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<p>Rosacea is a chronic inflammatory dermatosis characterized by facial erythema, flushing, and inflammatory lesions, in which neurovascular dysregulation plays an important role. Neuropeptides involved in vascular tone and inflammatory signaling have been increasingly implicated in rosacea pathophysiology. Pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) is a vasoactive and immunomodulatory neuropeptide; however, its systemic involvement in rosacea has not been well characterized. To compare serum PACAP-38 levels between patients with rosacea and healthy controls and to explore their associations with disease severity and clinical features. In this case–control study, 64 patients with rosacea and 64 age- and sex-matched healthy controls were included. Serum PACAP-38 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Disease severity was assessed using the Rosacea Area and Severity Index (RASI), and clinical subtypes and cutaneous features were recorded. Continuous variables were assessed for normality, and appropriate parametric or non-parametric statistical tests were applied accordingly. Correlations were evaluated using Spearman’s rank correlation coefficient. Serum PACAP-38 levels were significantly lower in patients with rosacea compared with healthy controls (<i>p</i> &lt; 0.01). PACAP-38 levels differed among clinical subtypes, with higher values observed in erythematotelangiectatic rosacea compared with papulopustular rosacea (<i>p</i> &lt; 0.01). Spearman correlation analysis demonstrated a significant but weak inverse association between serum PACAP-38 levels and RASI scores (rs = − 0.34, <i>p</i> &lt; 0.01). Associations between PACAP-38 levels and specific clinical features varied, indicating a complex relationship with disease expression. Serum PACAP-38 levels are reduced in patients with rosacea and show a statistically significant but weak inverse association with disease severity. The heterogeneous relationships across subtypes and clinical features suggest that PACAP-38 may be linked to neurovascular manifestations of rosacea rather than serving as a global marker of inflammatory burden. Further studies are warranted to clarify its clinical and biological significance.</p>

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Evaluation of serum PACAP-38 levels and their potential role in the pathogenesis of rosacea

  • 期刊论文

  • 发表日期：

    2026年7月11日

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  • Muharrem Çağatay Sürav,
  • Bengü Çevirgen Cemil,
  • Selda Pelin Kartal,
  • Aziz Şener

摘要

Rosacea is a chronic inflammatory dermatosis characterized by facial erythema, flushing, and inflammatory lesions, in which neurovascular dysregulation plays an important role. Neuropeptides involved in vascular tone and inflammatory signaling have been increasingly implicated in rosacea pathophysiology. Pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) is a vasoactive and immunomodulatory neuropeptide; however, its systemic involvement in rosacea has not been well characterized. To compare serum PACAP-38 levels between patients with rosacea and healthy controls and to explore their associations with disease severity and clinical features. In this case–control study, 64 patients with rosacea and 64 age- and sex-matched healthy controls were included. Serum PACAP-38 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Disease severity was assessed using the Rosacea Area and Severity Index (RASI), and clinical subtypes and cutaneous features were recorded. Continuous variables were assessed for normality, and appropriate parametric or non-parametric statistical tests were applied accordingly. Correlations were evaluated using Spearman’s rank correlation coefficient. Serum PACAP-38 levels were significantly lower in patients with rosacea compared with healthy controls (p < 0.01). PACAP-38 levels differed among clinical subtypes, with higher values observed in erythematotelangiectatic rosacea compared with papulopustular rosacea (p < 0.01). Spearman correlation analysis demonstrated a significant but weak inverse association between serum PACAP-38 levels and RASI scores (rs = − 0.34, p < 0.01). Associations between PACAP-38 levels and specific clinical features varied, indicating a complex relationship with disease expression. Serum PACAP-38 levels are reduced in patients with rosacea and show a statistically significant but weak inverse association with disease severity. The heterogeneous relationships across subtypes and clinical features suggest that PACAP-38 may be linked to neurovascular manifestations of rosacea rather than serving as a global marker of inflammatory burden. Further studies are warranted to clarify its clinical and biological significance.