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National Rosacea Society Awards Research Grants to Study Widespread, Poorly Understood Disorder

BARRINGTON, Illinois (December 12, 2003) -- The National Rosacea Society (NRS) announced that five new studies have been awarded funding as part of its research grants program to expand scientific knowledge of this widespread but poorly understood dermatological disorder that affects an estimated 14 million Americans.

"We are pleased to be receiving a growing number of high-quality grant applications for important studies relating to potential causes and other key aspects of rosacea," said Dr. Jonathan Wilkin, chairman of the NRS medical advisory board, which reviews and selects the research proposals for funding. "The newly awarded grants include promising new areas of scientific investigation as well as research that builds upon significant previous findings."

Dr. Youwen Zhou, assistant professor of dermatology and director of the Chieng Genomics Center at the University of British Columbia, was awarded $25,000 for the study, "Molecular disease markers: gene expression profile of rosacea." Dr. Zhou and his colleagues hypothesize that rosacea-affected skin may have characteristic gene expression profiles -- that is, patients with rosacea may express different levels of certain genes involved in new blood vessel formation, inflammation and other signs and symptoms of rosacea.

The researchers will first identify the gene expression profiles of normal skin and of skin from patients with subtype 1 rosacea (erythematotelangiectatic rosacea) and subtype 2 rosacea (papulopustular rosacea), respectively, by studying the RNA (genetic codes) from biopsy samples. They will then attempt to determine which metabolic pathways may be implicated in the pathogenesis (disease process) of rosacea.

The NRS awarded $25,000 to Dr. Martin Steinhoff and Dr. T. Luger, Department of Dermatology, University of Muenster, Germany, for their study, "Role of proteinase-activated receptor-2 in the pathophysiology of cutaneous inflammation." Dr. Steinhoff noted that proteinases, natural substances capable of activating a specific receptor on a cell to initiate an inflammatory reaction or activity, may induce signs of rosacea including erythema (redness), telangiectasia (visible blood vessels) and inflammation such as papules (bumps), pustules (pimples) or edema (swelling).

They will investigate whether proteinase-activated receptor-2 (PAR-2) and its activators are differentially expressed during progressively severe phases of rosacea; whether activators of PAR-2 modulate vascular endothelial growth factor (VEGF), which has been linked in earlier research to the development of telangiectasia, often seen in subtype 1 rosacea; and whether PAR-2 activators have an effect on the release of nitric oxide, a substance present in all cells that may be associated with erythema as well as inflammation.

Dr. Richard Granstein, chairman of dermatology at Cornell University, was awarded $23,283 to continue research on how neuropeptides and hormones, produced by nerves or cells in the skin, may play a role in the flushing, telangiectasia and inflammation associated with rosacea.

In their initial research sponsored by the NRS, Dr. Granstein and colleagues discovered that ultraviolet B (UVB) radiation found in sunlight may induce expression of VEGF as well as increase a cytokine that is associated with inflammation. Conversely, they found that a neuropeptide known as somatostatin appears to reduce production of VEGF.

In the coming year, the researchers will define how certain neuropeptides and hormones, alone or in combination with UVB irradiation, may affect the endothelial cells that line the blood vessels. This will also include the study of UVB-irradiated keratinocytes (cells that produce keratin, a constituent of outer skin, hair and nails) and their effects on vascular endothelial cells, combined with the characterization of the effects of a number of neuropeptides on keratinocyte and endothelial activation.

In addition, they pointed out that damaged sebaceous (oil) glands have been seen in severe cases of rosacea, and plan to study the role of sebocytes (sebaceous cells), which can produce a hormone that modifies vascular reactions and may also induce papules and pustules.

Dr. Richard Gallo, director of dermatology research, and researcher Dr. Masamoto Murakami at the Veterans Medical Research Foundation in San Diego will receive $25,000 for their study, "Role of the innate immune system in rosacea." In earlier NRS-funded research, they discovered that patients with rosacea have abnormally high levels of cathelicidins, proteins made by the skin in response to injury or infection that may induce rosacea-like histopathological changes, including telangiectasia and dermatitis.

They concluded these findings strongly suggest that an understanding of cathelicidins may be critical to understanding rosacea, and plan to further investigate the abnormal production of cathelicidins in rosacea patients. The researchers will also investigate peptides (natural proteins) that may help inhibit the disease process.

Dr. YaXian Zhen and Dr. Albert Kligman, professor of dermatology at the University of Pennsylvania, were awarded $25,000 for their research, "Experimental studies in the pathogenesis of rosacea." The researchers noted that acne vulgaris and rosacea may coexist more commonly than is widely recognized, and they hypothesize that rosacea and acne may have certain features in common that may underlie their pathogenesis.

They observed that the faces of rosacea patients may produce more oil and may have subclinical microcomedones (tiny blackheads), enlarged oil glands and an increased number of the bacteria Propionibacterium acnes. They will study the facial skin of rosacea patients to determine sebum output, microcomedones and various microscopic aerobic and anaerobic organisms that may be associated with the disease process.

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 2004 is July 15. More information is available online at www.rosacea.org/grants/.

Because the etiology (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.

Rosacea is a chronic disorder primarily of the facial skin, characterized by flare-ups and remissions. According to the NRS standard classification system for rosacea, developed by a consensus committee and review panel of 17 medical 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 recently published classification system also identifies four subtypes, defined as common patterns or groupings of signs and symptoms. These include subtype 1 rosacea, characterized by flushing and persistent erythema, and which may also include telangiectasia; subtype 2 rosacea, characterized by persistent erythema with transient papules and pustules; subtype 3 rosacea (phymatous rosacea), characterized by phymatous changes, most often rhinophyma -- enlargement of the nose from hyperplasia; and subtype 4 rosacea (ocular rosacea), characterized by ocular manifestations such as dry eye, tearing and burning, blepharitis, conjunctival injection, recurrent chalazion (styes) and potential vision loss from corneal damage. Many patients experience characteristics of more than one subtype at the same time.

The National Rosacea Society 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.

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Publication Date: 
Friday, December 12, 2003

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