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Research Grants Awarded

Monday, January 15, 2007

National Rosacea Society Awards New Grants for Rosacea Research

The National Rosacea Society (NRS) announced that five new studies have been awarded funding as part of its research grants program to advance scientific knowledge of the potential causes and other key aspects of this chronic and potentially life-disruptive disorder that affects an estimated 14 million Americans.

"We are extremely grateful to the many thousands of rosacea patients whose donations are used to fund this important research grants program," said Dr. Jonathan Wilkin, chairman of the NRS medical advisory board, which reviews and selects the research proposals for funding. "Study results to date are leading to important advances in the understanding of rosacea, and we are hopeful that these findings will result in significant improvements in its effective management and potential prevention or cure."

Dr. Sandra Cremers, assistant professor of ophthalmology at Harvard Medical School, was awarded $25,000 for a study evaluating the role of angiogenesis (new blood vessel formation) in ocular rosacea. Dr. Cremers will investigate the levels of angiogenesis markers, such as vascular endothelial growth factor (VEGF), in the conjunctiva and eyelids of patients with severe ocular rosacea, compared with normal subjects. She postulates that defining the role of angiogenesis in the development of ocular rosacea may bring focus to future research on this common rosacea subtype, and eventually lead to the development of an effective treatment.

Dr. Richard Gallo, chief of the division of dermatology at the University of California - San Diego, and Dr. Kenshi Yamasaki of the Veterans Medical Research Foundation were awarded $25,000 to continue their NRS-funded research of how cathelicidins, one of the body's own natural antibiotics, may play a role in the development of rosacea symptoms.

The investigators most recently determined that an excess of an enzyme in the facial skin of rosacea patients leads to an accumulation of cathelicidins, an antimicrobial peptide that can cause inflammation and increased blood vessel growth. In a new study, they will be investigating the causes of this enzymatic abnormality and testing whether this enzyme may be a key cause of rosacea.

Dr. Richard Granstein, chairman of dermatology at Cornell University, and colleagues were awarded $25,000 to continue their research on the role of adenosine triphosphate (ATP), an agent produced by nerves that earlier NRS-funded studies had shown initiates an inflammatory response in human dermal endothelial cells. The researchers will also expand their study to examine whether three other agents produced by nerves elicit effects similar to ATP, and will test whether therapeutic agents for rosacea work by inhibiting the expression of inflammation-causing molecules by endothelial cells.

Dr. Kent T. Keyser, professor of vision sciences at the University of Alabama at Birmingham, received $25,000 to study the effects of nicotine on rosacea. Because previous research has shown that nicotine can cause new blood vessels to form in the skin, Dr. Keyser plans to investigate which intracellular signaling pathways are affected and which cellular mechanisms may cause a reaction in rosacea. In addition, Dr. Keyser will examine the short- and long-term effects of nicotine on gene expression and transcription as they may relate to the development of rosacea.

Dr. Martin Steinhoff, department of dermatology, University of Muenster, Germany, was awarded $25,000 to study the role of neuroimmune interactions in the pathophysiology of rosacea. In previous NRS-funded studies, Dr. Steinhoff's team found that neuropeptide-positive sensory nerves around blood vessels increase during rosacea's development. In addition, they discovered that a combination of several neuropeptides, neuropeptide receptors and endopeptidases is involved in maintaining homeostasis, but this balance is compromised in rosacea skin. In the new study, the researchers will examine whether the ineffective interaction between neuropeptide receptors and neuropeptide-degrading enzymes results in dysregulation and contributes to the development of rosacea.

Researchers interested in applying for grants can obtain forms and instructions by contacting the National Rosacea Society, 800 South Northwest Highway, Suite 200, Barrington, Illinois 60010, telephone 1-888-662-5874, e-mail rosaceas@aol.com. The deadline for submitting proposals for research grants in 2007 is September 15. Further information is available on the NRS Web site at www.rosacea.org/grants/.

Because the cause of rosacea is unknown, a high priority in awarding grants is given to studies relating to its pathogenesis, progression, mechanism of action, cell biology and potential genetic factors. Proposals relating to epidemiology, predisposition, quality of life and relationships with environmental and lifestyle factors may also be considered.

