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Lasers in Medical Science May 2013Vitiligo is a relatively common acquired disorder, characterized by progressive loss of melanocytes from the epidermis and the epidermal appendages. The disease is... (Review)
Review
Vitiligo is a relatively common acquired disorder, characterized by progressive loss of melanocytes from the epidermis and the epidermal appendages. The disease is associated with considerable morbidity because of a major impact on the quality of life. The treatment for vitiligo is generally unsatisfactory and challenging. There are a variety of therapeutic possibilities including topical corticosteroids, topical calcineurin inhibitors, as well as phototherapy with Psoralen plus UVA (PUVA), narrow-band UVB, and a 308-nm excimer laser and/or lamps. Furthermore, surgical methods encompass grafting and transplantation while depigmentation treatments and psychological support may also be considered. The objective is to assess the effect of the 380-nm excimer laser in the treatment of vitiligo based on the available studies and case series. We searched the relevant literature about vitiligo and excimer laser published between 1990 and 2012 using the MEDLINE database. We reviewed all relevant articles about 308-nm excimer laser and light sources assessing their efficacy in the management of vitiligo as well as their side effects. The value of combination treatment methods was also analyzed. The available studies provide strong evidence that the excimer laser represents the most effective approach to treat vitiligo compared to ordinary phototherapy. Excimer laser is relatively safe and effective for localized disease. UV-sensitive areas respond best as well as a short duration of the disease. More frequent treatments achieve better results. Compared to other treatment modalities, the excimer laser most likely constitutes the treatment of choice for localized vitiligo. Its efficacy can be further improved in combination with other therapies such as corticosteroids, pimecrolimus, or tacrolimus.
Topics: Clinical Trials as Topic; Combined Modality Therapy; Humans; Lasers, Excimer; Photochemotherapy; Skin Pigmentation; Treatment Outcome; Ultraviolet Therapy; Vitiligo
PubMed: 22892613
DOI: 10.1007/s10103-012-1185-1 -
Frontiers in Immunology 2021Vitiligo is an acquired depigmentation skin disease caused by immune-mediated death of melanocytes. The most common treatment for vitiligo is narrow band ultraviolet B...
Vitiligo is an acquired depigmentation skin disease caused by immune-mediated death of melanocytes. The most common treatment for vitiligo is narrow band ultraviolet B phototherapy, which often is combined with topical therapies such as tacrolimus. However, patients' responses to these treatments show large variations. To date, the mechanism for this heterogeneity is unknown, and there are no molecular indicators that can predict an individual patient's response to therapy. The goal of this study is to identify clinical parameters and gene expression biomarkers associated with vitiligo response to therapy. Six patients with segmental vitiligo and 30 patients with non-segmental vitiligo underwent transcriptome sequencing of lesional and nonlesional skin at baseline before receiving combined UBUVB and tacrolimus therapy for 6 month, and were separated into good response and bad response groups based on target lesion achieving > 10% repigmentation or not. Our study revealed that treatment-responsive vitiligo lesions had significantly shorter disease duration compared with non-responsive vitiligo lesions (2.5 years vs 11.5 years, p=0.046, t-Test), while showing no significant differences in the age, gender, ethnicity, vitiligo subtype, or disease severity. Transcriptomic analyses identified a panel of 68 genes separating the good response from bad response lesions including upregulation of immune active genes, such as CXCL10, FCRL3, and TCR, Further, compared with vitiligo lesions with long disease duration, the lesions with short duration also have much higher level of expression of immune-active genes, including some (such as FCRL3 and TCR genes) that are associated with favorable therapeutic response. In conclusion, our study has identified clinical parameters such as short disease duration and a panel of immune active and other gene expression biomarkers that are associated with favorable response to immune suppressive NBUVB + tacrolimus therapy. These markers may be useful clinically for individualized therapeutic management of vitiligo patients in the future.
