.: ORİJİNAL ARAŞTIRMA
Fecal Calprotectin Level in Patients with Rosacea: Gut Inflammation May Be Associated with the Type of Rosacea, A Case-Control Study
Rozasea Hastalarında Fekal Kalprotektin Düzeyi: Bağırsak İltihabı Rozasea Tipi ile İlişkili Olabilir, Bir Vaka-Kontrol Çalışması
Turkiye Klinikleri J Dermatol. 2022;32(1):1-8
doi: 10.5336/dermato.2021-85699
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Rosacea is a chronic inflammatory skin disease that has complex pathogenesis. The association between rosacea and inflammatory gastrointestinal tract disorders is a popular topic, and fecal calprotectin is a potential marker to diagnose intestinal inflammation of any cause. In this study, the aims were to determine the relationship between disease type, disease severity, and fecal calprotectin levels in patients with rosacea, and also compare the calprotectin levels between healthy controls and rosacea patients. Material and Methods: Forty-six patients with rosacea, and sex-age-matched 92 healthy volunteers were enrolled in this study. Calprotectin levels of stool samples were calculated using enzymelinked immunosorbent assay. Results: Of these patients, 30 (65.2%) had erythematotelangiectatic type rosacea, and 16 (34.8%) had papulopustular type rosacea. There was not a statistically significant difference between the mean fecal calprotectin levels of the patient and control groups (p=0.414), whereas the mean fecal calprotectin levels of the erythematotelangiectatic type group was lower than the papulopustular type group, and this difference was significant (p<0.001). Conclusion: According to the results, the underlying pathogenesis of different types of rosacea may be different, and the papulopustular type of rosacea may be more related to gut inflammation. In addition, we think that fecal calprotectin may be useful in evaluating intestinal inflammation especially in patients with papulopustular type and severe rosacea.
Keywords: Rosacea; gastrointestinal tract; inflammation
Objective: Rosacea is a chronic inflammatory skin disease that has complex pathogenesis. The association between rosacea and inflammatory gastrointestinal tract disorders is a popular topic, and fecal calprotectin is a potential marker to diagnose intestinal inflammation of any cause. In this study, the aims were to determine the relationship between disease type, disease severity, and fecal calprotectin levels in patients with rosacea, and also compare the calprotectin levels between healthy controls and rosacea patients. Material and Methods: Forty-six patients with rosacea, and sex-age-matched 92 healthy volunteers were enrolled in this study. Calprotectin levels of stool samples were calculated using enzymelinked immunosorbent assay. Results: Of these patients, 30 (65.2%) had erythematotelangiectatic type rosacea, and 16 (34.8%) had papulopustular type rosacea. There was not a statistically significant difference between the mean fecal calprotectin levels of the patient and control groups (p=0.414), whereas the mean fecal calprotectin levels of the erythematotelangiectatic type group was lower than the papulopustular type group, and this difference was significant (p<0.001). Conclusion: According to the results, the underlying pathogenesis of different types of rosacea may be different, and the papulopustular type of rosacea may be more related to gut inflammation. In addition, we think that fecal calprotectin may be useful in evaluating intestinal inflammation especially in patients with papulopustular type and severe rosacea.
Keywords: Rosacea; gastrointestinal tract; inflammation
ÖZET
Amaç: Rozasea, karmaşık patogenezi olan kronik inflamatuar bir deri hastalığıdır. Rozasea ve inflamatuar gastrointestinal sistem bozuklukları arasındaki ilişki popüler bir konudur ve fekal kalprotektin, herhangi bir nedene bağlı intestinal inflamasyonu teşhis etmek için kullanılan potansiyel bir belirteçtir. Bu çalışmada, rozasealı hastalarda hastalık tipi, hastalık şiddeti ile fekal kalprotektin düzeyleri arasındaki ilişkiyi ve sağlıklı kontrollerle farkını belirlemek amaçlandı. Gereç ve Yöntemler: Bu çalışmaya rozasealı 46 hasta ve cinsiyet-yaş uyumlu 92 sağlıklı gönüllü alındı. Dışkı örneklerinin kalprotektin seviyeleri, enzime bağlı immünosorbent tahlili kullanılarak hesaplandı. Bulgular: Bu hastaların 30'unda (%65,2) eritematotelanjiektatik tip rozasea, 16'sında (%34,8) papülopüstüler tip rozasea vardı. Hasta ve kontrol gruplarının ortalama fekal kalprotektin düzeyleri arasında istatistiksel olarak anlamlı fark bulunmazken (p=0,414); eritematotelanjiektatik tip hastalığı olan grubun ortalama fekal kalprotektin düzeyleri papülopüstüler tip grubuna göre daha düşüktü ve bu fark anlamlıydı (p<0.001). Sonuç: Elde edilen sonuçlara göre farklı rozasea türlerinin altta yatan patogenezi farklı olabilir ve papülopüstüler tip rozasea daha çok bağırsak iltihabı ile ilişkili olabilir. Ayrıca özellikle papülopüstüler tip ve şiddetli rozasealı hastalarda, fekal kalprotektinin intestinal inflamasyonun değerlendirilmesinde faydalı olabileceğini düşünmekteyiz.
