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Sánchez-Pellicer P, Eguren-Michelena C, García-Gavín J, Llamas-Velasco M, Navarro-Moratalla L, Núñez-Delegido E, Agüera-Santos J, Navarro-López V. Rosacea, microbiome and probiotics: the gut-skin axis. Front Microbiol 2024; 14:1323644. [PMID: 38260914 PMCID: PMC10800857 DOI: 10.3389/fmicb.2023.1323644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Rosacea is an inflammatory skin disease involving diverse symptoms with a variable clinical progress which can severely impact the patient's quality of life as well as their mental health. The pathophysiological model of rosacea involves an unbalanced immune system predisposed to excessive inflammation, in addition to vascular and nervous alterations, being certain cutaneous microorganisms' triggers of the symptoms onset. The gut-skin axis explains a bidirectional interaction between skin and gut microbiota in some inflammatory skin diseases such as atopic dermatitis, psoriasis, or rosacea. The introduction and consolidation of the next-generation sequencing in recent years has provided unprecedented information about the microbiome. However, the characterization of the gut and skin microbiota and the impact of the gut-skin axis in patients with rosacea has been little explored, in contrast to other inflammatory skin diseases such as atopic dermatitis or psoriasis. Furthermore, the clinical evolution of patients with rosacea is not always adequate and it is common for them to present a sustained symptomatology with frequent flare-ups. In this context, probiotic supplementation could improve the clinical evolution of these patients as happens in other pathologies. Through this review we aim to establish and compile the basics and directions of current knowledge to understand the mechanisms by which the microbiome influences the pathogenesis of rosacea, and how modulation of the skin and gut microbiota could benefit these patients.
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Affiliation(s)
- Pedro Sánchez-Pellicer
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | | | | | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Laura Navarro-Moratalla
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Eva Núñez-Delegido
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Juan Agüera-Santos
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Vicente Navarro-López
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital of Vinalopó-Fisabio, Elche, Spain
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Rodrigues-Braz D, Zhao M, Yesilirmak N, Aractingi S, Behar-Cohen F, Bourges JL. Cutaneous and ocular rosacea: Common and specific physiopathogenic mechanisms and study models. Mol Vis 2021; 27:323-353. [PMID: 34035646 PMCID: PMC8131178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/11/2021] [Indexed: 11/21/2022] Open
Abstract
Rosacea is a chronic inflammatory disease that affects the face skin. It is clinically classified into the following four subgroups depending on its location and severity: erythematotelangiectatic, papulopustular, phymatous, and ocular. Rosacea is a multifactorial disease triggered by favoring factors, the pathogenesis of which remains imperfectly understood. Recognized mechanisms include the innate immune system, with the implication of Toll-like receptors (TLRs) and cathelicidins; neurovascular deregulation involving vascular endothelial growth factor (VEGF), transient receptor potential (TRP) ion channels, and neuropeptides; and dysfunction of skin sebaceous glands and ocular meibomian glands. Microorganisms, genetic predisposition, corticosteroid treatment, and ultraviolet B (UVB) radiation are favoring factors. In this paper, we review the common and specific molecular mechanisms involved in the pathogenesis of cutaneous and ocular rosacea and discuss laboratory and clinical studies, as well as experimental models.
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Affiliation(s)
- Daniela Rodrigues-Braz
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
| | - Min Zhao
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
| | - Nilufer Yesilirmak
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Selim Aractingi
- Department of Dermatology, AP-HP, Cochin Hospital, Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Jean-Louis Bourges
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
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Updates on the Risk of Neuropsychiatric and Gastrointestinal Comorbidities in Rosacea and Its Possible Relationship with the Gut-Brain-Skin Axis. Int J Mol Sci 2020; 21:ijms21228427. [PMID: 33182618 PMCID: PMC7696644 DOI: 10.3390/ijms21228427] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 02/07/2023] Open
Abstract
Rosacea is a common chronic cutaneous inflammatory disorder. Recently, patients with rosacea were identified as having a higher risk of developing various comorbidities such as cardiovascular disease, psychiatric disorders, neurologic disorders, and gastrointestinal disorders. However, the risks of some comorbidities in patients with rosacea are somewhat contradictory, depending upon the study design. Moreover, pathomechanisms associated with the comorbidities of patients with rosacea remain poorly elucidated. The purpose of this review was to provide the most up-to-date evidence on the risks of neuropsychiatric and gastrointestinal comorbidities in patients with rosacea. Moreover, the molecular pathomechanisms associated with neuropsychiatric and gastrointestinal comorbidities in patients with rosacea were evaluated based on recent studies. This review was also intended to focus more on the role of the gut–brain–skin axis in the association of neuropsychiatric and gastrointestinal comorbidities in rosacea.
