Rosacea is a Neuro-Vascular Disorder

As a Neuro-Vascular Physiologist I have been shouting from the roof tops for 12 years (including one major book publication and a dozen dermatology journal articles) that the genetic disturbances in blood vessels and nerves are the primary instigating factor for the development and progression of rosacea. This is the actual cause. Everything else is secondary.

Dermatologists and the National Rosacea Society are finally agreeing on rosacea as a Neuro-Vascular Disorder. Six years ago I published a major article in Practical Dermatology that suggested a fifth type of Rosacea: Neuro-Vascular Rosacea. It caught on and is now in several major Dermatology textbooks with references back to my journal publication.

There are now seven major National Rosacea Foundation (NRS) studies/grants on Neuro-Vascular Rosacea and the NRS just released this announcement:

Help New Genetics Study (Neuro-Vascular Rosacea)

Thursday, September 2, 2010

Rosacea patients are invited to participate in a medical research study designed to identify potential genetic factors relating to this common but poorly understood disorder. Patients must meet two criteria to be eligible to participate:

• They must experience facial flushing, burning, tingling or itching in response to alcohol, spicy foods, temperature change or other trigger factors.

• They must have a family member who is (or was) also affected by rosacea.

Selected volunteers will be asked to donate a small sample of blood. Researchers then will analyze the genes in the blood samples for comparison with those of control subjects who do not have rosacea in an effort to discover which genes may be involved in rosacea facial flushing and burning. The researchers hope their work will open new pathways for potential improvement in rosacea treatment and care.

Those interested in participating in the study should contact the researchers via email at rosacea2010@gmail.com. The email should include your name, city of residence, email address and which other family member is also affected by rosacea (mother, father, sister, brother, etc.)

Dr. Jamison Feramisco and Dr. Martin Steinhoff of the University of California – San Francisco were awarded a research grant by the National Rosacea Society earlier this year to undertake this genetic study as part of a broader investigation of the neurovascular system of rosacea patients.


Critique of Study


While I am glad to see the focus is now on blood vessels and nerves, this study is severly flawed and will not tell us anything about the "genetics of rosacea" or even "NeuroVascular Rosacea" because they are looking at the wrong part of physiology. There is nothing wrong with our blood - red blood cells, white blood cells, plasma, carrier proteins, humoral substances, hormones or neurotransmitters..... the genetic defect is in the blood vessels and nerves isolated in the facial skin and their reactivity defects.

They need to perform genetic studies on the blood vessels and nerves in the face to determine why rosacea sufferers are genetically predisposed to rosacea (and its not blood delivery). Do we have a lack of repair enzymes, do we have genetics that activate inflammatory proteins to all sorts of triggers, what are the genetics behind overgrowth of blood vessels (e.g. angiogenesis), etc..

Remember, it has to do with some genetic protein defect in the blood vessels of the facial skin, not in the blood. Plus, dozens of my rosacea consults have had endless blood tests at the Mayo Clinic and other top-notch clinics and genetic laboratories and they have found nothing wrong to date.

So, we are on the right track, but we are looking in the wrong direction.

Remember, people without a genetic predisposition for rosacea can actually get true rosacea via mastocytosis or carcinoid syndrome (which overwhelms the neurovascular protective peptides and repair enzymes in the facial skin). That is probably the most important information we have ever gathered regarding the true underlying cause(s) of rosacea. And that is where we should start.
Bring in patients with Mastocytosis and Carcinoid syndrome and study their changes in blood vessels and nerves.

Conversely, bring in major blushers and flushers who have flushed for decades and don't show one sign of true rosacea and we wil be able to isolate their genetics to tell us what protects their facial blood vessels and nerves from ever progressing into true rosacea. My stepmother has flushed her entire life (embarrasment and heat for nearly 50 years -- it's a moderate flush, but it only lasts for a few seconds and then immediately dissipates.... she never progresses, she does not show one sign of rosacea, she does not pay for it at the end of the day or the next day, and it has not progressed one bit since she was 13 years old). She and many others like her hold the genetic key to protection and repair systems in our facial blood vessels. This would give us key information that could be applied almost immediately to our disorder!
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Best,
Geoffrey

Dr. Geoffrey Nase
Ph.D: Neuro-Vascular Physiologist

Email: drnase1000@hotmail.com
Bibliography: http://drnase.com

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