patients with rosacea. Distinct subsets of patients with rosacea who had high and low baseline SPA were identified, and patients with high baseline exhibited a statistically significant reduction of SPA with 15% AzA gel treatment. LIMITATIONS Study size was insufficient to predict clinical efficacy based on the innate immune response to AzA. CONCLUSIONS These results show that cathelicidin and KLK5 decrease in association with AZA exposure. Our observations suggest a new mechanism of action for AzA and that SPA may be a useful biomarker for disease activity.
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Affiliation(s)
- Alvin B Coda
- Division of Dermatology, Department of Medicine, University of California-San Diego, San Diego, California
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197
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Murillo N, Raoult D. Skin microbiota: overview and role in the skin diseases acne vulgaris and rosacea. Future Microbiol 2013; 8:209-22. [PMID: 23374126 DOI: 10.2217/fmb.12.141] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
As the first barrier to environmental exposures, human skin has developed an integrated immune system to protect the inner body from chemical, physical or microbial insults. Microorganisms inhabiting superficial skin layers are known as skin microbiota and include bacteria, viruses, archaea and fungi. The microbiota composition is crucial in the instruction and support of the skin's immune system. Changes in microbiota can be due to individual, environmental or behavioral factors, such as age, climate, hygiene or antibiotic consumption, which can cause dysbiosis. The contribution of skin microbiota to disease development is known in atopic dermatitis, where there is an increase in Staphylococcus aureus. Culture-independent studies have enabled more accurate descriptions of this complex interplay. Microbial imbalance is associated with the development of various diseases. This review focuses on microbial imbalances in acne vulgaris and rosacea.
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Affiliation(s)
- Nathalia Murillo
- Université Aix Marseille, URMITE, UMR CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
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198
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Domínguez-Hüttinger E, Ono M, Barahona M, Tanaka RJ. Risk factor-dependent dynamics of atopic dermatitis: modelling multi-scale regulation of epithelium homeostasis. Interface Focus 2013; 3:20120090. [PMID: 23853706 PMCID: PMC3638487 DOI: 10.1098/rsfs.2012.0090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Epithelial tissue provides the body with its first layer of protection against harmful environmental stimuli by enacting the regulatory interplay between a physical barrier preventing the influx of external stimuli and an inflammatory response to the infiltrating stimuli. Importantly, this interdependent regulation occurs on different time scales: the tissue-level barrier permeability is regulated over the course of hours, whereas the cellular-level enzymatic reactions leading to inflammation take place within minutes. This multi-scale regulation is key to the epithelium's function and its dysfunction leads to various diseases. This paper presents a mathematical model of regulatory mechanisms in the epidermal epithelium that includes processes on two different time scales at the cellular and tissue levels. We use this model to investigate the essential regulatory interactions between epidermal barrier integrity and skin inflammation and how their dysfunction leads to atopic dermatitis (AD). Our model exhibits a structure of dual (positive and negative) control at both cellular and tissue levels. We also determined how the variation induced by well-known risk factors for AD can break the balance of the dual control. Our model analysis based on time-scale separation suggests that each risk factor leads to qualitatively different dynamic behaviours of different severity for AD, and that the coincidence of multiple risk factors dramatically increases the fragility of the epithelium's function. The proposed mathematical framework should also be applicable to other inflammatory diseases that have similar time-scale separation and control architectures.
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199
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200
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Reinholz M, Tietze JK, Kilian K, Schaller M, Schöfer H, Lehmann P, Zierhut M, Klövekorn W, Ruzicka T, Schauber J. Rosacea - S1 Guideline. J Dtsch Dermatol Ges 2013; 11:768-80; 768-79. [DOI: 10.1111/ddg.12101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Markus Reinholz
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Julia K. Tietze
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Katharina Kilian
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | | | - Helmut Schöfer
- Department of Dermatology; Venereology, and Allergology; University of Frankfurt/Main; Germany
| | - Percy Lehmann
- Center for Dermatology; Allergology, and Surgical Dermatology; Helios Clinic Wuppertal; Germany
| | | | | | - Thomas Ruzicka
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
| | - Jürgen Schauber
- Clinic and Polyclinic for Dermatology and Allergology; University of Munich; Germany
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