ROSACEA

This new information means that we now need to explain to clients that acne rosacea, or "adult" acne, may be caused by an overabundance of naturally occurring Anti-microbial proteins (peptides) in skin, and not, as previously thought, by the bacteria responsible for causing acne vulgaris the P.acnes bacteria.- Editor

What are antimicrobial peptides? (AMP’s)

Antimicrobial peptides (AMPs) are ancient components of the innate immunity.

These molecules interact with and rapidly inactivate infectious agents by a mechanism, which is generally mediated by disruption of the integrity of the microbial membranes.

In mammals, AMPs are synthesized and secreted in those tissues that are exposed to environmental microbes, such as skin and mucosal epithelia, where they provide an immediate-early defence against infection. The protection effected by locally synthesized peptides is reinforced by systemically derived AMPs, which are stored in the granules of phagocytes (Langerhans cell) and are released on demand at sites of microbial invasion.

Most AMPs are members of the defensin and of the cathelicidin peptide families. Accumulating evidence indicates that members of both families act not only as innate microbicidal agents, but can mediate a range of other biological effects and the movement of inflammatory and immune cells, re-epithelialization of healing skin, induction of angiogenesis, apoptosis of transformed and immune cells.

The Antimicrobial Protein called Cathelicidin Peptides

Cathelicidins are positively charged Anti Microbial Peptides, which can react with the negatively charged surface of microbes (such as bacteria, viruses and yeast) and destroy these organisms. Cathelicidins are produced by keratinocytes, neutrophils and mast cells.

They are found in sweat and saliva; attract neutrophils, mast cells, monocytes and T cells; and increase angiogenesis, keratinocyte proliferation, and synthesis of extracellular matrix. Cathelicidin Peptides are activated by serine protease enzymes (stratum corneum tryptic enzyme) through cleavage into smaller peptides and a cathelin peptide.

The link to Rosacea

It has been recently discovered that clients with Rosacea have abnormally high levels of Cathelicidin, these levels combined with associated higher levels of serine protease activity results in the generation of pro-inflammatory forms of the antimicrobial peptide, which in turn cause an inflammatory skin response. Cathelicidin messenger RNA was also evident in rosacea skin by in situ hybridization in contrast to normal epidermis where cathelicidin mRNA is hardly detectable.

Cathelicidin peptides can promote changes in tissue similar to those seen with rosacea, in addition individuals with other inflammatory diseases like psoriasis also expressed more cathelicidin than normal facial skin. Together, the evidence suggests that too much stratum corneum tryptic enzyme and too much cathelicidin leads to the abnormal peptides that cause the symptoms of these skin disorders.

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