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首页> 外文期刊>Dermatology and Therapy >The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?
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The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?

机译：Demodex螨虫在Rosacea中的致病作用：已经在红斑狼猫术治疗的潜在治疗靶标？

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Rosacea is a common facial dermatosis but its definition and classification are still unclear, especially in terms of its links with demodicosis. Triggers of rosacea (ultraviolet light, heat, spicy foods, alcohol, stress, microbes) are currently considered to induce a cascading innate and then adaptive immune response that gets out of control. Recent histological and biochemical studies support the concept that this inflammatory response is a continuum, already present from the onset of the disease, even when no clinical signs of inflammation are visible. The Demodex mite is beginning to be accepted as one of the triggers of this inflammatory cascade, and its proliferation as a marker of rosacea; moreover, the papulopustules of rosacea can be effectively treated with topical acaricidal agents. Demodex proliferation appears to be a continuum process in rosacea, and may not be clinically visible at the onset of the disease. Molecular studies suggest that Demodex may induce tolerogenic dendritic cells and collaborate with vascular endothelial growth factor (VEGF) to induce T?cell exhaustion and favor its own proliferation. These interactions among VEGF, Demodex , and immunity need to be explored further and the nosology of rosacea adapted accordingly. However, treating early rosacea, with only clinically visible vascular symptoms, with an acaricide may decrease early inflammation, limit potential flare-ups following laser treatment, and prevent the ultimate development of the papulopustules of rosacea. The effectiveness of this approach needs to be confirmed by prospective controlled clinical trials with long-term follow-up. Currently, the evidence suggests that patients with only vascular symptoms of rosacea should be carefully examined for the presence of follicular scales as signs of Demodex overgrowth or pityriasis folliculorum so that these patients, at least, can be treated early with an acaricidal cream.
机译：Rosacea是一种常见的面部皮肤病，但其定义和分类仍然不清楚，特别是在其与脱大症的联系方面。目前考虑促进Rosacea（紫外线，热，辛辣食物，酒精，应力，微生物），以诱导级联先天，然后进行自适应免疫应答。最近的组织学和生物化学研究支持这种炎症反应是一种连续性的概念，这些炎症反应已经存在于疾病的发作中，即使在没有炎症的临床症状中也是可见的。 DemoDex螨开始被接受为这种炎症级联的触发器之一，其作为Rosacea的标志物的增殖;此外，可以用局部杀螨剂有效地治疗Rosacea的椎间盘抑制。 Demodex增殖似乎是Rosacea中的连续过程，并且在疾病的发作时可能不会临床上可见。分子研究表明，DemoDex可以诱导耐甲状腺细胞，并与血管内皮生长因子（VEGF）合作，以诱导T 2细胞耗尽并有利于其自身的增殖。这些相互作用在VEGF，DEMODEX和免疫中需要进一步探索，并相应地进行的Rosacea的病理学。然而，治疗早期的Rosacea，只有临床上可见的血管症状，有一种杀螨剂可能会降低早期炎症，激光治疗后限制潜在的爆发，并防止Rosacea的突出膜的最终发展。这种方法的有效性需要通过长期随访的前瞻性对照临床试验来证实。目前，证据表明，只应对卵泡鳞片的血管症状进行血管症状的患者，因为卵形过度生长或悲观毛细血管的迹象，这些患者至少可以用杀螨霜治疗。

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