Topics: Adult; Aged; Biomarkers; Biopsy; Case-Control Studies; Combined Modality Therapy; Computational Biology; Disease Management; Disease Susceptibility; Female; Gene Expression Profiling; Humans; Male; Middle Aged; Transcriptome; Treatment Outcome; Vitiligo
PubMed: 33815367
DOI: 10.3389/fimmu.2021.613031 -
Allergology International : Official... Dec 2011Generalized vitiligo is an acquired disorder in which depigmented macules result from the autoimmune loss of melanocytes from the involved regions of skin. Generalized...
BACKGROUND
Generalized vitiligo is an acquired disorder in which depigmented macules result from the autoimmune loss of melanocytes from the involved regions of skin. Generalized vitiligo is frequently associated with other autoimmune diseases, particularly autoimmune thyroid diseases (Hashimoto's thyroiditis and Graves' disease), rheumatoid arthritis, adult-onset type 1 diabetes mellitus, psoriasis, pernicious anemia, systemic lupus erythematosus, and Addison's disease.
METHODS
One hundred and thirty-three Japanese patients with generalized vitiligo were enrolled in this study to investigate the occurrence of autoimmune diseases in Japanese patients with generalized vitiligo and their families.
RESULTS
Twenty-seven of the patients with generalized vitiligo (20.3%) had autoimmune diseases, particularly autoimmune thyroid disease (sixteen patients, 12%) and alopecia areata (seven patients, 5.3%). Thirty-five patients (26.3%) had a family history of generalized vitiligo and/or other autoimmune diseases. Familial generalized vitiligo was present in fifteen (11.3%), including four families with members affected by autoimmune disorders. Twenty (15.0%) had one or more family members with only autoimmune disorders.
CONCLUSIONS
Among Japanese vitiligo patients, there is a subgroup with strong evidence of genetically determined susceptibility to not only vitiligo, but also to autoimmune thyroid disease and other autoimmune disorders.
Topics: Adolescent; Adult; Age of Onset; Aged; Aged, 80 and over; Asian People; Autoimmune Diseases; Child; Child, Preschool; Female; Humans; Japan; Male; Middle Aged; Vitiligo; Young Adult
PubMed: 21778811
DOI: 10.2332/allergolint.11-OA-0303 -
The Science of the Total Environment Feb 2021Psoriasis and vitiligo are common, autoimmune skin diseases, their etiology is still unclear. The relationship between environmental factors including diet and various...
BACKGROUND
Psoriasis and vitiligo are common, autoimmune skin diseases, their etiology is still unclear. The relationship between environmental factors including diet and various skin diseases has been studied. The general mechanism of cadmium (Cd), lead (Pb) and mercury (Hg) toxicity is through the production of reactive oxygen species which are known to play a role in etiopathogenesis of skin disorders.
OBJECTIVE
The aim of this study was to estimate the influence of dietary habits on the concentration of Cd, Pb and Hg in the peripheral blood samples of patients with psoriasis and vitiligo.
METHODS
In this case-control study, sixty patients with psoriasis, fifty patients with vitiligo and fifty eight healthy people were examined. Blood levels of Cd, Pb and Hg were determined by atomic absorption spectrometry. Food-frequency questionnaires were implemented to collect the dietary data.
RESULTS
Significant differences (p < 0.05) of Cd levels were found between women and men with psoriasis and women and men in the control group. The concentration of Pb was significantly higher among vitiligo patients (50.04 ± 26.54 μg/L) than in healthy controls (36.04 ± 27.35 μg/L). Significantly lower ratio of Se/Pb, Zn/Pb and Cu/Pb was found among psoriatic men. Significantly (p < 0.05) lower values of Se/Hg ratio were observed among vitiligo patients compared to controls.
CONCLUSIONS
The elevated levels of toxic elements could increase oxidative stress which may partly contribute to inflammation in the pathogenesis of psoriasis and vitiligo, which requires further research. Analysis of the influence of frequent consumption of food products on toxic metals concentration showed that the dietary habits have impact on the content of examined toxic metals in the blood of patients. The obtained results may be useful for composing the diet and could be helpful in prevention of psoriasis and vitiligo.