Anahtar Kelimeler: Rozasea; gastrointestinal kanal; inflamasyon
Amaç: Rozasea, karmaşık patogenezi olan kronik inflamatuar bir deri hastalığıdır. Rozasea ve inflamatuar gastrointestinal sistem bozuklukları arasındaki ilişki popüler bir konudur ve fekal kalprotektin, herhangi bir nedene bağlı intestinal inflamasyonu teşhis etmek için kullanılan potansiyel bir belirteçtir. Bu çalışmada, rozasealı hastalarda hastalık tipi, hastalık şiddeti ile fekal kalprotektin düzeyleri arasındaki ilişkiyi ve sağlıklı kontrollerle farkını belirlemek amaçlandı. Gereç ve Yöntemler: Bu çalışmaya rozasealı 46 hasta ve cinsiyet-yaş uyumlu 92 sağlıklı gönüllü alındı. Dışkı örneklerinin kalprotektin seviyeleri, enzime bağlı immünosorbent tahlili kullanılarak hesaplandı. Bulgular: Bu hastaların 30'unda (%65,2) eritematotelanjiektatik tip rozasea, 16'sında (%34,8) papülopüstüler tip rozasea vardı. Hasta ve kontrol gruplarının ortalama fekal kalprotektin düzeyleri arasında istatistiksel olarak anlamlı fark bulunmazken (p=0,414); eritematotelanjiektatik tip hastalığı olan grubun ortalama fekal kalprotektin düzeyleri papülopüstüler tip grubuna göre daha düşüktü ve bu fark anlamlıydı (p<0.001). Sonuç: Elde edilen sonuçlara göre farklı rozasea türlerinin altta yatan patogenezi farklı olabilir ve papülopüstüler tip rozasea daha çok bağırsak iltihabı ile ilişkili olabilir. Ayrıca özellikle papülopüstüler tip ve şiddetli rozasealı hastalarda, fekal kalprotektinin intestinal inflamasyonun değerlendirilmesinde faydalı olabileceğini düşünmekteyiz.
Anahtar Kelimeler: Rozasea; gastrointestinal kanal; inflamasyon
REFERANSLAR:
- Rainer BM, Fischer AH, Luz Felipe da Silva D, Kang S, Chien AL. Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: results of a case-control study. J Am Acad Dermatol. 2015;73(4):604-8. [Crossref] [PubMed]
- Gupta AK, Chaudhry MM. Rosacea and its management: an overview. J Eur Acad Dermatol Venereol. 2005;19(3):273-85. [Crossref] [PubMed]
- Two AM, Wu W, Gallo RL, Hata TR. Rosacea: Part I. Introduction, categorization, histology, pathogenesis, and risk factors. J Am Acad Dermatol. 2015;72(5):749-58; quiz 759-60. [Crossref] [PubMed]
- Weiss E, Katta R. Diet and rosacea: the role of dietary change in the management of rosacea. Dermatol Pract Concept. 2017;7(4):31-7. [Crossref] [PubMed] [PMC]
- Kendall SN. Remission of rosacea induced by reduction of gut transit time. Clin Exp Dermatol. 2004;29(3):297-9. [Crossref] [PubMed]
- Woo YR, Lim JH, Cho DH, Park HJ. Rosacea: molecular mechanisms and management of a chronic cutaneous inflammatory condition. Int J Mol Sci. 2016;17(9):1562. [Crossref] [PubMed] [PMC]
- Wu CY, Chang YT, Juan CK, Shieh JJ, Lin YP, Liu HN, et al. Risk of inflammatory bowel disease in patients with rosacea: Results from a nationwide cohort study in Taiwan. J Am Acad Dermatol. 2017;76(5):911-7. [Crossref] [PubMed]
- Ayling RM, Kok K. Fecal calprotectin. Adv Clin Chem. 2018;87:161-90. [Crossref] [PubMed]
- Seo SC, Ahn SH, Ri S, Yoon Y, Byeon JH, Kim SH, et al. Elevated fecal calprotectin levels are associated with severity of atopic dermatitis in children. Asian Pac J Allergy Immunol. 2018;36(2):82-7. [PubMed]
- Premjeyanth V, Shipman AR, Shipman KE. Faecal calprotectin in dermatology practice. Clin Exp Dermatol. 2020;45(7):831-5. [Crossref] [PubMed]
- Aksu Çerman A, Aktaş Karabay E, Kaya HE, Türe Özdemir F, Özkur E, Erdem Y, et al. Evaluation of fecal calprotectin as a marker of gastrointestinal inflammation in rosacea: A case-control study. Dermatol Ther. 2021;34(3): e14946. [Crossref] [PubMed]
- Wilkin J, Dahl M, Detmar M, Drake L, Feinstein A, Odom R, et al. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol. 2002;46(4):584-7. [Crossref] [PubMed]
- Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, et al; National Rosacea Society Expert Committee. Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol. 2004;50(6):907-12. [Crossref] [PubMed]