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Oliveira CMMD, Almeida LMC, Bonamigo RR, Lima CWGD, Bagatin E. Consensus on the therapeutic management of rosacea - Brazilian Society of Dermatology. An Bras Dermatol 2020; 95 Suppl 1:53-69. [PMID: 33172727 PMCID: PMC7772594 DOI: 10.1016/j.abd.2020.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/14/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Rosacea is a chronic inflammatory disease of the skin, relatively more frequent in women over 30 with a low phototype and proven genetic predisposition. Although its etiology is unknown and possibly multifactorial, the immunological abnormality, associated with neurovascular dysregulation and triggering factors, are important elements in its pathophysiology, which lead to the main changes of inflammation, vasodilation, and angiogenesis that are responsible for the clinical manifestations. Despite the lack of cure, numerous therapeutic options are available for the different clinical presentations of the disease, with satisfactory responses. OBJECTIVE To reach a consensus, with recommendations from experts, on the therapeutic management of rosacea suitable to the Brazilian setting. METHODS The study was conducted by five specialized dermatologists from university centers, representatives of the different Brazilian regions, with experience in rosacea, who were appointed by the Brazilian Society of Dermatology. Based on the adapted DELPHI methodology, the experts contributed through an updated bibliographic review of the scientific evidence, combined with personal experiences. RESULTS The group of experts reached a consensus on the relevant aspects in the therapeutic management of rosacea, providing information on epidemiology, pathophysiology, triggering factors, clinical condition, classification, quality of life, and comorbidities. Consensus was defined as approval by at least 90% of the panel. CONCLUSION Despite the impossibility of cure, there are several therapeutic alternatives specific to each patient that provide excellent results, with chances of total improvement and long periods of remission, promoting a positive impact on quality of life. This consensus provides detailed guidance for clinical practice and therapeutic decisions in rosacea.
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Affiliation(s)
| | - Luiz Mauricio Costa Almeida
- Department of Dermatology, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil; Dermatology Service, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Renan Rangel Bonamigo
- Dermatology Service, Hospital das Clínicas de Porto Alegre, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Ediléia Bagatin
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Shah P, Sagar PR, Alhumaidi N, Bollampally VC, Malik BH. Parkinson's Disease and Its Dermatological Associations: Is Your Skin Whispering You a Diagnosis? Cureus 2020; 12:e9933. [PMID: 32968594 PMCID: PMC7505647 DOI: 10.7759/cureus.9933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disease characterized clinically by the triad of resting tremor, rigidity, and bradykinesia. Although PD is primarily known for motor disturbance, 98.6% of patients experience one or more non-motor symptoms at all stages of the disease. Dermatological disorders are discussed as common non-motor associations of PD since the 20th century. Many studies have shown that patients of PD are predisposed to skin disorders. This article is a traditional review done to analyze the association between PD and its dermatological manifestations. We did a literature search using six keywords in the PubMed database and took the relevant articles published in the last 10 years. We reviewed more than 100 articles, which also included animal studies. On meticulous review, we observed an increased incidence of certain skin disorders like seborrheic dermatitis, bullous pemphigoid, rosacea, and melanoma in patients of PD. These disorders share either common risk factors or underlying mechanisms revolving around genetics, immunology, inflammation, and pathophysiology of PD, but the exact causation yet seems obscured. We believe that this opens a horizon for more research in the link between the skin and nervous system. We also emphasize that the dermatologists, neurologists and general physicians should address the cutaneous disorders in PD timely, educate their patients, help them lessen the psychosocial distress, and improve their quality of life.
