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Expression of vascular endothelial growth factor and its receptors in rosacea
  1. Justine R Smith1,
  2. Virginia B Lanier1,
  3. Rita M Braziel2,
  4. Katherine M Falkenhagen1,
  5. Clifton White3,
  6. James T Rosenbaum1,4
  1. 1Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
  2. 2Department of Surigical Pathology, Oregon Health and Science University, Portland, Oregon, USA
  3. 3Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
  4. 4Department of Medicine, Oregon Health and Science University; Department of Surgical Pathology, Oregon Health and Science University, Portland, Oregon, USA
  1. Correspondence to: Dr J R Smith Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Biomedical Research Building, Mail Code L467AD, Portland, OR 97239, USA; smithjus{at}


Background: Rosacea is a common chronic disease of unclear pathogenesis, characterised by inflammation and vascular abnormalities of the facial skin and ocular surface. Recognising that vascular endothelial growth factor (VEGF) is vasoactive and has inflammatory activities, the expression of this molecule and its receptors, VEGF-R1 and VEGF-R2, in rosacea was investigated.

Methods: Formalin-fixed, paraffin wax-embedded sections of skin obtained from 20 patients with rosacea were immunostained to detect expression of VEGF, VEGF-R1 and VEGF-R2, using an indirect methodology incorporating antigen retrieval. Adjacent sections were stained with haematoxylin and eosin.

Results: Biopsy specimens were characterised by perivascular and perifollicular lymphohistiocytic infiltration and dilated vascular channels. In addition to keratinocyte and epithelial staining, which was also noted in normal skin, vascular endothelium frequently stained positive for VEGF-R1 (14/20, 70%) and VEGF-R2 (20/20, 100%), but infrequently for VEGF (2/20, 10%). In most specimens, infiltrating leucocytes, including lymphocytes, macrophages and plasma cells, expressed VEGF (17/20, 85%), VEGF-R1 (20/20, 100%) and VEGF-R2 (20/20, 100%).

Conclusion: Expression of VEGF receptors, both by vascular endothelium and infiltrating mononuclear cells, is observed in rosacea. Although not expressed by endothelium, VEGF is present in epidermis and epithelium, and is expressed by infiltrating cells. VEGF receptor–ligand binding may contribute to the vascular changes and cellular infiltration that occurs in rosacea.

  • VEGF, vascular endothelial growth factor

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  • Funding: This work was supported in part by grants from NEI/NIH (EY014909) and Research to Prevent Blindness (Career Development Award to JRS & Senior Scholar Award to JTR).

  • Competing interests: None declared.

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