Innate immunity in rosacea

Rosacea is an incurable and highly prevalent disease that results in redness of the facial skin, discomfort and pain. When affecting the periorbital skin and eyelids, this disorder results in ocular surface manifestations, such as lid margin telangiectases, corneal infiltrates and conjunctival injection. It affects over 16 million Americans. Although primarily considered a cutaneous condition, it may involve the eyes in up to 72% of patients. Despite its common occurrence and potentially devastating effects, the current therapies are often ineffective. Recently, several studies have advanced our understanding of the pathophysiology leading to rosacea in general, and ocular rosacea in particular. We and others showed that an increased involvement of the innate immunity is associated with this disease. Using eyelid biopsies obtained from elective blepharoplasties from subjects with or without rosacea, we recently demonstrated a drastic increase in the activation of Erk and p38 MAPKs in the keratinocytes of these patients, suggesting a novel potential avenue to treat these patients. We are actively pursuing the development of this therapeutic strategy.

Facial edema and swelling is a common feature of rosacea, but the mechanisms leading to this vascular leak are not known. We hypothesized that this sustained loss may be also regulated by cytokine-induced changes in the endothelial transcriptional program. We are testing this hypothesis using a combination of in vitro and clinical research.