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Antimikrobielle Peptide, Vitamin D3 und mehr

Wie Rosazea möglicherweise entsteht

Antimicrobial peptides, Vitamin D3 and more

How rosacea may develop

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Zusammenfassung

Die Rosazea ist eine chronische, entzündliche Hauterkrankung mit einer unvollständig verstandenen Pathogenese. In betroffener Haut findet sich bei Rosazea eine verstärkte Expression von Cathelicidin, einem antimikrobiellen Peptid und Effektormolekül der angeborenen Immunabwehr. Gleichzeitig ist die kutane Proteaseaktivität erhöht, die zur Bildung von Cathelicidinfragmenten mit proentzündlicher Aktivität führt. UV-Licht und mikrobielle Faktoren verstärken diese proinflammatorische Signalkaskade über eine Erhöhung des Vitamin-D3-Metabolismus und die Aktivierung von Toll-like-Rezeptoren (TLR). Retinoide, Azelainsäure und Doxycyclin hemmen die kutane Proteaseaktivität und die TLR-Expression und entfalten hierüber möglicherweise ihre antientzündliche Wirkung in der Therapie der Rosazea. Diese aktuellen Erkenntnisse erweitern zum einen das Verständnis der Pathogenese der Rosazea und ihrer erfolgreichen Behandlung. Zum anderen bieten sie mögliche Ansatzpunkte für neue, innovative Therapien bei dieser häufigen, stigmatisierenden Dermatose.

Abstract

The pathogenesis of rosacea – a common, chronic inflammatory skin disease mainly affecting the central portions of the face – is only partly understood. In affected skin the expression of cathelicidin – an antimicrobial peptide and effector of innate immunity – is strongly increased. In addition, the activity of cutaneous proteases is greatly increased leading to the generation of cathelicidin peptide fragments with pro-inflammatory activity. UV irradiation and microbial factors contribute to this inflammatory cascade by increasing vitamin D3 metabolism and the activation of toll-like receptors (TLR). Retinoids, azelaic acid and doxycycline inhibit both skin proteases and TLR expression and could mediate their anti-inflammatory effects in rosacea through these mechanisms. These data increase our understanding of the pathogenesis and therapy of rosacea. Also, these insights might uncover novel targets for innovative therapies of this common, stigmatizing skin disease.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Der Autor hat Vortragshonorare von Galderma erhalten. Hieraus ergeben sich nach Meinung des Autors keine Interessenkonflikte.

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  1. Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9–11, 80337, München, Deutschland

    J. Schauber

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Schauber, J. Antimikrobielle Peptide, Vitamin D3 und mehr. Hautarzt 62, 815–819 (2011). https://doi.org/10.1007/s00105-011-2142-9

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