Demodex Density, Immune Response and Oxidative Stress in Rosacea Patients

Study Overview
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Brief Summary
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Aim of study is to determine reactive oxygen products and antioxidant capacity with rosacea patients; to measure metalloproteinase level and inflammatory markers of immune response and investigate their corelation with demodex infestation and also investigate the role of photoaging and sebum secretion in rosacea.

Detailed Description
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Rosacea is a common and chronic inflammatory disease characterized by facial erythema, papule, pustule and telangiectasia. Ultraviolet, Demodex mite, oxidative stress and antioxidant system disorders are emphasized in increased inflammation seen in rosacea. The aim of our study was to evaluate the status of oxidative stress, matrix metalloproteinase (MMP) and inflammatory markers in systemic circulation, their relationship with demodex density and investigate the role of photoaging and sebum secretion in rosacea. Forty patients with rosacea and age, gender and skin phenotype matched 40 healthy volunteers were enrolled in the study. Reflectance confocal microscopy (RCM) was used to calculate facial demodex density. The number of demodex, follicle, the number of mite per follicle, the number of infested follicle and the number of mite per infested follicle were calculated with RCM. Photoaging severity and facial sebum levels were also assessed. Total oxidant capacity (TOC), total antioxidant capacity (TAC), oxidative stress index (OSI), paraoxonase-1 (PON-1), aryl esterase (ARES), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-9 (MMP-9) levels in venous blood were measured.

Official Title
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Investigation of Relation Between Demodex Density With Immune Response and Oxidative Stress in Rosacea Patients

Conditions
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Rosacea

Intervention / Treatment
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* Other: Obtaining a blood sample
* Device: Reflectance confocal microscopy
* Device: Sebumeter
* Device: Video dermoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between the ages of 18-70 No systemic illness No other inflammatory dermatoses except for rosacea No smoking Not using any topical, systemic treatment and sunblock at least a month for rosacea or other condition Exclusion Criteria: Systemic illness Other inflammatory dermatoses except for rosacea Smoking Using any topical, systemic treatment and sunblock for rosacea or other condition Type 4 rosacea patient (only ocular involvement)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| H, Rosacea patients<br>Rosacea patients who were between the ages of 18-70, having no systemic illness and who were not smoking. Obtaining a blood sample; TOC, TAC, OSI, PON-1, ARES, MPO, TNF-α, IL-1β, MMP-1 and MMP-9 levels in venous blood were measured Reflectance confocal microscopy; 1mm2-sized 10 images were taken from right cheek and forehead; the number of demodex, follicle, the number of mite per follicle, the number of infested follicle and the number of mite per infested follicle were calculated with RCM. And photoaging severity were also assessed by using RCM. Sebum rate at forehead and right cheek were evaluated with sebumeter. Dermoscopic photoaging scale were assessed by using video dermoscopy. | Other: Obtaining a blood sample<br>* Total oxidant capacity (TOC), total antioxidant capacity (TAC), oxidative stress index (OSI), paraoxonase-1 (PON-1), aryl esterase (ARES), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-9 (MMP-9) levels in venous blood were measured.<br>Device: Reflectance confocal microscopy<br>* 1mm2-sized 10 images were taken from right cheek and forehead; the number of demodex, follicle, the number of mite per follicle, the number of infested follicle and the number of mite per infested follicle were calculated with RCM. And photoaging severity were also assessed by using RCM.<br>Device: Sebumeter<br>* Sebum rate at forehead and right cheek were evaluated with sebumeter<br>Device: Video dermoscopy<br>* Dermoscopic photoaging scale were assessed by using video dermoscopy.<br>|
| K, Healthy volunteers<br>Healthy volunteers who were compatible in terms of age, sex and skin phenotype, having no systemic illness and who were not smoking. Obtaining a blood sample; TOC, TAC, OSI, PON-1, ARES, MPO, TNF-α, IL-1β, MMP-1 and MMP-9 levels in venous blood were measured Reflectance confocal microscopy; 1mm2-sized 10 images were taken from right cheek and forehead; the number of demodex, follicle, the number of mite per follicle, the number of infested follicle and the number of mite per infested follicle were calculated with RCM. And photoaging severity were also assessed by using RCM. Sebum rate at forehead and right cheek were evaluated with sebumeter. Dermoscopic photoaging scale were assessed by using video dermoscopy. | Other: Obtaining a blood sample<br>* Total oxidant capacity (TOC), total antioxidant capacity (TAC), oxidative stress index (OSI), paraoxonase-1 (PON-1), aryl esterase (ARES), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-9 (MMP-9) levels in venous blood were measured.<br>Device: Reflectance confocal microscopy<br>* 1mm2-sized 10 images were taken from right cheek and forehead; the number of demodex, follicle, the number of mite per follicle, the number of infested follicle and the number of mite per infested follicle were calculated with RCM. And photoaging severity were also assessed by using RCM.<br>Device: Sebumeter<br>* Sebum rate at forehead and right cheek were evaluated with sebumeter<br>Device: Video dermoscopy<br>* Dermoscopic photoaging scale were assessed by using video dermoscopy.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Severity of rosacea |  | Rosacea patients who refer to criteria will be evaluated throughout 4 months. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of demodex of right cheek and forehead |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| The number of follicle of right cheek and forehead |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| The number of mite per follicle of right cheek and forehead |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| The number of infested follicle of right cheek and forehead |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| The number of mite per infested follicle of right cheek and forehead |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Total oxidant capacity (TOC) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Total antioxidant capacity (TAC) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Oxidative stress index (OSI) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Paraoxonase-1 (PON-1) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Aryl esterase (ARES) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Myeloperoxidase (MPO) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Tumor necrosis factor-alpha (TNF-α) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Interleukin-1beta (IL-1β) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Matrix metalloproteinase-1 (MMP-1) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 
| Matrix metalloproteinase-1 (MMP-9) |  | Rosacea patients and healthy volunteers who refer to criteria will be evaluated throughout 4 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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demodex, oxidative stress, reflectance confocal microscopy