rosacea blog

Update

Friday, July 23rd, 2010 | rosacea | No Comments

To my readers:

I would like to thank all of you who have made valuable comments lately. I want you to know that I read all of them. I haven’t posted much in the last 6 months, this is mainly because I was busy with many different things.

I will take some time in the next few weeks to respond to some of you comments. Many of your comments contribute to this blog and everyone with rosacea can benefit from them.

I wish everybody a great summer and I’ll talk to you soon.

Iron, Ferritin and Rosacea Skin

Monday, June 21st, 2010 | rosacea | 1 Comment

As the exact cause of rosacea is still under investigation, researchers are looking at various factors that can play a role in the rosacea disease process. A recent publication(1) looked at the role of iron in rosacea pathology. It has been known that inflammation can be associated with the production of reactive oxygen species (ROS) and metals such as iron have the capacity to transform these reactive oxygen species into harmful radicals (see this article on free radicals – opens in a new window).

These radicals can attack cell membranes, proteins and DNA. An iron overload inside cells can amplify the damaging effects of ROS in chronic inflammation. Most iron is usually bound to a specific protein called ferritin. Ferritin is therefore important to limit the effect of oxidative reactions, by sequestering iron.

Ultraviolet light (and UV-A in particular) is one of the most important contributors to the skin’s oxidative stress. Studies have shown that UVA radiation leads to an immediate release of iron from ferritin. It has been found that skin that is exposed to UV-A light has approximately 3 times more iron content than unexposed skin. Excess iron can also be found in skin affected by certain skin disorders such as psoriasis and atopic eczema (2).

The study I mentioned above, looked at rosacea skin in particular. The study involved 60 rosacea patients and 11 control subjects. Skin biopsies from the face were studied for iron and ferritin content and serum was collected for determination of total peroxide levels (to get an idea of how much oxidative stress each person was under).

It was found that the more severe cases of rosacea had higher levels of ferritin and iron in their skin compared to the control groups. This could possibly also explain why the more advanced cases of rosacea are more sensitive to UV(A) exposure. Additionally, rosacea patients overall were found to have higher peroxide levels in their serum and a lower anti-oxidant potential.

The authors of this study suggested that the higher frequency of rosacea seen in women can be attributed to women having a thinner skin than men and the fact that iron supplementation is more common in women.

Limiting UV exposure and reducing stress in combination with a diet that is high in antioxidants may be helpful in reducing the severity of rosacea sysmptoms.

1. Tisma, VS, Basta-Juzbasic, A, Jaganjac, M et al (2009) Oxidative stress and ferritin expression in the skin of patients with rosacea. J Am Acad Dermatol 60: 270-6.

2. Bissett, DL, Chatterjee, R, Hannon, DP. (1991) Chronic ultraviolet radiation-induced increase in skin iron and the photoprotective effect of topically applied iron chelators. Photochem Photobiol 54:215-23.

What is your experience with iron? Have you ever been on iron supplementation for extended periods and have you seen an effect on rosacea symptoms?

Tags: ferritin, iron

Is Intestinal Alkaline Phosphatase a Link between Rosacea and Gastrointestinal Disease?

Thursday, October 8th, 2009 | rosacea | 6 Comments

As I have written previously in a post about rosacea and digestive problems, many people believe that rosacea co-exists with gastrointestinal disorders. A recent paper by J. Whitehead (2009) discusses the hypothesis that rosacea and gastrointestinal symptoms can be linked through an enzyme found in the intestines, called intestinal alkaline phosphatase.

Intestinal alkaline phosphatase (IAP) is a membrane-bound enzyme found in the intestines, which function is to take away phosphate groups from a large number of molecules. For example, the absorption of the B6 vitamins pyridoxal phosphate and pyridoxamine phosphate is dependent on their dephosphorylation by intestinal alkaline phosphatase. IAP is also responsible for removing the phosphate from lipopolysaccharide (LPS), an endotoxin found on gram-negative bacteria that normally induces the fever response. A properly functioning intestinal alkaline phosphatase is important to prevent an immune response against the (good) gram-negative bacteria living in our gut.

Crohn’s disease and colitis are believed to be caused by an abnormal immune response to gram-negative bacteria in the intestine, a feature which may be shared with rosacea. Both Crohn’s disease and colitis are associated with reduced levels of intestinal alkaline phosphatase and the pathology of these diseases have been suggested to be triggered by LPS. Taking oral antibiotics for rosacea is believed to help eradicate these bacteria, resulting in a decreased immune response and subsequent improvement in rosacea symptoms.

Many people with rosacea are advised to modify their diet as many dietary triggers exist for rosacea. However, these dietary trigger factors vary from individual to individual and thus far no clinical evidence for a so-called anti-rosacea diet exists. The author of the paper further suggests that the typical Western diet (which is high in processed foods and low in fresh fruits and vegetables) results in a more acidic environment in the intestines. As its name implies, intestinal alkaline phosphatase works best in a more alkaline (or basic) environment with a pH in the range of 9-10.

Foods that lower IAP activity
IAP enzyme is inhibited by phytates, a substance found in grains and legumes. The only way to properly get rid of phytates is to cook grains and legumes well. In addition, the amino acid phenylalanine (found in some artificial sweeteners) also inhibits intestinal alkaline phosphatase.

Foods that stimulate IAP activity
Here are a number of foods that increase intestinal alkaline phosphatase activity:

• Short chain fatty acids such as butyrate, derived from butter or from fermentation of dietary fiber in the gut
• Fish oils (Omega 3, 6 and 9, either as a supplement or from fresh sea food)
• Dietary Zinc (found in oysters or as a supplement)
• Vitamin A (as found in carrots, sweet potatoes, pumpkins)

It is further suggested to increase the gut’s alkalinity by eating a variety of fresh fruits and vegetables and stay away from hard and processed cheeses and processed meat. Finally, adding probiotics to your diet may further decrease rosacea symptoms by the colonization of the g.i. tract with beneficial gram-positive bacteria while reducing the growth of LPS containing gram-negative bacteria.

Intestinal alkaline phosphatase is also stimulated by estrogen and inhibited by progesterone. For this reason, rosacea symptoms could appear during pregnancy and in women who use birth control pills.

Whitehead J. (2009) Intestinal alkaline phosphatase: The molecular link between rosacea and gastrointestinal disease? Med Hypotheses [Epub ahead of print Jun 30] doi:10.1016/j.mehy.2009.02.049

Tags: intestinal alkaline phosphatase