Skip to main content

Advertisement

Log in

The investigation of the relationships of demodex density with inflammatory response and oxidative stress in rosacea

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

The relationships of demodex density with systemic oxidative stress, inflammatory response, and clinical severity in rosacea are not clear. This study aimed to (a) analyze the levels of systemic oxidative stress, antioxidant capacity, inflammatory parameters, and matrix metalloproteinases (MMPs) in systemic circulation in patients with rosacea, (b) identify the relationship between mite density and both oxidative stress and inflammation, and (c) investigate the role of photoaging and sebum secretion in etiopathogenesis. Forty patients with rosacea and 40 age-, sex-, and skin phenotype-matched healthy volunteers were included in the study. Clinical disease severity of the patients was determined. Sebum levels were measured in both the groups, and photoaging was evaluated. Reflectance confocal microscopy was used to calculate demodex density. Serum total antioxidant capacity (TAC), total oxidant capacity (TOC), myeloperoxidase (MPO), MMP-1, MMP-9, arylesterase (ARES), interleukin-1β (IL-1β), paraoxonase-1 (PON-1), and tumor necrosis factor-α (TNF-α) levels were also analyzed. The patients with rosacea had significantly higher serum TOC and lower TAC levels (p < 0.001). The serum ARES and PON-1 levels were significantly lower (p = 0.045 and p < 0.001, respectively); however, the serum levels of MMP-1, MMP-9, IL-1β and MPO were higher in the patient group. Demodex parameters were higher in the patient group compared to the control group. There was no significant correlation between the number of mites and disease severity. In addition, the number of mites was not correlated with the serum levels of TAC, TOC, OSI, MPO, MMP-1, MMP-9, ARES, PON-1, TNF-α, and IL-1β. However, sebum levels were directly proportional to the number of mites. Photoaging severity was similar between the patients and control subjects. The changing sebaceous microenvironment in rosacea leads to an increase in the number of demodex mites. However, increased demodex density does not alter disease severity, level of oxidative stress, or inflammation. Although none of the patients with rosacea had any underlying systemic disease, patients’ systemic oxidative stress and inflammation parameters were found high in systemic circulation. It is assumed that the patients with rosacea are more prone to systemic diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Abram K, Silm H, Maaroos HI, Oona M (2010) Risk factors associated with rosacea. J Eur Acad Dermatol Venereol 24:565–571

    Article  CAS  Google Scholar 

  2. Bakar O, Demircay Z, Yuksel M, Haklar G, Sanisoglu Y (2007) The effect of azithromycin on reactive oxygen species in rosacea. Clin Exp Dermatol 32:197–200

    Article  CAS  Google Scholar 

  3. Baz K, Cimen MY, Kokturk A, Aslan G, Ikizoglu G, Demirseren DD, Kanik A, Atik U (2004) Plasma reactive oxygen species activity and antioxidant potential levels in rosacea patients: correlation with seropositivity to Helicobacter pylori. Int J Dermatol 43:494–497

    Article  CAS  Google Scholar 

  4. Belli AA, Altun I (2017) Thickness of carotid intima and epicardial fat in rosacea: a cross-sectional study. An Bras Dermatol 92:820–825

    Article  Google Scholar 

  5. Bonnar E, Eustace P, Powell FC (1993) The Demodex mite population in rosacea. J Am Acad Dermatol 28:443–448

    Article  CAS  Google Scholar 

  6. Dosal JR, Rodriguez GL, Pezon CF, Li H, Keri JE (2014) Effect of tetracyclines on the development of vascular disease in veterans with acne or rosacea: a retrospective cohort study. J Invest Dermatol 134:2267–2269

    Article  CAS  Google Scholar 

  7. Duman N, Ersoy Evans S, Atakan N (2014) Rosacea and cardiovascular risk factors: a case control study. J Eur Acad Dermatol Venereol 28:1165–1169

    Article  CAS  Google Scholar 

  8. Forton F, Seys B (1993) Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol 128:650–659

    Article  CAS  Google Scholar 

  9. Forton F, Seys B, Marchal JL, Song AM (1998) Demodex folliculorum and topical treatment: acaricidal action evaluated by standardized skin surface biopsy. Br J Dermatol 138:461–466

    Article  CAS  Google Scholar 

  10. Georgala S, Katoulis AC, Kylafis GD, Koumantaki-Mathioudaki E, Georgala C, Aroni K (2001) Increased density of Demodex folliculorum and evidence of delayed hypersensitivity reaction in subjects with papulopustular rosacea. J Eur Acad Dermatol Venereol 15:441–444

    Article  CAS  Google Scholar 

  11. Gerber PA, Buhren BA, Steinhoff M, Homey B (2011) Rosacea: the cytokine and chemokine network. J Investig Dermatol Symp Proc. 15(1):40–7

    Article  Google Scholar 

  12. Holmes AD (2013) Potential role of microorganisms in the pathogenesis of rosacea. J Am Acad Dermatol 69:1025–1032

    Article  Google Scholar 

  13. Hua TC, Chung PI, Chen YJ, Wu LC, Chen YD, Hwang CY, Chu SY, Chen CC, Lee DD, Chang YT, Liu HN (2015) Cardiovascular comorbidities in patients with rosacea: a nationwide case-control study from Taiwan. J Am Acad Dermatol 73:249–254

    Article  Google Scholar 

  14. Isik B, Gurel MS, Erdemir AT, Kesmezacar O (2013) Development of skin aging scale by using dermoscopy. Skin Res Technol 19:69–74

