title: The effect of azithromycin on reactive oxygen species in rosacea.
abstract: BACKGROUND
  Recent evidence suggests that inflammation in rosacea is associated with generation of reactive oxygen species (ROS) that are released by inflammatory cells. The efficacy of current therapeutic agents for rosacea such as tetracyclines and metronidazole has also been attributed to their antioxidant properties. Recently, a macrolide antibiotic, azithromycin, has been found to be an effective alternative in the treatment of rosacea.
  
  
  OBJECTIVE
  We planned a study to evaluate the antioxidant effects of azithromycin on ROS in rosacea. We compared basal ROS concentrations measured in the facial skin of patients with rosacea with the post-treatment levels and with those of healthy controls.
  
  
  METHODS
  Facial skin biopsies of 17 papulopustular patients with rosacea and 25 healthy controls were taken. Rosacea patients were assigned to receive oral azithromycin 500 mg on three consecutive days each week for 4 weeks. The total number of inflammatory lesions (the sum of papules and pustules) on the face of each patient with rosacea was counted at each visit. The luminol- and lucigenin-enhanced chemiluminescence (CL) levels of patients with rosacea were measured before and after 4 weeks of treatment and compared with those of healthy controls.
  
  
  RESULTS
  Rosacea patients had higher ROS levels than healthy controls (P < 0.001). A statistically significant decrease of both luminol- and lucigenin-enhanced CL levels were observed in patients with rosacea after treatment with azithromycin (t = 4.602, P < 0.001; vs. t = 4.634, P < 0.001, respectively).
  
  
  CONCLUSIONS
  Rosacea patients have higher ROS levels than healthy controls. The results of our study support the antioxidant properties of azithromycin in rosacea.
authors.affiliation: Department of Dermatology, Acibadem Kozyatagi Hospital, Istanbul, Turkey. obakar@asg.com
authors.forename: O
authors.initials: O
authors.lastname: Bakar
authors.forename: Z
authors.initials: Z
authors.lastname: Demirçay
authors.forename: M
authors.initials: M
authors.lastname: Yuksel
authors.forename: G
authors.initials: G
authors.lastname: Haklar
authors.forename: Y
authors.initials: Y
authors.lastname: Sanisoglu
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D017963:Azithromycin / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D017382:Reactive Oxygen Species; D012393:Rosacea / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000900:Anti-Bacterial Agents; D017382:Reactive Oxygen Species; D017963:Azithromycin