QUIZ RECAP: Test Your Knowledge of Rosacea Research and Innovations

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This week we asked the question: How much do you know about rosacea research and innovations?

Haven't taken our quiz yet? Pause before reading below and follow this link to complete it: here.

Below, we recap our fourth and final quiz and the correct answers to each question.

Question 1: Which novel therapeutic approach has shown promising results in targeting the neurovascular component of rosacea?

Response options: Cannabinoids; Janus kinase inhibitors; Toll-like receptor agonists; Nerve growth factor inhibitors

Correct response option: Nerve growth factor inhibitors

Rosacea manifests through a combination of inflammatory, vascular, neuronal, and fibrotic mechanisms. Skin's nervous system plays a significant role in regulating inflammation, immunity, and vascular functions. Certain triggers such as spicy food, heat, cold, exercise, and alcohol activate receptors like TRPV1, contributing to rosacea symptoms. Patients are particularly sensitive to these triggers, which lead to flushing and other discomforts. TRPV1, expressed by sensory nerves, is involved in vasoregulation and pain sensation. In rosacea, TRPV1 may become hyperactive, leading to sustained flushing, warmth, and inflammation. Increased density of TRPV1 nerve fibers in rosacea patients suggests its potential as a therapeutic target. The interaction between the nervous and immune systems may worsen rosacea progression. Targeting TRPV1 overstimulation could be a new therapeutic approach for rosacea.¹

Question 2: Which emerging treatment modality for rosacea involves the use of intense pulsed light (IPL) therapy?

Response options: Microneedling; Photodynamic therapy; Low-level laser therapy; Radiofrequency ablation

Correct response option: Low-level laser therapy

Facial redness in rosacea lacks definitive treatments, with options often focusing on symptom relief. However, patients' perspectives on emerging modalities such as Low Level Light Therapy (LLLT) and laser treatments remain poorly understood. A study accessed an online rosacea forum in August 2013, employing a stratified random sampling method to analyze 10% of total posts (27,051). Qualitative analysis of posts from "Laser and IPL therapy" and "Low level light therapy" forums revealed patients' discussions on effectiveness, treatment education, and adverse effects as primary topics. Other factors such as the patient-health care provider relationship, cost, treatment execution, and convenience also influenced patients' decisions on utilizing these therapies.²

Question 3: Which ingredient has gained attention for its potential efficacy in the management of rosacea due to its anti-inflammatory and antioxidant properties?

Response options: Resveratrol; Caffeine; Niacinamide; Alpha-lipoic acid

Correct response option: Resveratrol

A study investigated the effectiveness of combining intense pulsed light (IPL) with a phyto-corrective mask, gel, and resveratrol antioxidant serum to improve outcomes and minimize adverse effects. In the 3-month study involving 10 women with moderate-to-severe rosacea, IPL was applied to both sides of the face, with additional skinc are applied only to the right side. Evaluations by independent assessors and patient-reported outcomes showed significant improvements, particularly on the skin care-treated side. The combination of IPL and skin care resulted in sustained improvements in symptoms and higher patient satisfaction compared to IPL alone, suggesting that adjunctive skin care may enhance IPL treatment for rosacea.³

Question 4: Which recent research finding suggests a potential role for gut microbiota modulation in the management of rosacea?

Response options: Dysbiosis of the skin microbiota; Increased presence of Demodex mites; Alterations in systemic inflammation markers; Abnormalities in gut microbial composition

Correct response option: Abnormalities in gut microbial composition

The relationship between the gut and skin microbiomes is complex and may impact conditions like rosacea. Probiotics, beneficial microbes, and prebiotics, substrates that support probiotics, can influence gut microbiota, potentially improving skin conditions. Helicobacter pylori, a bacterium linked to the gut, is associated with rosacea. Research suggests its presence may exacerbate skin inflammation and flushing. The gut-skin axis proposes a connection between gut health and skin conditions, mediated by the immune system. Studies indicate differences in gut microbiota composition in rosacea patients compared to controls, suggesting a potential role in disease pathogenesis. Treatments for rosacea include antibiotics, which may affect gut microbiota diversity. Topical and oral probiotics show promise in skin condition management by modulating skin microbiota and immune response. Certain bacteria, like Bacillus subtilis, may impact H. pylori colonization, potentially alleviating rosacea symptoms and gastrointestinal issues.⁴

Question 5: Which emerging therapeutic approach for rosacea involves the use of small interfering RNA (siRNA) to target specific genes involved in the inflammatory cascade?

Response options: Gene therapy; RNA interference therapy; Immunotherapy; Stem cell therapy

Correct response option: RNA interference therapy

Rosacea is primarily managed with small molecule drugs targeting inflammation. Molecular approaches, particularly RNA medicines like small interfering RNA (siRNA), hold promise for personalized management at the transcriptomic level. However, the use of topical siRNA delivery systems, common in rosacea management, remains largely unexplored. One study aimed to address this gap by designing siRNA targeting TLR2, a gene implicated in rosacea, and testing its delivery using dermatological emulsions. In vitro validation on murine cells showed effective genetic silencing. Further, the siRNA was incorporated into emulsions and characterized for topical application. In vivo testing on mice demonstrated promising siRNA delivery and TLR2 silencing, especially with specific excipients like urea and glycerol.⁵

References

1. Steinhoff M, Buddenkotte J, Aubert J, et al. Clinical, cellular, and molecular aspects in the pathophysiology of rosacea. J Investig Dermatol Symp Proc. 2011;15(1):2-11. Accessed May 2, 2024. doi:10.1038/jidsymp.2011.7
2. McGinley M, Alinia H, Kuo S, Huang KE, Feldman SR. Patient perspectives on low level light therapy and laser therapies for rosacea-associated persistent facial redness. Dermatol Online J. 2014;21(2):13030/qt2q39x891. December 13, 2024. Accessed May 2, 2024. https://pubmed.ncbi.nlm.nih.gov/25756491/
3. Barbarino SC, Bucay VW, Cohen JL, Gold MH. Integrative skincare trial of intense pulsed light followed by the phyto-corrective mask, phyto-corrective gel, and resveratrol BE for decreasing post-procedure downtime and improving procedure outcomes in patients with rosacea. J Cosmet Dermatol. 2022;21(9):3759-3767. Accessed May 2, 2024. doi:10.1111/jocd.15189
4. Zhu W, Hamblin MR, Wen X. Role of the skin microbiota and intestinal microbiome in rosacea. Front Microbiol. 2023;14:1108661. February 10, 2023. Accessed May 2, 2024. doi:10.3389/fmicb.2023.1108661
5. Colombo S, Harmankaya N, Water JJ, Bohr A. Exploring the potential for rosacea therapeutics of siRNA dispersion in topical emulsions. Exp Dermatol. 2019;28(3):261-269. Accessed May 2, 2024. doi:10.1111/exd.13881