Serum Zonulin and Its Role in Rosacea Pathogenesis: A Comprehensive Estimation Study

Fatma  Shabaka; Laila  Rashed; Mona  Ali; Aya Salama

doi:10.5826/dpc.1503a5027

Serum Zonulin and Its Role in Rosacea Pathogenesis: A Comprehensive Estimation Study

Authors

Fatma Shabaka Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
Laila Rashed Faculty of Medicine- Cairo University, Cairo, Egypt.
Mona Ali Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
Aya Salama Dermatology and Venereology, Damanhour Medical National Institute, Cairo, Egypt

Keywords:

Rosacea, Dermoscopy, Zonulin, Gut Microbiome

Abstract

Introduction: Rosacea is a chronic inflammatory skin disorder distinguished by recurrent episodes of inflammatory papules, persistent erythema, facial flushing, pustules, and telangiectasia. Any disturbance in the gut microbiome could influence the immune system equilibrium in rosacea through the release of zonulin, leading to increased intestinal permeability and the passage of many microbes into the circulation, causing inflammation.

Objectives: We aimed to estimate the serum zonulin levels in cases with rosacea compared with healthy controls. In addition, some fecal bacteria were investigated in an attempt to find a relationship between gut microbiome and rosacea.

Methods: This case-control study was performed on 42 participants aged above 18 years old, 21 patients with a clinical diagnosis of rosacea, approved by dermoscopy, and 21 healthy individuals as controls. The serum zonulin level was estimated by enzyme-linked immunosorbent assay technique and some gut microbiomes were investigated using real-time quantitative PCR.

Results: There was a highly statistically significant serum zonulin level increase in rosacea cases than in controls. There was a statistically significant elevation of Bacteroid and Lactobacillus gut microbiomes in rosacea patients compared to controls, while there was no statistically significant increase of Fusobacterium microbiome in patients. Zonulin levels didn’t show a significant correlation with gut microbiomes.

Conclusions: Serum zonulin measurement can be used as a discriminating marker between rosacea and healthy controls due to getting a specific cutoff point in ROC analysis with the highest specificity and sensitivity (100% and 100%, respectively). Gut microbial dysbiosis could play a valuable role in the disease pathogenesis.

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