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Metformin, an AMPK activator, inhibits TGF-1-induced myofibroblast differentiation by promoting AMPK expression, leading to myofibroblast deactivation and apoptosis, reduction in the expression of type I collagen, fibronectin (FN), and -SMA in fibroblasts, and downregulation of ECM protein levels, thereby slowing or reversing PF (Rangarajan et al., 2018)

Interestingly, the bacterium Bacillus oleronius, isolated from Demodex mites infesting the HFs of rosacea patients, has been shown to stimulate an inflammatory response in the skin, thus contributing to disease flares

756,776 The accumulation of lactate lowers the intracellular pH and inhibits effector T cells by reducing NFAT nuclear translocation and the activity of p38 and c-JNK/c-JUN

The safety data comes from extensive cell studies and animal experimentsnot human trials

10.1007/s00018-012-0988-3 [DOI] [PMC free article] [PubMed] [Google Scholar] 2.Whitfield JB