Topics: Cadmium; Case-Control Studies; Feeding Behavior; Female; Humans; Lead; Male; Mercury; Vitiligo
PubMed: 33302005
DOI: 10.1016/j.scitotenv.2020.143967 -
Chinese Medical Journal Dec 2023
Meta-Analysis
Topics: Humans; Janus Kinase Inhibitors; Vitiligo; Psoriasis; Protein Kinase Inhibitors
PubMed: 37027285
DOI: 10.1097/CM9.0000000000002581 -
Scientific Reports Mar 2023Coronavirus disease 2019 (COVID-19) is spreading rapidly around the world. However, the treatment of vitiligo combined with COVID-19 has not been reported. Astragalus...
Coronavirus disease 2019 (COVID-19) is spreading rapidly around the world. However, the treatment of vitiligo combined with COVID-19 has not been reported. Astragalus membranaceus (AM) has a therapeutic effect on patients with vitiligo and COVID-19. This study aims to discover its possible therapeutic mechanisms and provide potential drug targets. Using the Chinese Medicine System Pharmacological Database (TCMSP), GEO database and Genecards websites and other databases, AM target, vitiligo disease target, and COVID-19 related gene set were established. Then find the crossover genes by taking the intersection. Then use GO, KEGG enrichment analysis, and PPI network to discover its underlying mechanism. Finally, by importing drugs, active ingredients, crossover genes, and enriched signal pathways into Cytoscape software, a "drug-active ingredient-target signal pathway-" network is constructed. TCMSP screened and obtained 33 active ingredients including baicalein (MOL002714), NEOBAICALEIN (MOL002934), Skullcapflavone II (MOL002927), and wogonin (MOL000173), which acted on 448 potential targets. 1166 differentially expressed genes for vitiligo were screened by GEO. CIVID-19 related genes were screened by Genecards. Then by taking the intersection, a total of 10 crossover genes (PTGS2, CDK1, STAT1, BCL2L1, SCARB1, HIF1A, NAE1, PLA2G4A, HSP90AA1, and HSP90B1) were obtained. KEGG analysis found that it was mainly enriched in signaling pathways such as IL-17 signaling pathway, Th17 cell differentiation, Necroptosis, NOD-like receptor signaling pathway. Five core targets (PTGS2, STAT1, BCL2L1, HIF1A, and HSP90AA1) were obtained by analyzing the PPI network. The network of "active ingredients-crossover genes" was constructed by Cytoscape, and the 5 main active ingredients acting on the 5 core crossover genes acacetin, wogonin, baicalein, bis2S)-2-ethylhexyl) benzene-1,2-dicarboxylate and 5,2'-Dihydroxy-6,7,8-trimethoxyflavone. The core crossover genes obtained by PPI and the core crossover genes obtained by the "active ingredient-crossover gene" network are intersected to obtain the three most important core genes (PTGS2, STAT1, HSP90AA1). AM may act on PTGS2, STAT1, HSP90AA1, etc. through active components such as acacetin, wogonin, baicalein, bis2S)-2-ethylhexyl) benzene-1,2-dicarboxylate and 5,2'-Dihydroxy-6,7,8-trimethoxyflavone to activate IL-17 signaling pathway, Th17 cell differentiation, Necroptosis, NOD-like receptor signaling pathway, Kaposi sarcoma-associated herpesvirus infection, and VEGF signaling pathway and other signaling pathways to achieve the effect of treating vitiligo and COVID-19.
