In September last year a trial was listed to assess whether cromolyn sodium ophthalmic solution 4% could improve the redness associated with rosacea.
This trial was listed by Dr. Anna Di Nardo, who is a part of the UCSD and has received NRS funding in 2012 to research the link between Mast Cells and the overabundance of the antimicrobial peptides called cathelicidins in individuals with rosacea.
This trial has resulted in a recent paper in the Journal of Investigative Dermatology.
After demonstrating the Mast Cells were key mediators of cathelicidin in mice, erythematotelangiectatic rosacea sufferers also showed a decrease in the expression of MMP activity after 8 weeks of topical cromolyn treatment.
The active ingredient in the topical cromolyn treatment – cromolyn soduim forms the basis of the eye drops known as Crolom and Opticrom and the nasal allergy spray NasalCrom. The operation of this chemical is known as a mast cell stablizer.
NasalCrom, Crolom and Opticrom are typically used to prevent seasonal eye allergy symptoms such as itching, burning, watering, swelling, redness, or sensitivity to light.
This research suggests that sufferers of the red faces of rosacea may have another effective topical treatment. If this initial success can be replicated in further trials – this trials is very early – Cromolyn may join the ranks of Brimonidine and Oxymetazoline as redness treatments.
There has been just a few sprinklings of posts over several years from rosacea sufferers who have tried Nasalcrom.
Please let us know if you try any of the Cromolyn based treatments.
I found a post from 1999 that talked about Nasalcrom and decided to give it a try, in addition to my daily Loratidine. The result is a VERY signficant reduction in the visibility of the telangiectasia/redness on my nose
I’ve started using nasalcrom again after having read on the internet that it is used topically for eczema. Since my cheeks tend to itch at times I thought this might reduce the itching and indeed it does. It also definitely shrinks my papules. Great!
Yumiko Muto, Zhenping Wang, Matthieu Vanderberghe, Aimee Two, Richard L Gallo and Anna Di Nardo
Division of Dermatology, Department of Medicine, University of California, San Diego, USA
Rosacea is a chronic inflammatory skin disease whose pathophysiological mechanism is still unclear. However, it is known that mast cell (MC) numbers is increased in the dermis of rosacea patients.
MC proteases not only recruit other immune cells, which amplify the inflammatory response, but also cause vasodilation and angiogenesis. MCs are also one of the primary sources of cathelicidin LL-37 (Cath LL-37), an antimicrobial peptide that has been shown to be an enabler of rosacea pathogenesis.
Here, we demonstrate that MCs are key mediators of cathelicidin initiated skin inflammation. Following Cath LL-37 injection into the dermis, MC deficient B6.Cg-KitW-sh/HNihrJaeBsmJ (KitW-sh) mice did not develop rosacea-like features.
Conversely, chymase (P<0.001), tryptase and Mmp9 (P<0.01) mRNA levels were significantly higher in C57BL/6 Wild Type (WT) mice.
Treating WT mice with a MC stabilizer significantly decreased the expressions of Mmp9 and Cxcl2 (P<0.01).
Our data was confirmed on Erythematotelangiectatic rosacea subjects that showed a decrease in MMP activity (P<0.05), after eight weeks of topical cromolyn treatment.
We conclude that MCs play a central role in the development of inflammation subsequent to Cath LL-37 activation and that down regulation of activated MCs may be a therapy for rosacea treatment.