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Mascarenhas MRM, Oliveira MDC, Oliveira LFD, Magalhães AS, Machado PRL. Clinical profile of vitiligo patients and relationship with immuno-inflammatory markers. An Bras Dermatol 2024; 99:196-201. [PMID: 37985303 PMCID: PMC10943265 DOI: 10.1016/j.abd.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/04/2023] [Accepted: 03/13/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Vitiligo is the most common pigmentary disorder and is considered a chronic, cumulative, multifactorial disease. The crucial role of cytotoxic CD8+ T lymphocytes and the IFNγ/CXCL10 axis has been demonstrated in its pathogenesis. OBJECTIVE To evaluate the clinical profile and immuno-inflammatory markers in patients with vitiligo in a reference medical center. METHODS Cross-sectional study in which all patients with vitiligo seen at the medical center the from 2019 to 2022 were evaluated, to outline the clinical profile. Moreover, cardiovascular risk biomarkers (neutrophil/lymphocyte ratio and C-reactive protein levels) were measured, as well as cytokines and chemokines (TNFα, IFNγ, IL10, IL15 and CXCL10) in the serum of a subgroup of 30 patients. RESULTS There was a predominance of females, with a mean age of 43 years. Most were phototypes IV or V (71.3%), without comorbidities (77.55%), and without a family history of vitiligo (70.41%). Higher levels of neutrophil/lymphocyte ratio, C-reactive protein, and inflammatory cytokines/chemokines were documented in vitiligo patients when compared to the control group (non-significant). As relevant data, the highest values of CXCL10 were detected in patients with vitiligo versus controls, as well as in patients with disease of shorter duration (p<0.05). STUDY LIMITATIONS The number of assessed patients was small due to recruitment difficulties caused by the COVID-19 pandemic. CONCLUSION The present data contribute to confirming the relevant role of the IFNγ/CXCL10 axis in the pathogenesis of vitiligo, highlighting CXCL10 as a possible activity marker.
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Ju HJ, Kang H, Han JH, Lee JH, Lee S, Bae JM. All-Cause and Cause-Specific Mortality among Patients with Vitiligo: A Nationwide Population-Based Study in Korea. J Invest Dermatol 2024; 144:125-132.e3. [PMID: 37517513 DOI: 10.1016/j.jid.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
Vitiligo is a common autoimmune skin disorder; however, there is limited information about risks of mortality among patients with vitiligo. Therefore, we aimed to investigate the mortality in patients with vitiligo. A population-based cohort study was conducted using the data linkage of the National Health Insurance Service database and the National Death Registry. Patients with incident vitiligo were matched with sociodemographic factors-matched controls without vitiligo in a 1:5 ratio. All-cause and cause-specific mortalities were compared between patients with vitiligo and controls. In total, 107,424 patients with incident vitiligo and 537,120 matched controls were included. The mortality rates were 34.8 and 45.3 per 10,000 person-years in patients and controls, respectively. Patients with vitiligo showed a significantly lower risk of mortality (adjusted hazard ratio = 0.75, 95% confidence interval = 0.72-0.78). The cause-specific mortality from infectious diseases, oncologic diseases, hematologic diseases, endocrine diseases, neurologic diseases, cardiovascular diseases, respiratory diseases, and renal/urogenital disease was significantly lower in patients with vitiligo. Patients with vitiligo were associated with a lower risk of mortality, suggesting that vitiligo-associated autoimmunity might contribute to reduced morbidity and mortality.
