Evidence map›Paper›PMID 30658871›Full record

ArticleJournal of dermatological science2019

Botulinum toxin blocks mast cells and prevents rosacea like inflammation.

Jae Eun Choi, Tyler Werbel, Zhenping Wang, Chia Chi Wu, Tony L Yaksh, Anna Di Nardo

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of dermatological science, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06282679 (Clinical Observation of Intradermal Injections With Botulinum Toxin A in the Treatment of Rosacea Erythema Telangiectasia), which is not on this map. Cited by 56 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 2 pooled it
5.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06282679 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Clinical Observation of Intradermal Injections With Botulinum Toxin A in the Treatment of Rosacea Erythema Telangiectasia

TypeinterventionalSponsorNanjing First Hospital, Nanjing Medical UniversityRan2022 to 2024Enrolled30ConditionsRosacea, Botulinum ToxinArmsBotulinum Toxin Type A Injection [Botox]
3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 2 syntheses or guidelines pooled it, 96 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Review
  8. Review
  9. Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
  15. Therapeutic effect of an MRGPRX2/MRGPRB2 antagonist on LL-37-induced rosacea-like inflammation in mice.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025
    Article
  16. Review
  17. Article
  18. Antimicrobial Peptide Signaling in Skin Diseases.JID innovations : skin science from molecules to population health · 2025
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jae Eun ChoiDepartment of Dermatology, University of California, San Diego, CA, USA.
Tyler WerbelSchool of Medicine, University of California, San Diego, CA, USA.
Zhenping WangDepartment of Dermatology, University of California, San Diego, CA, USA.
Chia Chi WuDepartment of Dermatology, University of California, San Diego, CA, USA.
Tony L YakshDepartment of Anesthesiology and Pharmacology, University of California, San Diego, CA, USA.
Anna Di NardoDepartment of Dermatology, University of California, San Diego, CA, USA. Electronic address: adinardo@ucsd.edu.
University of California, San Diego · US

Funding

Mast cells in skin innate immune defenseR01AI093957 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DI NARDO, ANNA · 2011 to 2023
$4.6M
The Microbiome Drives Masts Cell Recruitment in the SkinR01AI106874 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DI NARDO, ANNA · 2015 to 2019
$2.0M
NIAID NIH HHS R01 AI093957NIAID NIH HHS R01 AI106874
6 · The paper itself

Abstract

backgroundRosacea is a chronic inflammatory skin condition whose etiology has been linked to mast cells and the antimicrobial peptide cathelicidin LL-37. Individuals with refractory disease have demonstrated clinical benefit with periodic injections of onabotulinum toxin, but the mechanism of action is unknown.

objectivesTo investigate the molecular mechanism by which botulinum toxin improves rosacea lesions.

methodsPrimary human and murine mast cells were pretreated with onabotulinum toxin A or B or control. Mast cell degranulation was evaluated by β-hexosaminidase activity. Expression of botulinum toxin receptor Sv2 was measured by qPCR. The presence of SNAP-25 and VAMP2 was established by immunofluorescence. In vivo rosacea model was established by intradermally injecting LL-37 with or without onabotulinum toxin A pretreatment. Mast cell degranulation was assessed in vivo by histologic counts. Rosacea biomarkers were analyzed by qPCR of mouse skin sections.

resultsOnabotulinum toxin A and B inhibited compound 48/80-induced degranulation of both human and murine mast cells. Expression of Sv2 was established in mouse mast cells. Onabotulinum toxin A and B increased cleaved SNAP-25 and decreased VAMP2 staining in mast cells respectively. In mice, injection of onabotulinum toxin A significantly reduced LL-37-induced skin erythema, mast cell degranulation, and mRNA expression of rosacea biomarkers.

conclusionsThese findings suggest that onabotulinum toxin reduces rosacea-associated skin inflammation by directly inhibiting mast cell degranulation. Periodic applications of onabotulinum toxin may be an effective therapy for refractory rosacea and deserves further study.

Indexed as

Acetylcholine Release InhibitorsAnimalsAntimicrobial Cationic PeptidesBiopsyBotulinum Toxins, Type ACathelicidinsCell DegranulationCells, CulturedDisease Models, AnimalErythemaHumansInjections, IntradermalMast CellsMiceMice, Inbred C57BLp-Methoxy-N-methylphenethylamineAcetylcholine Release InhibitorsAntimicrobial Cationic PeptidesBotulinum Toxins, Type ACathelicidinsonabotulinum toxin Ap-Methoxy-N-methylphenethylamineBotoxBotulinum toxinMast cellMechanism of actionRosacea

Identifiers

PMID30658871
PMCPMC7680644
OpenAlexW2907549300

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.