Summary
Flushing in rosacea has been investigated by means of (a) pharmacological inhibition of some possible chemical mediators and (b) titration of bradykinin as a possible effector directly in the blood. Clonidine-inhibited flushing was seen in all patients (mean 45%), other drugs had poorer results. Bradykinin increased in all patients at the climax of flushing (mean 60%). These findings support the hypothesis that epinephrine promotes a bradykinin release responsible for vasodilation.
Zusammenfassung
Die Flush-Reaktion bei Rosazea wurde (a) durch pharmakologische Hemmung einiger Mediatoren und (b) durch Titration von Bradykinin, das möglicherweise einen direkten Effektor im Blut darstellt, untersucht.
Clonidin konnte die Flush-Reaktion bei allen Patienten (durchschnittlich um 45%) hemmen. Andere Medikamente zeigten schlechtere Ergebnisse. Der Bradykininspiegel fand sich auf dem Höhepunkt der Flush-Reaktion bei allen Patienten deutlich eleviert (durchschnittlich um 60%). Diese Ergebnisse belegen die Hypothese, daß Adrenalin die Freisetzung von Bradykinin fördert und somit eine Vasodilatation bewirken kann.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abelin I, Herren C, Berli W (1958) Über die erregende Wirkung des Alkohols auf den Adrenalinund Noradrenalinhaushalt des menschlichen Organismus. Helv Med Acta 25:591–600
Adamson AR, Grahame-Smith DG, Peart WS, Starr M (1969) Pharmacological blockade of carcinoid flushing provoked by catecholamines and alcohol. Lancet 2:293–296
Bergström S, Puner H, Von Euler WS, Pernow B, Sjövall J (1959) Observations on the effects of infusion of prostaglandin E in man. Acta Physiol Scand 45:145–151
Bergström S, Carlson LA, Ekelund LG, Orö L (1965) Cardiovascular and metabolic response to infusion of prostaglandin E1 and to simultaneous infusions of noradrenaline and prostaglandin E1 in man. Acta Physiol Scand 64:332–339
Clayden JR, Bell JW, Pollard P (1974) Menopausal flushing: double-blind trial of non-hormonal medication. Br Med J 1:409–412
Cunliffe WJ, Dodman B, Binner JG (1977) Clonidine and facial flushing in rosacea. Br Med J 1: 105
Demis DJ, Zimmer JG (1962) Carcinoid flush. Lancet 2:360–362
Hakanson R (1965) Formation of amines in the gastric mucosa of the rat. Nature 208:793–794
Hilton SM, Lewis GP (1956) The relationship between glandular activity, bradykinin formation and functional vasodilatation in the submandibular salivary gland. J Physiol 134:471–483
Horton EW, Main IHM, Thompson CJ, Wright PM (1968) Effect of orally administered prostaglandin E1 on gastric secretion and gastrointestinal mobility in man. Gut 9:655
Langer SZ, Cavero I, Massingham R (1980) Recent developments in noradrenergic neurotransmission and its relevance to the mechanism of action of certain antihypertensive agents. Hypertension 5:372–382
Metz SA, Halter J, Porte A, Robertson RP (1976) Paroxysmal hypothalamic discharge: clonidine blockade of flushing and plasma catecholamine (PCA) elevations. Clin Res 25:127A
Metz SA, Halter JB, Porte D Jr, Robertson RP (1978) Suppression of plasma catecholamines and flushing by clonidine in man. J Clin Endocrinol Met 46:83–90
Morelli H, Brown E, Melmon KL (1967) Two possible mechanisms for effective therapy of the carcinoid flush. Clin Res 15:95
Oates JA, Sjoerdsma A (1962) An unique syndrome associated with secretion of 5-hydroxytryptophan by metastatic gastric carcinoid. Am J Med 32:333–342
Oates JA, Melmon K, Sjoerdsma A, Gillespie L, Mason DT (1964) Release of a kinin peptide in the carcinoid syndrome. Lancet 1:514–517
Oates JA, Pettinger WA, Doctor RB (1966) Evidence for the release of bradykinin in carcinoid syndrome. J Clin Invest 45:173–178
Onabanjo AO (1970) A simple micro-method for the estimation of plasma kinins. Pharmacol Res Comm 2:165–168
Parodi A, Guarrera M, Rebora A (1980) Flushing in rosacea: an experimental approach. Arch Dermatol Res 269:269–273
Perman ES (1960) The effect of ethyl alcohol on the secretion from adrenal medulla of the rat. Acta Physiol Scand 48:323–328
Sigroth K (1974) Effect of clonidine on nicotinic-acid flushing. Lancet 2:58
Smith AG, Greaves MW (1974) Blood prostaglandin activity associated with noradrenaline-provoked flush in the carcinoid syndrome. Br J Dermatol 90:547–551
Williams CWL (1973) Clonidine in treatment of menopausal flushing. Lancet 1:1388
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Guarrera, M., Parodi, A., Cipriani, C. et al. Flushing in rosacea: A possible mechanism. Arch Dermatol Res 272, 311–316 (1982). https://doi.org/10.1007/BF00509061
Issue Date:
DOI: https://doi.org/10.1007/BF00509061