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Affiliation(s)
- Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Kang
- Department of Dermatology, College of Medicine, Yonsei University, Wonju, Korea
| | - Ju Hee Han
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hae Lee
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Solam Lee
- Department of Dermatology, College of Medicine, Yonsei University, Wonju, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Vats V, Makineni P, Hemaida S, Haider A, Subramani S, Kaur N, Butt AN, Scott-Emuakpor R, Zahir M, Mathew M, Iqbal J. Gluten Intolerance and Its Association With Skin Disorders: A Narrative Review. Cureus 2023; 15:e44549. [PMID: 37790051 PMCID: PMC10544948 DOI: 10.7759/cureus.44549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
Gluten sensitivity is defined as a chronic intolerance to gluten ingestion in genetically predisposed individuals. The etiology is thought to be immune-mediated and has a variable dermatologic presentation. Celiac disease (CD) is one of the most common forms of gluten intolerance and encompasses a wide range of extra-intestinal pathology, including cutaneous, endocrine, nervous, and hematologic systems. Psoriasis, another long-term inflammatory skin condition, has been linked to significant symptomatic improvement with a gluten-free diet (GFD). Palmoplantar pustulosis (PP), a variant of psoriasis, and aphthous stomatitis, which causes recurrent oral ulcers, have also exhibited beneficial results after the dietary elimination of gluten. In addition to this, dermatitis herpetiformis (DH), another immune-mediated skin disorder, is genetically similar to CD and has, therefore, shown tremendous improvement with a GFD. Another highly prevalent long-term skin condition called atopic dermatitis (AD), however, has revealed inconsistent results with gluten elimination and would require further research in the future to yield concrete results. Hereditary angioedema (HA) has shown an association with gluten intolerance in some patients who had symptomatic benefits with a GFD. Similarly, vitiligo and linear IgA bullous dermatosis have also shown some clinical evidence of reversal with a GFD. On the contrary, rosacea enhances the risk of developing CD. This narrative review emphasizes the potential impact of gluten intolerance on different cutaneous conditions and the potential therapeutic effect of a GFD on various symptomatic manifestations. There is a need for additional clinical and observational trials to further expand on the underlying pathophysiology and provide conclusive and comprehensive recommendations for possible dietary interventions.
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Affiliation(s)
- Vaibhav Vats
- Internal Medicine, Smt. Kashibai Navale Medical College and General Hospital, Mumbai, IND
| | - Pallavi Makineni
- Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | | | - Anum Haider
- Internal Medicine, Bahria University Medical & Dental College, Karachi, PAK
| | | | - Navjot Kaur
- Medicine, Government Medical College, Amritsar, Amritsar, IND
| | - Amna Naveed Butt
- Medicine/Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | | - Mohammad Zahir
- Medicine, Ayub Medical College, Abottabad, Abottabad, PAK
| | - Midhun Mathew
- Internal Medicine, Pennsylvania Hospital, Philadelphia, USA
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Yoon JH, Youn K, Jun M. Discovery of Pinostrobin as a Melanogenic Agent in cAMP/PKA and p38 MAPK Signaling Pathway. Nutrients 2022; 14:nu14183713. [PMID: 36145089 PMCID: PMC9504415 DOI: 10.3390/nu14183713] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Melanogenesis is the process of melanin synthesis to protect the skin against ultraviolet radiation and other external stresses. The loss of skin pigmentation is closely related to depigmented skin disorders. The melanogenic effects of pinostrobin, an active flavanone found in honey, were evaluated. B16F10 cells were used for melanin content, tyrosinase activity, and the expression of melanogenesis-related markers. Moreover, computational simulations were performed to predict docking and pharmacokinetics. Pinostrobin increased melanin levels and tyrosinase activity by stimulating the expression of melanogenic regulatory factors including tyrosinase, tyrosinase-related protein (TRP) 1 and microphthalmia transcription factor (MITF). Specifically, the phosphorylation of cAMP response element binding (CREB) involved in the MITF activation was augmented by pinostrobin. Moreover, the compound upregulated the β-catenin by cAMP/PKA-mediated GSK-3β inactivation. Co-treatment with a PKA inhibitor, inhibited melanin production, tyrosinase activity, and expression of MITF, p-CREB, p-GSK-3β and p-β-catenin, demonstrating that pinostrobin-stimulated melanogenesis was closely related to cAMP/PKA signaling pathway. Furthermore, the combination of pinostrobin and a specific p38 inhibitor, showed that MITF upregulation by pinostrobin was partly associated with the p38 signaling pathway. Docking simulation exhibited that the oxygen group at C-4 and the hydroxyl group at C-5 of pinostrobin may play an essential role in melanogenesis. In silico analysis revealed that pinostrobin had the optimal pharmacokinetic profiles including gastrointestinal absorption, skin permeability, and inhibition of cytochrome (CYP) enzymes. From the present results, it might be suggested that pinostrobin could be useful as a potent and safe melanogenic agent in the depigmentation disorder, vitiligo.
