Re: Immune System (quote from Nase book)

May 20, 2002

, I find these references confusing. In particular, the

abstract to the second reference doesn't support what's Dr. Nase's

saying.

The statistics described in the study are confusing, but at a minumum

the authors found that 12 of the study's 24 rosaceans had tissue

biopsy evidence of altered immune function, and 6 of the 24 had

laboratory evidence of auto-immunity (remember, evidence of

autoantibodies isn't enough to call a condition auto-immune). The

abstract doesn't say how many of the controls had similiar findings,

but Dr. Nase's " ...The average rosacea sufferer has a perfectly

health immune system. " contradicts the authors' closing

statement, " It is suggested that altered immune function plays a

significant role in the pathogenesis of the disease.

That study is published in a respected journal but it's 20 years old -

- frankly, that's just too old to reference in this area, whatever

the study found or didn't find. And the first reference comes from a

15 year old Proceedings. A proceeding is a short, non-peer-reviewed

entry or presentation for a specific conference (each conference puts

out its own Proceeding). Proceedings are used to keep everyone

abreast of completed research during the year or two it takes for the

study to be officially published in peer-review journal. Proceedings

that are 1-3 years old are credible references, but referencing a 15

year old Proceeding doesn't carry the same credibility.

Here's the second abstract. It does support what we've been talking

about -- rosacea has features of a primary immune-mediated condition,

and there is an association between rosacea and other auto-immune

disorders:

Br J Dermatol 1982 Aug;107(2):203-8

Involvement of immune mechanisms in the pathogenesis of rosacea.

Manna V, Marks R, Holt P.

Twenty-five patients with rosacea were compared with twenty-five

control subjects for previous medical history and tests of immune

function. cea patients were found to have a higher incidence of

disorders of the auto-immune type and were significantly more

difficult to sensitize to DNCB than the controls. In addition, twelve

of the rosacea patients and eleven other rosacea patients had

biopsies which were examined by the direct immunofluorescence

technique. In only five was the test negative. In the remainder

deposits of IgM and/or IgG and/or complement were found at the dermo-

epidermal junction and/or in the dermal collagen. Serum from the

rosacea patients was also examined by the indirect technique and in

six cases a circulating antinuclear antibody of IgM type was found.

It is suggested that altered immune function plays a significant role

in the pathogenesis of the disease.

Marjorie

Marjorie Lazoff, MD

> Hi,

>

> While we're on the topic of rosacea / auto-immune disease, there is

a

> snippet in Dr. Nase's book (http://www.drnase.com) on page 93 which

> gives the flip-side of the coin. I'll quote the main point here.

>

> " It is important for rosacea sufferers and general physicians to

> understand that rosacea is _NOT_ an auto-immune disease (242,

243).

> The immune system does _NOT_ produce antibodies or

> specifically " attack " the facial skin and blood vessels. The

average

> rosacea sufferer has a perfectly health immune system. (242, 243)

>

> [emphasis in book is bold and underlined lower-case where I have

used

> _THIS_ format]

>

> The references are as follows:

>

> 242: Marks, R. " cea: hopeless hypotheses, marvellous myths and

> dermal disorganisation " . In: Proceedings of an international

> symposium, Cardiff, edited by R. Marks and G. Plewid. Cardiff:

> Dunitz Ltd, 1988, p.293-299

>

> 243: Manna, V., R. Marks, and P. Hold. Involvement of immune

> mechanisms in the pathogenesis of rosacea. Br J Dermatol 107:203-

> 208, 1982

>

> .

May 21, 2002

Hi,

I've not read the full papers myself (and you're right, they are old)

so can't really make a comment as educated as I'd like.

I can say that on the same page as I took the direct quotes from,

Nase explains how the immune system reacts to the chronic flushing

environment and the side-effects that causes. I will dig out any

further references tonight.

The hypothesis which you wrote in your message last week is most

closely mirrored by Lupus which presents rosacea-like symptoms on the

facial skin (permanent facial redness) but which also affects other

organs in the body. I haven't studied Lupus in any depth at all,

however I don't believe it has flushing as a symptom -- unlike

rosacea, where flushing to triggers (usually transient) is the first

symptom and primary cause and mediator of the disease process.

It seems that if rosacea was an auto-immune disease like Lupus, but

only affecting the skin, the symptoms would mirror Lupus, i.e. NOT be

flushing to triggers causing vascular damage, but the onset of

permanent redness without a flushing pattern.

Those are just my thoughts,

.

>

> , I find these references confusing. In particular, the

> abstract to the second reference doesn't support what's Dr. Nase's

> saying.

>

> The statistics described in the study are confusing, but at a

minumum

> the authors found that 12 of the study's 24 rosaceans had tissue

> biopsy evidence of altered immune function, and 6 of the 24 had

> laboratory evidence of auto-immunity (remember, evidence of

> autoantibodies isn't enough to call a condition auto-immune). The

> abstract doesn't say how many of the controls had similiar

findings,

> but Dr. Nase's " ...The average rosacea sufferer has a perfectly

> health immune system. " contradicts the authors' closing

> statement, " It is suggested that altered immune function plays a

> significant role in the pathogenesis of the disease.

>

> That study is published in a respected journal but it's 20 years

old -

> - frankly, that's just too old to reference in this area, whatever

> the study found or didn't find. And the first reference comes from

May 21, 2002