ReviewDrug design, development and therapy2026
Neurohormonal-Immune Dysregulation in Rosacea: Emerging Perspectives from the Skin-Gut-Brain Axis.
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.
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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.
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Authors and funding
12 authors.
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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.
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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.