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Affiliation(s)
- Jeong-Hyun Yoon
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea
| | - Kumju Youn
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
| | - Mira Jun
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Food & Bio Innovation, Dong-A University, Busan 49315, Korea
- Correspondence: ; Tel.: +82-51-200-7323; Fax: +82-51-200-7535
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Sorrick J, Huett W, Byrne KA, Erf GF. Immune Activities in Choroids of Visually Impaired Smyth Chickens With Autoimmune Vitiligo. Front Med (Lausanne) 2022; 9:846100. [PMID: 35547230 PMCID: PMC9082495 DOI: 10.3389/fmed.2022.846100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Vitiligo is a common dermatological disorder affecting 1–2% of the world’s population. It is characterized by postnatal, autoimmune destructions of melanocytes in the skin, resulting in patches of depigmentation. Autoimmunity in vitiligo may also affect melanocytes in non-integumental tissues, including the eyes where choroidal melanocytes are the target of the autoimmune response. The Smyth line (SL) of chicken is the only animal model that spontaneously and predictably develops all clinical and biological manifestations of autoimmune vitiligo. In SL vitiligo (SLV), destruction of epidermal melanocytes in growing feathers (GFs) involves a melanocyte-specific, Th1-mediated cellular immune response. Smyth chickens may also exhibit uveitis and vision impairment. Previous studies established a strong association between SLV and vision impairment, including similar pathology in affected eyes and GFs. To determine the presence, types, and activities of choroid infiltrating mononuclear cells, we collected eyes before, near onset, and during active SLV from sighted, partially blind, and blind SL chickens. All SL chickens with vision impairment had SLV. Immunohistochemistry and quantitative reverse transcriptase-PCR analyses revealed mononuclear cell and cytokine expression profiles in the autoimmune destruction of melanocytes in choroids that are identical to those described in GF, demonstrating the systemic nature of autoimmunity against melanocytes in SLV. In addition, we observed aberrant melanogenesis in SL eyes. The immunopathogenesis in SL vision impairment resembles human vitiligo-associated ocular diseases, especially Vogt–Koyanagi–Harada syndrome and sympathetic ophthalmia. Hence, the Smyth chicken autoimmune vitiligo model provides the opportunity to expand our understanding of spontaneous autoimmune pigmentation disorders and to develop effective treatment strategies.
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Affiliation(s)
- Jordan Sorrick
- Department of Biological Sciences, University of Arkansas, Fayetteville, AR, United States
| | - Wilson Huett
- Department of Biological Sciences, University of Arkansas, Fayetteville, AR, United States
| | - Kristen A Byrne
- Department of Poultry Science, University of Arkansas System Division of Agriculture, Fayetteville, AR, United States
| | - Gisela F Erf
- Department of Poultry Science, University of Arkansas System Division of Agriculture, Fayetteville, AR, United States
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Zhang JZ, Abudoureyimu D, Wang M, Yu SR, Kang XJ. Association between celiac disease and vitiligo: A review of the literature. World J Clin Cases 2021; 9:10430-10437. [PMID: 35004975 PMCID: PMC8686139 DOI: 10.12998/wjcc.v9.i34.10430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/25/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023] Open
Abstract
Celiac disease (CD) is an autoimmune intestinal disease caused by the intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes. Vitiligo is a commonly acquired depigmentation of the skin; its clinical manifestation are skin patches caused by localized or generalized melanin deficiency. Both diseases have similar global incidence rates (approximately 1%) and are associated to similar diseases, including autoimmune bullous disease, inflammatory bowel disease, autoimmune thyroiditis, autoimmune gastritis, and type 1 diabetes. The relationship between CD and vitiligo has been reported in several studies, but their conclusions are inconsistent. Further, it has also been reported that a gluten-free diet (GFD) can improve the symptoms of immune-related skin diseases such as vitiligo. In this mini-review, we summarize and review the literature on the relationship between CD and vitiligo, assess the therapeutic significance of GFD for patients with vitiligo, and explore their possible physiopathology. We are hopeful that the information summarized here will assist physicians who treat patients with CD or vitiligo, thereby improving the prognosis.