Topics: Humans; Vitiligo; Astragalus propinquus; Interleukin-17; Network Pharmacology; Benzene; Cyclooxygenase 2; COVID-19; Hypopigmentation; Computational Biology; NLR Proteins; Drugs, Chinese Herbal; Molecular Docking Simulation; Medicine, Chinese Traditional
PubMed: 36890149
DOI: 10.1038/s41598-023-29207-6 -
Journal of Immunology Research 2022Vitiligo is a noncontagious autoimmune skin depigmenting disease. Regulatory T cells (Tregs) play a key role in maintaining peripheral tolerance; however, Tregs' number,... (Meta-Analysis)
Meta-Analysis Review
Vitiligo is a noncontagious autoimmune skin depigmenting disease. Regulatory T cells (Tregs) play a key role in maintaining peripheral tolerance; however, Tregs' number, suppressive function, and associated suppressive molecules (FOXP3, IL-10, and TGF-) are found to be reduced in vitiligo patients. Although, the role of Tregs in vitiligo pathogenesis is well established, there are several contrary findings which suggest a controversial role of Tregs in vitiligo. Therefore, to clarify the role of Tregs in vitiligo pathogenesis, we aimed to study Tregs' frequency, suppressive capacity, and associated suppressive molecules (FOXP3, IL-10, and TGF-) in vitiligo patients through meta-analysis approach. A total of 30 studies involving 1223 vitiligo patients and 1109 controls were included in the study. Pooled results from our meta-analysis suggested significantly reduced Treg cells' frequency in vitiligo patients ( = 0.002). Interestingly, Tregs' suppressive capacity was also significantly reduced in vitiligo patients ( = 0.0002); specifically, Treg-mediated suppression of CD8T cells was impaired in vitiligo patients ( < 0.00001). Moreover, FOXP3, a key Tregs' transcription factor, was significantly reduced in blood and skin of vitiligo patients ( < 0.00001). Intriguingly, the FOXP3 expression was significantly reduced in the lesional skin as compared to perilesional and nonlesional skin ( = 0.007 and = 0.04). Furthermore, the expression of key Treg-associated suppressive cytokines IL-10 and TGF- were significantly reduced in vitiligo patients ( = 0.0005 and = 0.01). The disease activity-based analysis suggested for reduced Tregs' frequency and FOXP3 expression in active vitiligo patients ( = 0.05 and = 0.01). We also studied the effect of microRNA-based treatment, narrow band-UVB phototherapy, and Treg-associated treatments on Tregs' frequency, FOXP3, and IL-10 expression. Interestingly, we found increased Tregs' frequency, FOXP3, and IL-10 expression after the treatment ( = 0.007, < 0.0001, and = 0.002). Overall, our meta-analysis suggests that the Tregs play a crucial role in pathogenesis and progression of vitiligo, and hence, Treg-based therapeutic interventions could be effective in vitiligo patients.
Topics: Autoimmune Diseases; Cytokines; Forkhead Transcription Factors; Humans; Interleukin-10; MicroRNAs; T-Lymphocytes, Regulatory; Transforming Growth Factor beta; Vitiligo
PubMed: 36164321
DOI: 10.1155/2022/6952299 -
Mathematical Biosciences and... Jan 2021To improve the understanding of the molecular mechanism of vitiligo is necessary to predict and formulate new targeted gene therapy strategies.
BACKGROUND
To improve the understanding of the molecular mechanism of vitiligo is necessary to predict and formulate new targeted gene therapy strategies.
METHODS
GSE65127, GSE75819, GSE53146 and GSE90880 were collected, and obtained four groups of differentially expressed genes (DEGs) by limma R package. Through weighted gene co-expression network analysis (WGCNA), the co-expression of genes with large variance in GSE65127 and GSE75819 was identified. Enrichment analysis of intersection gene between module genes and DEGs with the same up-regulated or down-regulated in GSE65127 and GSE75819 was performed. In addition, ssGSEA was used to identify the immune infiltration of vitiligo in four datasets.
RESULTS
A total of 3083 DEGs and 16 modules were identified from GSE65127, and 5014 DEGs and 6 modules were screened from GSE75819. Finally, 77 important DEGs were identified. Enrichment analysis showed that 77 DEGs were mainly involved in spliceosome etc. The results of GSVA showed that melanogenesis, Fc gamma R-mediated phagocytosis, leishmaniasis, Wnt pathway and glycolipid metabolism were important KEGG pathways. The genes involved in these pathways were identified as key genes (MARCKSL1, MC1R, PNPLA2 and PRICKLE2). The AUC values of MC1R were the highest. Furthermore, different immune cells had different infiltration in vitiligo. There was a high correlation between immune cells and key genes.
