Elevated calcitonin gene-related peptide levels linked to rosacea: A Groundbreaking Study

CGRP levels were unaffected by several factors, including sex, age, BMI, rosacea subtypes, migraine, comorbidities, or ongoing treatments. The findings suggest CGRP's role in the pathogenesis of rosacea. Targeting CGRP signaling might hold therapeutic promise in individuals affected by this disease.

Rosacea, a chronic inflammatory skin condition affecting millions worldwide, has long confounded sufferers and clinicians with its elusive causes and variable symptomatology. Capsaicin, a well-known trigger of rosacea flushing, has been demonstrated to increase dermal skin blood flow in the forearm by activating transient receptor potential vanilloid (TRPV) channels and promoting the release of CGRP.

Traditional treatments for rosacea, such as oral antibiotics and topical agents, primarily address symptoms rather than underlying mechanisms. However, modulating CGRP signaling could represent a more targeted approach, potentially offering improved efficacy and tolerability for patients with refractory or severe disease.

Against the above background, Messoud Ashina, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark, and colleagues aimed to compare plasma levels of CGRP between individuals with rosacea and healthy controls.

For this purpose, the researchers conducted a cross-sectional case-control study in Copenhagen, Denmark. They collected blood samples from the antecubital vein from adults with rosacea and healthy controls. 123 individuals with rosacea and 68 healthy controls were enrolled.

The study revealed the following findings:

• After adjusting for age and sex, plasma levels of CGRP were significantly higher in individuals with rosacea (mean, 95% confidence interval: 140.21 pmol/L, 128.50–151.92 pmol/L), compared with controls (110.77 pmol/L, 99.91–120.14 pmol/L).
• Plasma levels of CGRP were not affected by age, sex, BMI, rosacea sub- or phenotype, concomitant migraine, concomitant disease, or current treatment.

The main limitation was that the participants were not age-, sex- and BMI-matched.

In conclusion, the study provides evidence that plasma CGRP levels are elevated in individuals with rosacea versus healthy controls. However, the researchers did not find a correlation between CGRP levels and rosacea severity or subtype, indicating that CGRP might not be a reliable biomarker for diagnosing or assessing rosacea severity.

"Nevertheless, our findings suggest that CGRP might be involved in the pathophysiology of rosacea," the researchers wrote. "Thus, there is a need for further research to investigate the potential of medications targeting CGRP signaling in managing rosacea."

Reference:

F. Wienholtz, N. K., Christensen, C. E., Ashina, H., Jørgensen, N. R., Egeberg, A., Thyssen, J. P., & Ashina, M. Elevated plasma levels of calcitonin gene-related peptide in individuals with rosacea: A cross-sectional case–control study. Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.19954