    Article  Google Scholar 

  15. Jarmuda S, O’Reilly N, Zaba R, Jakubowicz O, Szkaradkiewicz A, Kavanagh K (2012) Potential role of Demodex mites and bacteria in the induction of rosacea. J Med Microbiol 61:1504–1510

    Article  Google Scholar 

  16. Lacey N, Delaney S, Kavanagh K, Powell FC (2007) Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol 157:474–481

    Article  CAS  Google Scholar 

  17. Lacey N, Kavanagh K, Tseng SC (2009) Under the lash: Demodex mites in human diseases. Biochem (Lond) 31(4):2–6

    Google Scholar 

  18. Lee Y, Kim H, Kim S, Shin MH, Kim YK, Kim KH, Chung JH (2009) Myeloid differentiation factor 88 regulates basal and UV-induced expressions of IL-6 and MMP-1 in human epidermal keratinocytes. J Invest Dermatol 129:460–467

    Article  CAS  Google Scholar 

  19. Longo C, Casari A, De Pace B, Simonazzi S, Mazzaglia G, Pellacani G (2013) Proposal for an in vivo histopathologic scoring system for skin aging by means of confocal microscopy. Skin Res Technol 19:e167–e173

    Article  Google Scholar 

  20. McAleer MA, Fitzpatrick P, Powell FC (2010) Papulopustular rosacea: prevalence and relationship to photodamage. J Am Acad Dermatol 63:33–39

    Article  Google Scholar 

  21. McMillen TS, Heinecke JW, LeBoeuf RC (2005) Expression of human myeloperoxidase by macrophages promotes atherosclerosis in mice. Circulation 111:2798–2804

    Article  CAS  Google Scholar 

  22. Moran EM, Foley R, Powell FC (2017) Demodex and rosacea revisited. Clin Dermatol 35:195–200

    Article  Google Scholar 

  23. Ni Raghallaigh S, Bender K, Lacey N, Brennan L, Powell FC (2012) The fatty acid profile of the skin surface lipid layer in papulopustular rosacea. Br J Dermatol 166:279–287

    Article  CAS  Google Scholar 

  24. O’Reilly N, Bergin D, Reeves EP, McElvaney NG, Kavanagh K (2012) Demodex-associated bacterial proteins induce neutrophil activation. Br J Dermatol 166:753–760

    Article  Google Scholar 

  25. Oztas MO, Balk M, Ogus E, Bozkurt M, Ogus IH, Ozer N (2003) The role of free oxygen radicals in the aetiopathogenesis of rosacea. Clin Exp Dermatol 28:188–192

    Article  CAS  Google Scholar 

  26. Porta Guardia CA (2015) D emodex folliculorum: its association with oily skin surface rather than rosacea lesions. Int J Dermatol 54:e14–e17

    Article  Google Scholar 

  27. Rainer BM, Fischer AH, Luz Felipe da Silva D, Kang S, Chien AL (2015) Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: results of a case-control study. J Am Acad Dermatol 73:604–608

    Article  Google Scholar 

  28. Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C (2012) Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy. Br J Dermatol 167:1042–1047

    Article  CAS  Google Scholar 

  29. Sulk M, Seeliger S, Aubert J, Schwab VD, Cevikbas F, Rivier M, Nowak P, Voegel JJ, Buddenkotte J, Steinhoff M (2012) Distribution and expression of non-neuronal transient receptor potential (TRPV) ion channels in rosacea. J Invest Dermatol 132:1253–1262

    Article  CAS  Google Scholar 

  30. Takci Z, Bilgili SG, Karadag AS, Kucukoglu ME, Selek S, Aslan M (2015) Decreased serum paraoxonase and arylesterase activities in patients with rosacea. J Eur Acad Dermatol Venereol 29:367–370

    Article  CAS  Google Scholar 

  31. Tisma VS, Basta-Juzbasic A, Jaganjac M, Brcic L, Dobric I, Lipozencic J, Tatzber F, Zarkovic N, Poljak-Blazi M (2009) Oxidative stress and ferritin expression in the skin of patients with rosacea. J Am Acad Dermatol 60:270–276

    Article  Google Scholar 

  32. Turgut Erdemir A, Gurel MS, Koku Aksu AE, Bilgin Karahalli F, Incel P, Kutlu Haytoglu NS, Falay T (2014) Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites. Skin Res Technol 20:435–439

    Article  CAS  Google Scholar 

  33. Vera N, Patel NU, Seminario-Vidal L (2018) Rosacea comorbidities. Dermatol Clin 36:115–122

    Article  CAS  Google Scholar 

  34. Verma RP, Hansch C (2007) Matrix metalloproteinases (MMPs): chemical-biological functions and (Q)SARs. Bioorg Med Chem 15:2223–2268

    Article  CAS  Google Scholar 

  35. Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, Powell F (2004) Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 50:907–912

    Article  Google Scholar 

Download references

Funding

This research was supported by Istanbul Training and Research Hospital, Education Planning and Coordination Unit.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tuğba Falay Gur.

Ethics declarations

Conflict of interest

There are no conflicts of interest to declare.

Ethical approval

was obtained from Bezmialem University Clinical Research Ethics Committee and the study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed consent

A written informed consent was obtained from each participant.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Falay Gur, T., Erdemir, A.V., Gurel, M.S. et al. The investigation of the relationships of demodex density with inflammatory response and oxidative stress in rosacea. Arch Dermatol Res 310, 759–767 (2018). https://doi.org/10.1007/s00403-018-1857-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-018-1857-1

Keywords

Navigation