Missing Link for Rosacea?

Posted: 09/15/2008

In an article [PDF] in Experimental Dermatology, Dr. Richard Gallo and colleagues at the University of California-San Diego reported that vitamin D3 may be a critical step in an inflammatory pathway that could be a therapy target against the bumps and pimples of rosacea.1

In ongoing studies investigating the specific chemical interactions to rosacea triggers, the researchers have noted that the normal immune system protects the body by producing protective substances called cathelicidins that isolate and neutralize any harmful effects.2 The missing link, however, has been what prompts the production of these cathelicidins.

Cathelicidins are produced in many cell types. The researchers noted that a breakthrough in the understanding of cathelicidin expression in the skin came with the identification of a vitamin D response element. Several research groups confirmed that cathelicidin is a direct target of vitamin D3 in keratinocytes, they reported. Though cathelicidin expression is found to be high in rosacea patients, its exact mechanism had been unclear as classic triggers of inflammation did not prompt it.

The missing link involved the discovery that skin injury or infection causes a local increase in expression of an enzyme that activates vitamin D3, which in turn induces cathelicidin. However, in previous studies funded by the National Rosacea Society, the researchers found that the forms of cathelicidins are different in rosacea patients from those in normal subjects. Like overzealous guards, they turn the body on itself, leading to inflammation.

1. Schauber J, Gallo RL. The vitamin D pathway: a new target for control of the skin's immune response? [PDF] Experimental Dermatology 2008;17:633-639.

2. Yamasaki K, Di Nardo A, Bardan A, Masamoto M, Ohtake T, Coda A, Dorschner RA, Bonnart C, Descarques P, Hovnanian A, Morhenn VB, Gallo RL. Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nature Medicine 2007;13:975-980.

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