Some recent NRS supported research has made more steps towards showing a possible link between demodex mites and rosacea symptoms. Although this Br J Dermatol paper was mentioned by Rosacea News in (see demodex mite bacteria causes the inflammation ?) June last year, I just got hold of the full text this week.
A couple of interesting thoughts arise. The researchers were able to extract 2 proteins from the bacteria cultured from a demodex mite. These 2 proteins more commonly produced an inflammatory response in rosacea sufferers, compared to non-rosacea sufferers.
This is an example of how medical research makes quite small and steady steps. This was, as I can see, the main result of this piece of research – 2 proteins from bacillus eleronius were extracted from a demodex mite from a rosacea sufferer, and these proteins might cause aggravated symptoms in rosacea sufferers.
Now for the bad news – the researchers could only isolate the bacteria from one mite from one sufferer out of 40. The researchers are unsure why this is the case- whether it is their methods or sufferers had taken antibiotics in the last 14 days. So we are still a long way from being able to say that demodex bacteria causes rosacea symptoms.
The paper makes the argument that the relative efficacies of different types of antibiotics in rosacea treatment leads to the suggestion that rosacea is bacterial in origin (b. oleronius is sensitive to tetracycline, doxycycline and minocycline) ;
The mechanism by which antibiotics successfully clear the inflammatory lesions of papulopustular rosacea is unknown. It has been suggested that antibiotics work through anti-inflammatory mechanisms, but other potent anti-inflammatory drugs are ineffective and immunosuppressive agents such as steroids (administered topically or systemically) and tacrolimus can make the inflammatory eruption of rosacea worse.
The fact that only selective antibiotics are effective in rosacea suggested to us the possibility that a bacterial agent may be involved in the pathogenesis of the disease. A D. folliculorum related bacterium sensitive to the antibiotics used in the treatment of rosacea could explain the induction of inflammatory changes in papulopustular rosacea.
The researchers conclude that the significance of finding b. oleronius in association with demodex mites and their biological functions need to be further defined. Other mite related bacteria also need to be investigated.
An enormous amount of research effort has been invested in demodex mites. This paper takes a baby step towards perhaps understanding a possible link.
2 comments ↓
I’m going to be more optimistic on this one. On the point of whether or not B. Oleronius is the true culprit, the study is a small step. However, I think they discovered a lot along the way. I found the details to be extremely eye-opening. I read the paper, and it’s complicated, but I think I understood it enough to comment on a few points.
First off, they pointed out all the huge holes in in the anti-inflammatory theory. I had never stopped to think about it, but I’m now much more open to the idea that antibiotics help by clearing away bacteria containing antigens we are allergic to (B. Oleroneous or otherwise). Consider the fact that we tend to get worse when we eat sugar and carbs, the most appealing food for bacteria. Cut sugar and decrease carbs for a day, bacterial activity decreases, symptoms are depressed.
Also, the antibiotics that work for rosacea are the same ones that B. Oleroneus are sensitive to. That’s a big coincidence.
OK we already knew that stuff, but here’s more: The researchers found that two proteins on that bug (B. Oleroneus) caused an allergic reaction when mixed with sera (blood serum) from rosacea patients. This wasn’t found in sera from non-rosaceans. Wouldn’t it be something if rosacea were nothing more than an allergic reaction to a bacteria normally found in termites? (B. Oleroneus is not normally found in humans.)
I’d normally argue that because our skin is so compromised, it’s sensitive to everything and a reaction to a bacteria would be no big deal. However, they tested with blood (the sera) and showed a reaction, so that really caught my attention.
So they only cultured out one colony from one mite. To me, this proves it’s a possibility. They could have very easily lost them through their culturing method. They chose to culture at 30 degrees instead of 37. Seems to me these critters would have preferred the warmer temp
Cheers! Artist
It is interesting that only the rosacea sufferers’ blood showed a reaction to the 2 proteins that they isolated – something that is worth investigating further. If they could show that that these 2 proteins could somehow induce an immune response in rosacea sufferers in general, then we would indeed want to know why !
The whole inflammatory pathway vs. bacteria argument is also something that needs to nailed down. It feels a bit like the chicken and an egg argument. What came first, the bacteria fielding the antigens or are the bacteria just bystanders to another reason that the inflammation is present ? Add to the mix the fact that antibiotics in low doses interrupt the inflammation without killing the bacteria themselves, but still show a reduction in rosacea symptoms.
I wonder if low doses of antibiotics also eliminate the antigens that the bacteria produce ?
More good question that needs to be addressed !
regards,
davidp.
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