- Ellis SR, Nguyen M, Vaughn AR, Notay M, Burney WA, Sandhu S, et al. The skin and gut microbiome and its role in common dermatologic conditions. Microorganisms. 2019;7(11): 550. [Crossref] [PubMed] [PMC]
- Nam JH, Yun Y, Kim HS, Kim HN, Jung HJ, Chang Y, et al. Rosacea and its association with enteral microbiota in Korean females. Exp Dermatol. 2018;27(1):37-42. [Crossref] [PubMed]
- Wang FY, Chi CC. Association of rosacea with inflammatory bowel disease: A MOOSE-compliant meta-analysis. Medicine (Baltimore). 2019;98(41):e16448. [Crossref] [PubMed] [PMC]
- Papoutsopoulou S, Satsangi J, Campbell BJ, Probert CS. Review article: impact of cigarette smoking on intestinal inflammation-direct and indirect mechanisms. Aliment Pharmacol Ther. 2020;51(12):1268-85. [Crossref] [PubMed]
- Cosnes J. What is the link between the use of tobacco and IBD? Inflamm Bowel Dis. 2008;14 Suppl 2:S14-5. Erratum in: Inflamm Bowel Dis. 2009;15(9):1438-47. [Crossref] [PubMed]
- Berkowitz L, Schultz BM, Salazar GA, Pardo-Roa C, Sebastián VP, Álvarez-Lobos MM, et al. Impact of cigarette smoking on the gastrointestinal tract inflammation: opposing effects in Crohn's disease and ulcerative colitis. Front Immunol. 2018;9:74. [Crossref] [PubMed] [PMC]
- Egeberg A, Weinstock LB, Thyssen EP, Gislason GH, Thyssen JP. Rosacea and gastrointestinal disorders: a population-based cohort study. Br J Dermatol. 2017;176(1):100-6. [Crossref] [PubMed]
- Spoendlin J, Karatas G, Furlano RI, Jick SS, Meier CR. Rosacea in patients with ulcerative colitis and crohn's disease: a population-based case-control study. Inflamm Bowel Dis. 2016;22(3):680-7. [Crossref] [PubMed]
- O'Neill CA, Monteleone G, McLaughlin JT, Paus R. The gut-skin axis in health and disease: A paradigm with therapeutic implications. Bioessays. 2016;38(11):1167-76. [Crossref] [PubMed]
- Yilmaz K, Altindis M, Dikicier BS, Yüksekal G, Köroglu M. Is there a relationship between rosacea with gut dysbiosis? Dermatol Sin. 2020;38(2):88-93. [Crossref]
- D'Haens G, Ferrante M, Vermeire S, Baert F, Noman M, Moortgat L, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis. 2012;18(12):2218-24. [Crossref] [PubMed]
- Costa F, Mumolo MG, Ceccarelli L, Bellini M, Romano MR, Sterpi C, et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease. Gut. 2005;54(3):364-8. [Crossref] [PubMed] [PMC]
- Wang S, Song R, Wang Z, Jing Z, Wang S, Ma J. S100A8/A9 in Inflammation. Front Immunol. 2018;9:1298. [Crossref] [PubMed] [PMC]
- Eşer E, Engin B, Yüksel P, Kocazeybek BS, Kutlubay Z, Serdaroğlu S, et al. Relationship between fecal calprotectin level and disease activity in patients with hidradenitis suppurativa. Dermatol Ther. 2020;33(2):e13232. [Crossref] [PubMed]
- Kluger N, Salava A, Lybeck E, Kiiski LL, Nuutinen P, Ruohoalho T, et al. Faecal calprotectin in hidradenitis suppurativa: a study of 55 patients. Eur J Dermatol. 2020;30(4):422-4. [Crossref] [PubMed]
- Adarsh MB, Dogra S, Vaiphei K, Vaishnavi C, Sinha SK, Sharma A. Evaluation of subclinical gut inflammation using faecal calprotectin levels and colonic mucosal biopsy in patients with psoriasis and psoriatic arthritis. Br J Dermatol. 2019;181(2):401-2. [Crossref] [PubMed]
- Polkowska-Pruszyńska B, Gerkowicz A, Rawicz-Pruszyński K, Krasowska D. The role of fecal calprotectin in patients with systemic sclerosis and small intestinal bacterial overgrowth (SIBO). Diagnostics (Basel). 2020; 10(8):587. [Crossref] [PubMed] [PMC]
- Özşeker B, Şahin C, Özşeker HS, Efe SC, Kav T, Bayraktar Y. The role of fecal calprotectin in evaluating intestinal involvement of Behçet's disease. Dis Markers. 2016;2016: 5423043. [Crossref] [PubMed] [PMC]
- Kim MJ, Kim JY, Kang M, Won MH, Hong SH, Her Y. Reduced fecal calprotectin and inflammation in a murine model of atopic dermatitis following probiotic treatment. Int J Mol Sci. 2020;21(11):3968. [Crossref] [PubMed] [PMC]
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