Systemic Proteomic Alterations and Predictive Biomarkers of Paroxetine Response in Refractory Rosacea

What are the systemic molecular mechanisms underlying the therapeutic efficacy of paroxetine in patients with refractory erythematous rosacea, and can protein biomarkers be identified to predict clinical response?In secondary analysis of a randomized clinical trial including 24 patients with refractory erythematous rosacea treated with daily paroxetine, 25 mg, for 12 weeks, exploratory proteomic profiling revealed 497 differentially expressed proteins after treatment, with downregulated proteins including 98 reversed-response proteins enriched in immune, neural, and vascular pathways. Protein signatures were associated with clinical improvement, and candidate biomarkers, such as OLFML3 and IGFBP2, showed hypothesis-generating preliminary predictive value for therapeutic response.This exploratory analysis found an association between paroxetine treatment and modulation of systemic neuro-vascular-immune networks in rosacea, with a candidate protein signature for pathway-specific reversal, offering a preliminary basis for future studies of patient stratification and precision treatment development for rosacea.

Corresponding Authors: Yiya Zhang, PhD (yiya0108@csu.edu.cn) and Jundong Huang, MD (JD-huang@csu.edu.cn), Department of Dermatology, Xiangya Hospital, Central South University, Xiangya Road, Kaifu District, Changsha, Hunan 410008, China.

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