The key cause of rosacea is found in the treatment to nourish the skin and nourish the heart

Once they encounter skin diseases, many people will think of buying various drugs or cosmetics to relieve symptoms, but a study jointly conducted by Professor Li Ji’s team from the Department of Dermatology of Xiangya Hospital of Central South University and Professor Zhang Guohong’s team from Shantou University School of Medicine found that genetic variations of genes such as LRRC4 can promote the occurrence of neurogenic inflammation of rosacea through peripheral neurosecretion of neuropeptides, suggesting that “curing the root” of skin diseases such as rosacea is more important than “curing the symptoms”.

The results were published online July 5 in Nature Communications. Deng Chile, associate researcher of the Department of Dermatology of Xiangya Hospital, and Chen Mengting, assistant researcher, are the first authors, Li Ji and Zhang Guohong are the co-corresponding authors, and Xiangya Hospital is the first author and corresponding author.

Professor Li Ji (left) and team members conduct research on rosacea. Photo courtesy of the interviewed team

Discover the key cause of rosacea

Rosacea, as the name suggests, is a skin condition that occurs mainly in the middle of the face and manifests as facial flushing, erythema, papular pustules with conscious symptoms such as burning. A common rosacea is rosacea, which occurs in the nose.

Rosacea patients suffer from their face being red and hot, blowing hot air conditioners in winter, stepping green in spring, basking in the sun in summer and even having a slight mood swing, and their faces will be red and hot when wearing makeup and removing makeup. Even if they have eaten or applied drugs such as doxycycline, hydroxychloroquine, azelaic acid, etc., and even photorejuvenation, they have not worked, and they still blush without changing color.

Since 2013, the team of Professor Li Ji and Professor Xie Hongfu has been conducting research on rosacea and collected more than 10,000 clinical data. In the course of long-term clinical treatment, the team found that the treatment of rosacea inflammation is relatively easy, but the treatment of refractory erythema, flushing and burning symptoms is limited, and many treatments are not satisfactory, and the root cause of this problem is that the cause of the disease is still unknown.

“Clinically, we found that about one-third of rosacea patients have a familial cluster, and often a family with a father and daughter will have rosacea at the same time.” Li Ji said.

Based on this phenomenon, the above team jointly used whole genome sequencing of disease families to screen and obtain multiple genetic variant genes related to disease occurrence, most of which are related to neural function regulation, suggesting that neural regulation may play an important role in the pathogenesis of rosacea.

Next, the research team used animal and cellular models to confirm that genetic variants such as LRRC4 can promote neurosecretion of neuropeptides (a class of active substances that can act on blood vessels or immune cells to induce abnormal dilation and inflammatory response of blood vessels), leading to the development of rosacea.

In other words, the onset of rosacea is actually the aforementioned genetic variant gene. This provides new ideas and potential therapeutic targets for neurological intervention in the clinical treatment of this disease.

Skin nourishment is more important to nourish the heart

“After discovering the important role of neuromodulation in the pathogenesis of rosacea, we are also trying to apply some drugs that regulate nerve function to improve the red hot symptoms of rosacea, and have obtained some unexpected clinical effects.” Li Ji said.

Paroxetine is a classical regulator of neurotransmitter reuptake that is effective in improving mood and nerve function. Recently, Li Ji and Wang Ben, associate researcher of the Department of Dermatology of Xiangya Hospital, together with the dermatology departments of four tertiary hospitals in China, jointly completed a national multi-center, randomized double-blind, placebo-controlled clinical study on the treatment of rosacea erythema by paroxetine, which proved that paroxetine can effectively treat rosacea erythema and improve flushing, and significantly improve symptoms such as rosacea intractable red perming.

Clinical application has also further confirmed that after medication, many patients think that their symptoms of hot fever have decreased, sleep has improved, their mood has been much better, and the state of the whole person has changed greatly. In June, the findings were published in the Journal of the American Academy of Dermatology.

Wang Wei said that this study is the first large-scale clinical trial in the world to regulate mood drugs for rosacea, which provides new ideas and basis for the treatment of clinically refractory rosacea.

“Based on this clinical study, we are more convinced that neuromodulation is very important in the pathogenesis of rosacea, and may also become a mainstream treatment in the future.” We will continue to explore other neuromodulating drugs or physiotherapy methods to improve the treatment effect of rosacea red perm. Li Ji said.

The above team also appealed to the majority of rosacea patients: the treatment of rosacea is not only about the improvement of skin surface symptoms, that is, “skin nourishment”; More importantly, we must pay attention to our own emotions, sleep, and mental state, which is often called “nourishing the heart”. When the “heart” is set, the “red” rose will naturally fade.

It is reported that Professor Li Ji’s team is committed to basic, clinical and translational research on hair follicle sebaceous gland related diseases (such as rosacea and hair loss diseases, etc.), and has proposed the diagnostic criteria for rosacea in China and led the formulation of the first “Guidelines for the diagnosis and treatment of rosacea in China”.

The above series of research have been funded by the National Natural Science Foundation of China. (Source: Wang Haohao, China Science News)

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