Hi all,

As you know, I don't have any medical background, but I'm personally
becoming increasingly convinced that pathogens likely play a major
role in rosacea, with one in particular, Chlamydia pneumoniae (Cpn),
likely to play a significant role in this disease, potentially even
causing the chronic blood vessel inflammation and epithelial barrier
disruption that leads to the additional infection and complications
with co-infections such as demodex mites and the fungi/yeasts
associated with seborrheic dermatitis, etc that we see in rosacea.
I've recently created a page on the potential link between Cpn and
rosacea for cpnhelp.org, a site dedicated to presenting emerging
information about chlamydia pneumoniae in disease and its treatment:

http://www.cpnhelp.org/chlamydia_pneumoniae_an_0

Cpn has also been implicated in CFS/FMS in the past and since there
are several rosaceans that have one or both of these diseases, a
discussion about the link between Cpn and CFS/FMS can be found here
(this article also provides a history of Cpn study and information
important to understanding the potential link between Cpn and rosacea):

http://www.cpnhelp.org/chlamydiapneumoniaechronicfatigue

Basically Cpn, which originally infects the respiratory tract, invades
and persists in the bloodstream and infects among other cells, the
epithelial cells of the blood vessels throughout the body, likely
causing the type of chronic blood vessel inflammation and barrier
disruption that we see in rosacea. Cpn is being closely studied for
its involvement in Multiple Sclerosis (chronic blood vessel
inflammation and barrier disruption in the brain), Asthma (chronic
blood vessel inflammation and barrier disruption of the lungs) and
Atherosclerosis (chronic arterial inflammation), and has been
implicated in Interstitial Cystitis (chronic blood vessel inflammation
and barrier disruption of the urinary tract) and IBD (chronic blood
vessel inflammation and barrier disruption of the gastrointestinal
tract).

With the possibility of an infectious nature in rosacea in mind,
recent studies suggest the importance of Vitamin D3 in immunity.
Vitamin D3 promotes the production of the human antimicrobial peptides
cathelicidins:

http://www.jimmunol.org/cgi/content/full/173/5/2909

Cathelicidins have been found to have broad spectrum antimicrobial
activity:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1\
4620153&dopt=Abstract

And indeed, Vitamin D3 has been implicated as playing an important
role in various inflammatory / autoimmune diseases, including
diabetes, multiple sclerosis, rheumatoid arthritis, hypertension,
cardiovascular heart disease, and many common deadly cancers:

http://jn.nutrition.org/cgi/content/full/135/11/2739S

Here's a great article about how Vit D3 and calcium were so important
in our evolving from the low level organisms that originated in the
organically rich tide pools on the third rock from the sun:

http://www.ajcn.org/cgi/content/full/79/3/362

While the cathelicidins produced by Vitamin D3 show no direct activity
against Cpn, Vit D3 does interfere with Cpn's interference with
cellular apoptosis (or cell death), and may indirectly help reduce its
levels in the body by reducing its ability to hide out (and replicate)
inside cells.

Vitamin D3 also seems to have important immunomodulating effects:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra\
ctPlus&list_uids=16543659&query_hl=25&itool=pubmed_docsum

There is currently much controversy surrounding the optimum levels of
Vit D3 supplementation, and while the currently established safe upper
limit for Vit D3 is currently listed as 2000iu per day, potentially
even less in certain cases, many are now questioning this level and
calling for revised upper limit:

http://www.ajcn.org/cgi/content/full/85/1/6

The safest way to get high levels of Vit D3, is through @ 15 minutes
of near full body exposure to the sun. In this amount of time, your
skin produces @ 10,000iu of Vit D3. No additional Vit D3 is
produced in longer exposure, and 10,000iu is produced prior to any
sunburn pinkness.

I'm wondering if Vit D3 might help in managing rosacea and potentially
help decrease any pathogen burdens. Again the safest way to increase
Vit D3 levels is through @ 15 minutes of sun exposure. If this is
not possible, potentially Vit D3 supplementation at lower doses makse
sense, although supplementation may be contraindicated in certain
diseases including sarcoidosis, so please talk to your doctor before
taking high level supplements of Vit D3.

For anyone interested, here is a great video presentation that
discusses many of the important aspects about Vit D3:

http://www.insinc.com/onlinetv/directms13oct2005/softvnetplayer.htm

Anyway, hope you find this interesting...

Dan