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Research Grants Awarded

Thursday, February 26, 2009

The National Rosacea Society (NRS) has awarded funding to four new studies 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 thousands of rosacea patients whose donations are used to support this important program," said Dr. Jonathan Wilkin, chairman of the NRS medical advisory board, which reviews and selects grant applications for funding. "The ongoing study results are making significant inroads toward the better understanding and management of rosacea, as well as its potential prevention or cure."

Dr. Robert W. Walters, assistant professor, Division of Dermatology, and Dr. Robert J. Lefkowitz, professor, Department of Medicine, Duke University Medical Center, were awarded $25,000 to study the role of beta-arrestin in cutaneous flushing. The researchers pointed out that niacin, or vitamin B3, long associated with severe flushing, stimulates receptors on skin cells that react by activating both G and beta-arrestin proteins. However, they noted that a recent study has identified niacin-like drugs that can stimulate only the G protein but do not induce flushing, suggesting that it is the beta-arrestins that may regulate flushing. The results of the new project are intended to lead to better understanding of changes in skin blood flow and possible treatments for this significant symptom of rosacea.

Dr. Curdin Conrad, senior postdoctoral research fellow, Department of Immunology, MD Anderson Cancer Center, and Dr. Alexander Navarini, senior postdoctoral research fellow, Department of Dermatology, University Hospital of Zurich, Switzerland, were awarded $21,450 to study the role of plasmacytoid dendritic cells and interferon alpha in rosacea.

They noted that their work is a logical follow-on to the studies by Dr. Richard Gallo and colleagues, also supported by the NRS, which found that in rosacea, antimicrobial peptides such as cathelicidins are involved. Given that these peptides are part of the innate immune system, their work will examine the next steps in the body's immunological process to see whether type I interferon, glycoproteins that help fight viral infections, and plasmacytoid dendritic cells, which produce interferon, are present in rosacea. They noted that these mechanisms contribute to psoriasis, and a similar finding in rosacea could form a sound basis for newer treatment strategies for rosacea.

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 may play a role in the development of subtype 2 (papulopustular) rosacea.

Past support from the NRS has enabled them to show that people with rosacea have too much of a molecule known as cathelicidin, and using mice and artificial cell culture techniques, they showed that this excess leads to rosacea symptoms. They have also shown that the overabundance of cathelicidin is the result of an excess of an enzyme in the facial skin.

In the new study, the researchers will test their hypothesis that the abnormal enzyme is a critical step in the development of rosacea. Too much cathelicidin and too much of this specific class of enzyme may explain its presence, which may in turn suggest a therapy that will inhibit the production or action of these molecules.

Dr. Joseph Rothnagel, associate professor, and Dr. Manuela Trabi, adjunct lecturer, Department of Molecular and Microbial Sciences, The University of Queensland, Australia, were awarded $18,000 for their study, "The role of tissue kallikreins in rosacea." This study will also build from the work of Dr. Gallo and colleagues. They noted that these previous studies reported involvement of the enzyme hK5 and protein CAP18, and hypothesize that at least one other enzyme is also elevated in rosacea. They will study whether proteins known to be crucial for skin integrity are also digested at a higher than normal rate by these enzymes, allowing easier access for pathogens.

Researchers interested in applying for grants may obtain forms and instructions in the research grants section of rosacea.org, or 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 2009 is October 15.

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 Mayo Clinic-Scottsdale and former American Academy of Dermatology (AAD) president; Dr. Michael Detmar, professor of pharmacogenics, Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology, Zurich, Switzerland; Dr. Lynn Drake, Harvard Medical School and former AAD president; Dr. Marian Macsai, vice chair of ophthalmology at Northwestern University; Dr. David Norris, chairman of dermatology, University of Colorado and former president of the Society for Investigative Dermatology; Dr. Richard Odom, professor of clinical dermatology, University of California-San Francisco and former president of the AAD; Dr. Frank Powell, consultant dermatologist, Regional Centre of Dermatology, Mater Misericordiae Hospital, Dublin, Ireland; Dr. Bryan Sires, clinical associate professor of ophthalmology, University of Washington; and Dr. Diane Thiboutot, professor of dermatology, Pennsylvania State University.

Rosacea Awareness in April

Thursday, February 5, 2009

While the negative impact of rosacea on personal and professional life is increasingly recognized, new research continues to suggest that this often life-disruptive disorder may be far more common than is widely believed. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to alert the public to the warning signs of this conspicuous, red-faced condition now estimated to affect well over 14 million Americans.

"The early clues to rosacea are confusing for many people because the signs and symptoms often come and go, and are easily mistaken for something else," said Dr. Jonathan Wilkin, chairman of the NRS medical advisory board. "Unfortunately, without medical treatment rosacea usually continues and may become worse, and can have substantial impact not only physically but on an individual's emotional, social and work life."

In NRS surveys, more than 76 percent of rosacea patients said their condition had lowered their self-confidence and self-esteem, and 52 percent reported that it had caused them to avoid public contact or social engagements. Among rosacea patients with severe symptoms, nearly 70 percent said the disorder had adversely affected their professional interactions and nearly 30 percent said they had even missed work because of their condition -- which may be especially harmful in today's economic setting.

The good news is that 80 percent of the survey respondents reported that medical therapy had also improved their emotional, social and professional well being.

During Rosacea Awareness Month, public education activities will be conducted by the NRS to increase awareness and understanding of this widespread disorder, emphasizing its warning signs and urging those who suspect they may have the condition to see a dermatologist or other physician. In addition, bulk quantities of NRS educational materials are available to health professionals for their patients.

Although rosacea varies from one patient to another, its primary signs may include facial flushing or transient erythema (redness), persistent erythema, papules (bumps) and pustules (pimples), and telangiectasia (visible blood vessels), according to the NRS standard classification of rosacea, developed by a consensus committee and review panel of 17 experts worldwide. Secondary features may include burning or stinging, plaques (raised patches on the skin), a dry appearance, edema (swelling), ocular manifestations and phymatous changes, in which the skin thickens.

The standard subtypes of rosacea reflect the most common patterns of signs and symptoms, and characteristics of more than one subtype may occur at the same time. Subtype 1 (erythematotelangiectatic) rosacea is characterized by flushing and persistent redness on the central portion of the face, while subtype 2 (papulopustular) rosacea also features papules and pustules. Subtype 3 (phymatous) rosacea includes thickening of the skin, irregular nodularities and enlargement, especially of the nose. Subtype 4 is ocular rosacea, where the eyes may have a watery or bloodshot appearance, the sensation of a foreign body, burning or stinging, dryness, itching, light sensitivity or a host of other signs and symptoms.