Evidence mapPaperPMID 42325915Full record

ReviewDrug design, development and therapy2026

Neurohormonal-Immune Dysregulation in Rosacea: Emerging Perspectives from the Skin-Gut-Brain Axis.

Lei Shi, Siying Li, Xiaodong Yao, Zijian Zhang, Qinyi Dong, Han Zhang, Xinman Wang, Jiahao Bai, Huiyan Han, Xiaoyi Fu and 2 more

Abstract readReview
In one paragraph

Review in Drug design, development and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lei ShiThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.ORCID 0009-0002-5474-5780
Siying LiThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Xiaodong YaoThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Zijian ZhangThe Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, People's Republic of China.
Qinyi DongThe Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, People's Republic of China.ORCID 0009-0005-7636-0701
Han ZhangThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Xinman WangThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Jiahao BaiThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Huiyan HanThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Xiaoyi FuThe Third Clinical College, Shanxi University of Chinese Medicine, Taiyuan, People's Republic of China.
Kaili ZhengThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.
Lili LiangThe Cosmetic and Plastic Surgery, Department of Shanxi Provincial People' s Hospital, Shanxi Medical University, Taiyuan, 030012, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rosacea is a chronic inflammatory skin disease with a global prevalence of approximately 5.1%. Existing evidence suggests that its pathogenesis may be associated with dysregulation of the neuro-hormone-immune network within the skin-gut-brain axis framework. This review summarizes the potential roles of stress hormones, sex hormones, and insulin-like growth factor-1 in the four major subtypes. In erythematotelangiectatic rosacea, glucocorticoid resistance within keratinocytes may induce CCL20-driven Th17 inflammation, while catecholamines released by sympathetic nerves are associated with neurovascular flushing. In papulopustular rosacea, androgen excess, relative estrogen deficiency, LL-37-mediated innate immune activation, and gut microbiota dysbiosis may collectively contribute to the formation of inflammatory skin lesions.In the phymatous type, insulin-like growth factor-1 and androgens may interact through the PI3K/Akt/mTOR and FoxO1 pathways, promoting sebaceous gland hyperplasia and fibrosis. Ocular rosacea is associated with gut-derived low-grade systemic inflammation and neurogenic inflammation. For treatment, β-receptor blockers such as carvedilol and selective serotonin reuptake inhibitors such as paroxetine can be used for erythematotelangiectatic rosacea; anti-androgen drugs like spironolactone and metformin may be explored for papulopustular rosacea; metformin for the phymatous type; and for ocular rosacea, topical corticosteroids can be used cautiously for a short term under ophthalmological supervision. Adjunctive interventions such as eradication of small intestinal bacterial overgrowth, a low glycemic index diet, and mindfulness-based stress reduction therapy also demonstrate potential.Taken together, existing evidence supports viewing rosacea as a systemic disease potentially mediated by the skin-gut-brain axis and characterized by dysregulation of the neuro-hormone-immune network. However, more high-quality randomized controlled trials and stratified studies guided by hormone-related biomarkers are currently needed to further validate its mechanisms and advance precision treatment.

Indexed as

BrainNeurotransmitter AgentsRosaceaSkinAnimalsHumansNeurotransmitter Agentsneuro-hormone-immune networkrosaceaskin-gut-brain axistargeted therapy

Identifiers

PMID42325915
PMCPMC13282955

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.