Collagenex has launched a swish looking consumer and practitioner web site at www.rosaceatoday.com. Collagenex are indirectly using this site to promote their `new’ treatment Oracea as an effective way to treat rosacea. The site is supporting the idea that rosacea is a chronic inflammatory disease.
Many rosacea sufferers are helped by taking systemic antibiotics. This benefit does not lead to the conclusion that rosacea is microbial in origin. Researchers are finding that rosacea symptoms are mitigated by the antibiotic’s ability to interfere with mediators in the inflammatory pathway.
Unfortunately the inflammatory pathways are complex and take some time to understand. One particular page on this on RosaceaToday, `Rosacea is a Chronic Inflammatory Disease‘ has some good text and a helpful digram ;
Sequence of Events
While the evolution of the inflammatory response in rosacea has not been precisely elucidated, investigators suspect a sequence of events similar to the following:
- Vasodilation of dermal capillaries, possibly mediated by histamine, prostacyclin, prostaglandin E2, nitric oxide, or other vasoactive compounds, causes initial erythema
- Prolonged dilation weakens capillary walls, allowing neutrophils and proinflammatory cytokines such as TNF-a, IL-1, and IL-6 to leak into the surrounding dermis
- Extravascular fluid builds up, overwhelming lymphatic vessels, and results in edema
- Additional neutrophils are recruited by chemotactic factors released from inflamed dermal tissues
- Activated neutrophils release degradative compounds, including matrix metalloproteinases (collagenases and gelatinases), reactive oxygen species, and nitric oxide—that exacerbate the inflammatory response and lead to tissue damage.
Also see a cute 2:20 video (looking like something from Star Wars) explaining how doxycline may help in relieving the inflammatory response in rosacea. See Doxycycline Method of Action.
Collagenex are also keen to promote the advantages of low-dose antibiotics. By prescribing doses that are low enough to not kill flora or pathogens but still give some anti-inflammatory benefits, any risk of antibiotic resistances is mitigated.
Looking to the future and quoting from Optimized Oral Therapy to Treat Rosacea ;
A Novel Oral Therapy
It may be possible to modify the pharmacokinetics of systemic antibiotics in a way that isolates their anti-inflammatory properties from their antimicrobial properties. By maintaining plasma concentrations within a defined therapeutic window—high enough for anti-inflammatory effect, yet low enough to avoid antibacterial activity—one might be able to achieve inflammatory, but not microbial, suppression.
There is a ton of reading on the net to further explain the concepts presented at a high level at RosaceaToday.
- RSRP: 5-LOX Inhibitors
- RSRP: Role of Inflammation **
- RSRP: Antibiotics / Anti-Inflammatories
- low dose doxycycline hyclate (SDD)
- Periostat (doxycycline) goes generic, get ready for Oracea
- Subantimicrobial Dose Doxycycline for Acne and Rosacea
- Tetracyclines: their non-antibiotic properties
- macrolides and inflammatory pathways
- focus on macrolides (biaxin, zithromax, dynabac, rulid, surlid)
2 comments ↓
Hi
I hope to try this and still work on the root cause. Some how I have a lack or inefficient working inflammation system.
My mom died of Amyloidosis and her family all have differing degrees of Rosacea. I have watched my skin change from childhood to early old age, noticing no matter what I do the Rosacea never go’s away. I am very good at using whatever products are available to me to reduce the “congestion” around my pores. This article helps to put into perspective the “congestion” I was at wit’s ’s end to explain and combat. This will be a way to halt the damage of continuous congestion cycles. My goal is to find out and correct the nutritive elements lacking that initiate the cycling process.
I think it may started by infant formula instead of breast milk. The fat compounds needed at that time for development may find other avenues of satiation and thus set the body up for continued misdirected nutritional function.
I am not a scientist, just observations and reading about my condition plus living the condition. I also witnessed my daughter have the same cradle cap reaction, when I had to give up breast-feeding. What ever go’s wrong starts at that point in the body’s ability to process fat and fat based chemical functions.
The body’s fat storing process and things related to that
function go’s off and is difficult to adjust again.
One of my daughters has had great success by eating a gluten free diet. With elimination of sugar. Again
these are part of the fat storage of our body. I hope someone smarter than me figures it out
Thanks for sharing some good thoughts, Patricia. I notice this article about the pulsed light treatment is old, yet my derm today didn’t mention it, but did give me a trial run of Oracea. Wonder what’s up with that.
The word so far is there is no root cause that can be cured for rosacea, but I think your ideas are good about trying those different things; I’m sure they can provide relief if not a cure. I for one agree with your thoughts on how artificial things we’ve added to our environment the past few decades have set us up for these illnesses.
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