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Innate immune effector molecules are consistently upregulated in patients with erythematotelangiectatic rosacea, leading to low-grade inflammation, redder faces, and sensitive skin. The epidermis in these patients contains high levels of the antimicrobial peptide cathelicidin and its processing enzyme kallikrein 5, as though the skin were attempting to fend off a microbial threat.
To see if the innate immune systems of rosacea patients are reacting to external danger signals associated with bacteria, investigators measured the constitutive expression of the toll-like receptors (TLRs) 1–9 in biopsied rosaceous skin. TLRs are proteins whose role in the innate immune system involves pattern recognition of bacteria. Rosaceous skin had higher TLR…