Results from previous research funded by the National Rosacea Society have led investigators Dr. Richard Granstein and colleagues at the Cornell University Medical School to focus in their current study on adenosine triphosphate (ATP), a natural substance in the body that may play a key role in the flushing, telangiectasia and bumps and pimples of rosacea.

"We are very excited about the possible role of ATP in triggering the signs of rosacea," said Dr. Granstein, the study's lead investigator. "We suspect ATP may play a significant part in causing the bumps and pimples of subtype 2 (papulopustular) rosacea."

In their earlier NRS-funded research investigating the biochemical pathways that regulate the growth of new blood vessels, flushing and inflammation, Dr. Granstein's group 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, and may also increase interleukin 8, which plays a role in inflammation.

In addition, the researchers' early data indicated that endothelial cells -- cells that line the blood vessels -- respond to ATP with changes in the expression of inflammatory cytokines, which are proteins that act to recruit inflammatory cells. ATP also may affect vascular tone by inducing vasodilation -- enlargment of the blood vessels -- which may result in the appearance of redness.

Known as the "molecular currency" of intracellular energy transfer, ATP acts like a rechargeable battery and is able to store and transport chemical energy within cells. The substance not only is present in neurons, or nerve cells, which are affected by rosacea triggers such as stress, but also serves as an extracellular messenger, according to Dr. Granstein. "In this way, it can tell endothelial cells to release the inflammatory cytokines discussed earlier," he said.

"Its widespread presence suggests there may be many pathways by which ATP may mediate rosacea," Dr. Granstein said. "ATP may play a significant role in producing inflammation, and have a profound effect in response to rosacea triggers. If so, blocking these pathways may lead to major advances in therapy."

The researchers plan to look at this substance under a variety of different conditions and in different concentrations to track its potential role in rosacea.