Evidence that points to interleukin-17 (IL-17) playing a role in the development and progression of rosacea also indicates research should investigate IL-17 inhibition as a therapeutic option for some patients, an expert says.
“Although available treatments for rosacea usually control symptoms in patients with mild-to-moderate disease, current options are not always effective, and there is a particular unmet need for better therapies to manage more severe disease,” says Ronald Vender, M.D., associate clinical professor of dermatology, McMaster University, and founder and director, Dermatrials Research Inc, Hamilton, Ontario, Canada.
Dr. Vender and colleagues recently reviewed data supporting a role for IL-17 in the pathophysiology of rosacea, including a discussion of how existing treatments may act along the IL-17 pathway.1 He was incentivized to explore this topic after serving as an investigator in pivotal trials of IL-17 inhibitors for psoriasis.
LINKS BETWEEN IL-17 AND ROSACEA
IL-17 is a CD4+-derived pro-inflammatory cytokine that is produced by T helper (Th) 17 cells, but also by innate immune cells, including neutrophils. Acting through a variety of pathways, IL-17 stimulates the production of numerous inflammatory mediators, including cytokines, chemokines and other effectors.
“Analysis of the inflammatory infiltrate in all three subtypes of rosacea (erythematotelangiectatic, papulopustular and phymatous) has shown a Th1/Th17 dominance of the T-cell response along with increased levels of CD4+ cells and IL-17. Elevated levels of IL-17 have also been found in the tears of patients with ocular rosacea associated with Demodex infestation, and there is documentation through gene expression analysis that various inflammatory mediators induced by IL-17 or involved in its induction are increased in rosacea,” Dr. Vender says.
Dr. Vender has received grants and/or research support from companies that market IL-17 inhibitors and treatments for rosacea. He received no financial support for the research, authorship or publication of his article on IL-17 and rosacea.
Amir ali A, Vender R, Vender R. The Role of IL-17 in Papulopustular Rosacea and Future Directions. J Cutan Med Surg. 2019;:1203475419867611.