Tetracyclines and Rosacea: what we already knew

Written by on October 1, 2009 in tetracyclines with 0 Comments

Reading this just published abstract highlights for me just how slowly indeed research moves along. These recently proposed methods of action of tetracyclines seem to embody far from ground breaking research.

We learnt in 2007 that tetracyclines have anti-inflammatory actions:  “Tetracyclines are known to exhibit multiple significant anti-inflammatory actions … the mechanisms of this anti-inflammatory activity, such as inhibition of chemotaxis, granuloma formation, and protease.”

Further, back in in 2006 we learnt that tetracyclines help rosacea via their anti-inflammatory effects – “More recently, biologic actions affecting inflammation, proteolysis, angiogenesis, apoptosis, metal chelation, ionophoresis, and bone metabolism have been researched.”.

More related research from 2006: how do tetracyclines help rosacea ?

“Thus the therapeutic effect of tetracyclines in acne may at least in part be due to reduction in neutrophilic chemotaxis as well as their inhibitory effect on proinflammatory cytokines and MMP-9.

The anti-inflammatory effects of tetracyclines already mentioned may explain, at least in part, their beneficial effects in rosacea. Inhibition of angiogenes  may be a contributory factor in the therapeutic effect of tetracyclines in this group of disorders. Features that favor angiogenesis may contribute to the telangiectasia of rosacea. These include protease-triggered release of angiogenetic factors stored in the extracellular matrix, release of inhibition of endothelial factors, and release of angiogenic factors from activated macrophages.”

So the following abstract hardly seems to be moving us forward in rosacea research ;

Tetracycline Actions Relevant to Rosacea Treatment, Skin Pharmacol Physiol. 2009 Sep 25;22(6):287-294

Until today, the pathogenesis of rosacea is not known in detail. Yet in recent years evidence has been accumulating that rosacea with its common symptoms such as inflammatory lesions, erythema, telangiectasia, phymatous changes, and ocular symptoms is of inflammatory nature. Tetracycline derivatives like doxycycline successfully used in the treatment of skin diseases like acne and rosacea seem to inhibit different inflammatory pathways involved in the pathogenesis by various modes of action. Although data for skin diseases are relatively scanty, the following modes of action of tetracyclines seem to be most relevant for an effective treatment of acne and rosacea: inhibition of matrix metalloproteinases, downmodulation of cytokines, inhibition of cell movement and proliferation, inhibition of granuloma formation, inhibition of reactive oxygen species, nitric oxide, and angiogenesis, whereas inhibition of phospholipase A2 seems to be of lower importance. The role of the saprophytic mite Demodex folliculorum remains to be clarified. Additional studies are necessary to further elucidate how tetracyclines work in rosacea treatment.

Oh well, all rosacea specific research is welcomed and seeing rosacea researchers from around the world get papers published is a good thing for all rosacea sufferers.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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