Link Between Rosacea and Increased Parkinson’s Risk

Patients with rosacea, a chronic inflammatory skin condition, appeared to have increased risk of new-onset Parkinson disease compared with individuals in the general Danish population but further studies are need to confirm this observation and the clinical consequences of it, according to an article published online by JAMA Neurology.

What causes rosacea is unclear but increased matrix metalloproteinase (an enzyme used by the body to break down proteins) target tissue activity appears to play an important role. Parkinson disease (PD) and other neurodegenerative disorders also show increased matrix metalloproteinase activity that contribute to neuronal loss.

Alexander Egeberg, M.D., Ph.D., of the University of Copenhagen, Denmark, and coauthors examined the risk of new-onset PD in patients with rosacea. The authors analyzed Danish population data and the study included more than 5.4 million individuals.

Drawing illustrates red areas of rosecea on a man's cheeks and forehead.
What causes rosacea is unclear but increased matrix metalloproteinase (an enzyme used by the body to break down proteins) target tissue activity appears to play an important role. Parkinson disease (PD) and other neurodegenerative disorders also show increased matrix metalloproteinase activity that contribute to neuronal loss. Image is for illustrative purposes only.

Of the 5.4 million individuals, 22,387 were diagnosed with PD and 68,053 were registered as having rosacea. The incidence rates of PD were 3.54 per 10,000 person-years in the population and 7.62 per 10,000 person-years in patients with rosacea, according to the results. PD also appeared to occur about 2.4 years earlier in patients with rosacea.

Patients who filled prescriptions for tetracyclines, which are used to treat rosacea, appeared to have a slightly decreased risk of PD, regardless of the presence of rosacea, the study also reports.

While the authors hypothesized about a possible pathogenic link between rosacea and PD, they note the basis for that link is unknown and that other factors could contribute to the association. The authors make clear their study cannot prove causation and that the Danish population, which is primarily of Northern European descent, may limit extrapolating the results to other ethnicities.

“Further studies are needed to confirm this observation and its clinical consequences,” the authors conclude.

About this neurology research

Source: Alexander Egeberg – JAMA Network
Image Source: The image is in the public domain.
Original Research: Abstract for “Exploring the Association Between Rosacea and Parkinson Disease: A Danish Nationwide Cohort Study” by Alexander Egeberg, MD, PhD; Peter Riis Hansen, MD, PhD, DMSci; Gunnar H. Gislason, MD, PhD; and Jacob P. Thyssen, MD, PhD, DMSci in JAMA Neurology. Published online March 21 2016 doi:10.1001/jamaneurol.2016.0022


Abstract

Exploring the Association Between Rosacea and Parkinson Disease: A Danish Nationwide Cohort Study

Importance The pathogenesis of rosacea is unclear, but increased matrix metalloproteinase target tissue activity appears to play an important role. Parkinson disease and other neurodegenerative disorders also display increased matrix metalloproteinase activity that contribute to neuronal loss.

Objective To investigate the risk of incident (new-onset) Parkinson disease in patients with rosacea.

Design, Setting, and Participants A nationwide cohort study of the Danish population was conducted using individual-level linkage of administrative registers. All Danish citizens 18 years or older from January 1, 1997, to December 31, 2011 (N = 5 472 745), were included. Data analysis was conducted from June 26 to July 27, 2015.

Main Outcomes and Measures The main outcome was a diagnosis of Parkinson disease. Incidence rates (IRs) per 10 000 person-years were calculated, and incidence rate ratios (IRRs) adjusted for age, sex, socioeconomic status, smoking, alcohol abuse, medication, and comorbidity were estimated by Poisson regression models.

Results A total of 5 404 692 individuals were included in the reference population; of these, 22 387 individuals (9812 [43.8%] women; mean [SD] age at diagnosis, 75.9 [10.2] years) received a diagnosis of Parkinson disease during the study period and 68 053 individuals (45 712 [67.2%] women; mean age, 42.2 [16.5] years) were registered as having rosacea. The IRs of Parkinson disease per 10 000 person-years were 3.54 (95% CI, 3.49-3.59) in the reference population and 7.62 (95% CI, 6.78-8.57) in patients with rosacea. The adjusted IRR of Parkinson disease was 1.71 (95%, CI 1.52-1.92) in patients with rosacea compared with the reference population. There was a 2-fold increased risk of Parkinson disease in patients classified as having ocular rosacea (adjusted IRR, 2.03 [95% CI, 1.67-2.48]), and tetracycline therapy appeared to reduce the risk of Parkinson disease (adjusted IRR, 0.98 [95% CI, 0.97-0.99]).

Conclusions and Relevance Rosacea constitutes an independent risk factor for Parkinson disease. This association could be due to shared pathogenic mechanisms involving elevated matrix metalloproteinase activity. The clinical consequences of this association require further study.

“Exploring the Association Between Rosacea and Parkinson Disease: A Danish Nationwide Cohort Study” by Alexander Egeberg, MD, PhD; Peter Riis Hansen, MD, PhD, DMSci; Gunnar H. Gislason, MD, PhD; and Jacob P. Thyssen, MD, PhD, DMSci in JAMA Neurology. Published online March 21 2016 doi:10.1001/jamaneurol.2016.0022

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