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Affiliation(s)
- Puja Shah
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Prem Raj Sagar
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Norah Alhumaidi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Bilal Haider Malik
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Wang L, Li XH, Wen X, Li XX, Du D, Li Y, Jiang X. Retrospective analysis of 19 papulopustular rosacea cases treated with oral minocycline and supramolecular salicylic acid 30% chemical peels. Exp Ther Med 2020; 20:1048-1052. [PMID: 32765658 PMCID: PMC7388548 DOI: 10.3892/etm.2020.8740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 03/19/2020] [Indexed: 02/05/2023] Open
Abstract
Papulopustular rosacea (PPR) is characterized by central facial erythema and transient papules and/or pustules, with or without telangiectases. The treatment of PPR is challenging due to the unclear and complex pathogenesis. In the present retrospective study, patients with PPR treated with oral minocycline and supramolecular salicylic acid (SSA) 30% chemical peels enrolled between June 2018 and June 2019 were evaluated. All patients were treated with 50 mg minocycline twice a day and SSA 30% twice a month. A total of 19 patients were enrolled and all received the therapy for 12 weeks. A significant reduction of rosacea severity was observed by Investigator Severity Assessment (ISA) after treatment; the mean score reduced from 3.32±0.6 at baseline to 0.89±0.7 (P<0.01) at 12 weeks. After 12 weeks, all patients achieved at least a ‘moderate response’ and 17 patients (89.47%) obtained ‘excellent improvement’ in the Investigator Global Assessment of efficacy. No obvious adverse reactions were observed during each patient's visit. In conclusion, the combination treatment of minocycline and SSA 30% was an effective therapy for PPR. The limitation of the present study was that it was a retrospective analysis; more high-quality, prospective, blinded, controlled clinical trials are required to evaluate the efficacy based on the current study.
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Affiliation(s)
- Lian Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiao-Hua Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiao-Xue Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Dan Du
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yong Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Babadjanov OA, Karimov HY, Arifov SS, Boboev KT. Evaluation into the Role of the VEGF Gene Polymorphism rs2010963 in the Development of Rosacea and its Relationship with Clinical Subtypes of the Disease. CYTOL GENET+ 2019. [DOI: 10.3103/s0095452719030083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Won E, Han KM, Kim A, Lee MS, Kim YK, Chang HS, Ham BJ. The associations of TAC1 gene polymorphisms with major depressive disorder. Mol Cell Toxicol 2019. [DOI: 10.1007/s13273-019-0016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Xiao Y, Zhao XP. Screening pathways and hub genes involved in osteoclastogenesis by gene expression analysis of circulating monocytes based on Gibbs sampling. Exp Ther Med 2019; 17:2529-2534. [PMID: 30906441 PMCID: PMC6425127 DOI: 10.3892/etm.2019.7225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 01/03/2019] [Indexed: 12/14/2022] Open
Abstract
Differential expression pathways and hub genes in circulating monocytes from healthy Chinese women with high peak bone mass (PBM) vs. low PBM were explored using a Markov chain Monte Carlo (MCMC) algorithm. Human circulating monocytes transcription profiling (containing 14 samples with high PBM and 12 samples with low PBM) and KEGG pathways were all downloaded from the public database. Initial state of all the pathways were constructed and Gibbs sampling was performed to obtain a Markov chain and the posterior values of all the pathways were calculated. The probability (α) of occurrence of each pathway was calculated based on the posterior value and it was adjusted by taking gene expression variation into account. Pathways with αadj >0.8 were considered as differentially expressed pathways. Then, these steps were performed again on all the genes in the differentially expressed pathways to find the hub genes in the differential pathways. After Gibbs sampling, neuroactive ligand-receptor interaction (hsa04080) with αadj = 0.986 was screened out as the differentially expressed pathway. Analyzing the genes in this pathway, three genes (neurotensin, tachykinin receptor 3 and follicle-stimulating hormone receptor) with αadj >0.8 were identified as hub genes in circulating monocytes which may associate with osteoporosis development. One pathway and three genes which may possess close relationship with osteoporosis development were found in this study. These results provide insights into our understanding of the role of circulating monocytes in osteoporosis development.
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Affiliation(s)
- Yu Xiao
- Department of Joint, Tianjin Hospital, Hexi, Tianjin 300211, P.R. China
| | - Xue-Ping Zhao
- Department of Orthopedics, Guizhou Space Hospital, Zunyi, Guizhou 563000, P.R. China
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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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