Five new studies of rosacea have been awarded funding as part of the National Rosacea Society's research grants program to advance scientific and medical understanding of this widespread but poorly understood facial disorder, estimated to affect 14 million Americans.

"We are now receiving a growing number of grant applications for quality research on potential causes and other key aspects of this common and often life-disruptive condition," said Dr. Jonathan Wilkin, chairman of the Society's medical advisory board, which reviews and selects the grant applications for funding. "Their findings should continue to deepen our understanding of rosacea and provide valuable insight for improvements in its management as well as its potential cure or prevention."

Dr. Richard Granstein, chairman, Department of Dermatology at Cornell University, was awarded $23,283 to study how neuropeptides and hormones, produced by nerves or cells in the skin, may play a role in the telangiectasia (visible blood vessels) and inflammation associated with rosacea.

Many neuropeptides are vasoactive, affecting the diameter of blood vessels, and the researchers noted that these substances can act in the skin. They will test cells that line tiny blood vessels in the skin.

These cells will be exposed to either ultraviolet radiation or neuropeptides for the secretion of vascular endothelial growth factor (VEGF), which may be associated with the development of telangiectasia, as well as for cytokines and adhesion molecules, which may be responsible for the inflammation -- including papules (bumps) and pustules (pimples). Furthermore, they will test whether sebaceous cells, which produce oil in the skin, can be induced to produce factors that affect blood vessels.

The NRS awarded $25,000 to Dr. Richard Gallo, director of dermatology research, and researcher Dr. Masamoto Murakami at the Veterans Medical Research Foundation in San Diego for their study, "Role of the innate immune system in rosacea."

They plan to investigate whether cathelicidins -- proteins made by the skin in response to injury or infection -- will induce rosacea-like histopathological changes, including telangiectasia and dermatitis. This research expands on the results of their study sponsored by the NRS last year, which demonstrated an association between these proteins and rosacea.

Dr. Wendy Roberts, medical director at Desert Dermatology Medical Associates in Rancho Mirage, California, was awarded $20,000 for the study, "Histopathologic and clinical study of erythematotelangiectatic rosacea: Before and after long pulse 532 nm laser." This study will investigate the hypothesis that rosacea may be preceded by degenerative changes in the vascular and surrounding collagen and elastin tissues. These changes are theorized to lead to small vessel dilation, resulting in flushing, erythema (redness), telangiectasia and ultimately inflammation from leakage as dilated vessels become worn.

Dr. Roberts noted that the histopathologic features of rosacea have not been well documented, and plans to record microscopic findings -- correlated with clinical appearance -- in patients with subtype 1 (erythematotelangiectatic) rosacea both before and after exposure to long-pulse 532-nm laser. Subtype 1 rosacea is characterized by central facial redness with or without telangiectasia.

Dr. Kevin Kavanagh, Department of Biology, National University of Ireland Maynooth, and Dr. Frank Powell, consultant dermatologist, Regional Centre of Dermatology, Mater Misericordiae Hospital, Dublin, were granted $22,500 for their study, "The role of bacterial antigen(s) in the etiology and persistence of papulopustular rosacea."

In an earlier study funded by the Society, they found that Demodex mites from rosacea patients carry bacteria that are sensitive to those antibiotics that are used to control rosacea. In this new study, they will examine whether these bacteria produce antigens that may cause papules and pustules in rosacea patients.

A grant of $12,250 was awarded to Drs. Richard Burroughs, Mark Peake and Richard Vinson of the William Beaumont Army Medical Center; Dr. Scott Norton, chief, Dermatology Service, Walter Reed Army Medical Center; and Dr. John Werren, professor of biology, and Seth Bordenstein of the University of Rochester for their study, "Symbiotic intracellular bacteria of Demodex folliculorum and the pathogenesis of rosacea."

They hypothesize that the cutaneous changes of rosacea may be due to an inflammatory response to bacteria within Demodex rather than to the mite itself. They will test Demodex from rosacea patients for the presence of bacteria, and analyze data to determine whether there is a statistical or clinical link between the presence of bacteria and the presence of rosacea.