Members of the NRS medical advisory board include Dr. Jonathan Wilkin, former director of dermatologic and dental drug products for the U.S. Food and Drug Administration; Dr. Mark Dahl, chairman of dermatology at the Mayo Clinic-Scottsdale and former American Academy of Dermatology (AAD) president; Dr. Michael Detmar, associate professor of dermatology at Harvard Medical School; Dr. Lynn Drake, Harvard Medical School and former AAD president; Dr. David Norris, chairman of dermatology at the University of Colorado and former president of the Society for Investigative Dermatology; Dr. Frank Powell, consultant dermatologist with the Regional Centre of Dermatology, Dublin, Ireland; Dr. Richard Odom, professor of dermatology at the University of California - San Francisco and former AAD president; and Dr. Bryan Sires, clinical associate professor of ophthalmology at the University of Washington.

Rosacea is a chronic disorder primarily of the facial skin, characterized by flare-ups and remissions. According to the standard classification system for rosacea, developed by an NRS consensus committee and review panel of 17 experts worldwide, the primary features of rosacea include flushing, persistent erythema, papules and pustules, and telangiectasia, while secondary features may include ocular manifestations, burning and stinging, plaques, dry appearance, edema, locations beyond the face and phymatous changes. In most cases, some rather than all of these signs and symptoms appear in any given patient.

The NRS is a nonprofit organization dedicated to improving the lives of people with rosacea by raising awareness, providing public health information and supporting research on this common but biologically poorly understood disorder.

Dark Side of ATP

Friday, January 5, 2007

New Study Uncovers the Dark Side of ATP

Researchers have found that one of the most common and hard-working substances in the body may have a Jekyll and Hyde quality in rosacea patients, assuming a darker role when activated by flare-up triggers.

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

The researchers have discovered that when adenosine 5'-triphosphate (ATP) -- a neurotransmitter and carrier of chemical energy throughout the body -- is released into the skin by the nerves, a cascade of microscopic events may occur in rosacea patients that ultimately leads to the bumps and pimples of subtype 2 (papulopustular) rosacea.

"As with many disorders, inflammation represents a normal body process gone awry," Dr, Granstein explained. Inflammation is a protective response to injury or destruction of tissues that serves to destroy, dilute or wall off both the agent of injury and the injured tissue, so that tissue can repair itself.

The most evident outward signs and symptoms of inflammation are pain, heat, redness, swelling and loss of function. However, the biochemical processes that accomplish this reaction are complex, and involve dilation of blood vessels accompanied by increased blood flow, release of fluids and the movement of leukocytes -- blood cells that engulf and digest bacteria and fungi and are an important part of the body's defense system, according to Dr. Granstein.

While ATP has many functions in the body, its role in the development of rosacea may involve its job as a messenger from the nerves. The nervous system regulates blood flow to the skin, using ATP to prompt the dilation of blood vessels following exposure to rosacea triggers such as sunlight, emotional stress or alcohol. This process may result in the flushing and redness of subtype 1 (erythematotelangectatic) rosacea.

According to Dr. Granstein, ATP has also been shown to be involved in the movement and buildup of leukocytes onto endothelial cells -- cells that line the blood vessels. In rosacea, the researchers found that endothelial cells respond to ATP with changes in the expression of inflammatory cytokines and other substances that act to recruit inflammatory cells and may lead to rosacea's bumps and pimples.

"As we continue to learn more about the biochemical processes that lead to rosacea, we should increasingly be able to identify how signs and symptoms occur in order to develop appropriate means to prevent them," Dr. Granstein said. He noted that, while current therapies may block some of these pathways, the process is still unclear and should become increasingly evident through continuing research.

In previous NRS-funded studies, Dr. Granstein's team demonstrated that ultraviolet B (UVB) radiation, which is found in sunlight and causes sunburn, may increase vascular endothelial growth factor (VEGF), a regulator of blood vessel growth that may cause visible blood vessels (telangiectasia) associated with subtype 1 rosacea. In addition, they found that UVB may increase interleukin 8, which plays a role in inflammation.

For more information on results of NRS-funded studies, visit the Research Results page in the research grants section.