Biomarkers in rosacea: A systematic review

Area of Science:

• Dermatology
• Immunology
• Biochemistry

Background:

• Rosacea is a chronic skin condition affecting 1-3% of the global population, often associated with psychological distress.
• Identifying reliable biomarkers for rosacea is crucial for improving diagnosis, disease management, and clinical trial objectivity.

Purpose of the Study:

• To systematically identify and categorize all known rosacea biomarkers.
• To analyze trends in rosacea biomarker research and their relation to disease pathogenesis.
• To assess the potential of identified biomarkers for diagnostic utility and clinical application.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines was conducted, including RCTs, case-control, cohort, and observational studies.
• Searches were performed without demographic or language restrictions until February 2023.
• Study quality was assessed using the NIH quality assessment tool, with 38 studies included from 805 screened articles.

Main Results:

• A total of 119 unique biomarkers were identified across the included studies.
• The innate cathelicidin and inflammasome pathways, along with T_h1 and T_h17 pathways, received the strongest support as key pathogenic mechanisms.
• Commonly reported biomarkers include Interleukin-1 beta (IL-1β), Tumor Necrosis Factor-alpha (TNF-α), IL-37, Interferon-gamma (IFN-γ), and Matrix Metalloproteinase-9 (MMP-9).

Conclusions:

• The identified biomarkers support current theories on rosacea pathogenesis and offer directions for future research.
• Significant heterogeneity in rosacea subtypes may present challenges in developing diagnostic biomarker panels.
• Additional research is necessary to establish biomarker panels with definitive diagnostic utility for rosacea.