CONCLUSIONS
MC1R was found as a key gene in vitiligo and involved in the melanogenesis. The immune cells were different infiltration in vitiligo. These results suggested that key genes may be used as markers of vitiligo, and were associated with immune cell, especially MC1R.
Topics: Gene Expression Profiling; Humans; Vitiligo
PubMed: 33757175
DOI: 10.3934/mbe.2021057 -
BMC Veterinary Research Jul 2019Autoimmune dermatoses targeting melanocytes have gained attention in human medicine due to their progressive nature and the social impact suffered by affected... (Review)
Review
Autoimmune dermatoses targeting melanocytes have gained attention in human medicine due to their progressive nature and the social impact suffered by affected individuals. In veterinary medicine, vitiligo and the uveodermatological syndrome are the two autoimmune diseases that are known to affect skin melanocytes.In the first part of this article, we will review the signalment, clinical signs, histopathology and the treatment outcome of vitiligo in dogs, cats and horses; where pertinent, we compare the animal diseases to their human homologue. In a similar fashion, the information on the uveodermatological syndrome in dogs is reviewed and, where relevant, it is compared to the Vogt-Koyanagi-Harada (VKH) syndrome in humans.Canine, feline and equine vitiligo have many features that mirror their human counterparts. The most effective treatment and outcome of vitiligo in animals remain unclear. The canine uveodermatological syndrome resembles the incomplete VKH variant in humans; for affected individuals, an immediate diagnosis and aggressive treatment are crucial to prevent the development of blindness.
Topics: Animal Diseases; Animals; Autoimmune Diseases; Cats; Dogs; Horses; Melanocytes; Pigmentation Disorders; Vitiligo
PubMed: 31324191
DOI: 10.1186/s12917-019-2003-9 -
The British Journal of Dermatology Nov 2020The associations between disease activity and several clinical signs in vitiligo have been described, but a widely accepted and validated scoring system is lacking.
BACKGROUND
The associations between disease activity and several clinical signs in vitiligo have been described, but a widely accepted and validated scoring system is lacking.
OBJECTIVES
To validate the Vitiligo Signs of Activity Score (VSAS) for physicians.
METHODS
Three visible clinical signs were scored on 15 body locations: confetti-like depigmentation (c), Koebner phenomenon (k) and hypochromic areas/borders (h). The inter- and intrarater reliability of the global VSAS and VSAS subscores (c-VSAS, k-VSAS and h-VSAS) were tested by four and three raters (physicians), respectively. Construct validity and feasibility were evaluated.
RESULTS
The VSAS demonstrated good inter-rater reliability, with an intraclass correlation coefficient (ICC) of 0·87 in the first round and 0·90 in the second round. The intrarater reliability ICCs were all ≥ 0·86. The inter-rater reliabilities of the subscores were excellent for c-VSAS and fair for k-VSAS and h-VSAS (ICC 0·83, 0·51 and 0·53, respectively, in the first round). Evidence for construct validity was provided. The completion time by the raters (median 2·18 min per patient) improved during the second round (median 1·33 min per patient). A limitation of the study is the low number of patients, mainly of skin phototypes II-III, from a single tertiary centre.
CONCLUSIONS
The VSAS appears to be a valid and reliable instrument to score visible clinical signs linked to disease activity in a standardized way. What is already known about this topic? Evidence exists for a possible link between several visible clinical signs in vitiligo and disease activity. A widely accepted and validated scoring system to quantify these clinical signs is lacking. What does this study add? The Vitiligo Signs of Activity Score (VSAS) underwent preliminary validation and may assist quantification of visible clinical signs linked to disease activity in a standardized way in clinical practice and trials. What are the clinical implications of this work? VSAS may be used for future trials that aim to establish the clinical significance of the specific visible clinical signs in vitiligo in a more controlled setting. Linked Comment: Eleftheriadou. Br J Dermatol 2020; 183:801-802.
Topics: Humans; Hypopigmentation; Reproducibility of Results; Vitiligo
PubMed: 32064583
DOI: 10.1111/bjd.18950