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Affiliation(s)
- Jing-Zhan Zhang
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Key Laboratory of Dermatology Research, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
| | - Dilinuer Abudoureyimu
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Key Laboratory of Dermatology Research, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
| | - Man Wang
- Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
| | - Shi-Rong Yu
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Key Laboratory of Dermatology Research, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
| | - Xiao-Jing Kang
- Department of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Key Laboratory of Dermatology Research, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
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Ahn HS, Lee DH, Kazmi SZ, Kang T, Lee YS, Sung R, Cha J, Choi YJ, Hong G, Hann HJ, Kim HJ. Familial Risk and Its Interaction With Body Mass Index and Physical Activity in Anterior Cruciate Ligament Injury Among First-Degree Relatives: A Population-Based Cohort Study. Am J Sports Med 2021; 49:3312-3321. [PMID: 34491137 DOI: 10.1177/03635465211032643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Genetic and behavioral risk factors have been suggested to play a role in anterior cruciate ligament (ACL) injury. However, population-based familial risk estimates are unavailable. PURPOSE To quantify familial risk of ACL injury among first-degree relatives (FDRs) after controlling for certain behavioral risk factors. To estimate the combined effect of family history and body mass index (BMI) or physical activity on the risk of ACL injury. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Using nationwide data from the Korean National Health Insurance and National Health Screening Program databases on kinship, lifestyle habits, and anthropometrics, 5,184,603 individuals with blood-related FDRs were identified from 2002 to 2018. Familial risk of ACL injury, as represented as incidence risk ratios (IRRs) with 95% CIs, was analyzed using Cox proportional hazards models among individuals with versus without affected FDRs. Analyses were adjusted for age, sex, and behavioral risk factors. Interaction testing between familial history and BMI or physical activity was performed on an additive scale. RESULTS The risk of ACL injury was 1.79-fold higher (IRR, 1.79; 95% CI, 1.73-1.85) among individuals with versus without affected FDRs, and the incidence was 12.61 per 10,000 person-years. The IRR (95% CI) was highest with affected twins at 4.49 (3.01-6.69), followed by siblings at 2.31 (2.19-2.44), the father at 1.58 (1.49-1.68), and the mother at 1.52 (1.44-1.61). High BMI and high level of physical activity were significantly associated with the risk of ACL injury. Individuals with positive family history and either high BMI or physical activity had a 2.59- and 2.45-fold increased risk of injury as compared with the general population, respectively, and the combined risks exceeded the sum of their independent risks. CONCLUSION Familial factors are risk factors for ACL injury with an additional contribution of 2 behavioral factors: BMI and physical activity level. A significant interaction was observed between family history of ACL injury and high BMI/level of physical activity.
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Affiliation(s)
- Hyeong Sik Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Dae-Hee Lee
- Department of Orthopedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Sayada Zartasha Kazmi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Taeuk Kang
- Health and Wellness College, Sungshin Women's University, Seoul, Republic of Korea
| | - Young Sung Lee
- Department of Health Informatics and Management, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Ryunsu Sung
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jaewoo Cha
- Department of Public Health, Korea University, Seoul, Republic of Korea
| | - Yoon Jung Choi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Gahwi Hong
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hoo Jae Hann
- College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
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Kim HJ, Kazmi SZ, Kang T, Sohn SY, Kim DS, Hann HJ, Ahn HS. Familial Risk of Hashimoto's Thyroiditis Among First-Degree Relatives: A Population-Based Study in Korea. Thyroid 2021; 31:1096-1104. [PMID: 33514269 DOI: 10.1089/thy.2020.0213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Few small-scale studies have reported a genetic and familial predisposition in Hashimoto's thyroiditis (HT), however, quantified familial risk estimates from population-level data are unavailable. We aimed to estimate the incidence and familial risk of HT among first-degree relatives (FDR) according to age, sex, and family relationships. Methods: We conducted a population-based study in the general population of Korea from 2002 to 2017. Using the nationwide health insurance database, which has full population coverage and family relationship information, a cohort of 22 million individuals with blood-related FDR comprising 12 million families were followed up for a familial occurrence of HT. Age- and sex-adjusted incidence risk ratios (IRRs) were calculated in individuals with an affected FDR compared with those without an affected FDR. Results: Among 21,940,795 individuals, 234,912 had an HT-affected FDR, of whom 2425 familial cases developed HT with an incidence of 7.12/10,000 person-years. The familial risk for HT was 6.5-fold (95% confidence interval [CI]: 6.24-6.78) higher in individuals with versus without affected FDR. According to relationship, familial risks were IRR 102.71, IRR 7.80, IRR 5.54, and IRR 5.52 with an affected twin, sibling, mother, and father, respectively, and the corresponding incidence (/10,000 person-years) was 115.57, 10.66, 5.73, and 5.91. Same-sex twins had three times higher risk of developing HT than opposite-sex twins (IRR 121.01 vs. 21.46). The sex-specific familial risk was higher in males than females. The risks demonstrated age dependence, being higher in younger age groups. Conclusions: This study represents the largest population-based study of familial HT risk in Asia. We demonstrated elevated familial risk of incident HT among FDR, but with lower magnitude as those observed in previous studies. Familial risk increased with the degree of genetic relatedness among FDR indicating a prominent role of genetic factors in the familial aggregation of HT. Elevated risks in the younger age groups should motivate clinicians to screen people with a family history, especially those <30 years.
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Affiliation(s)
- Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sayada Zartasha Kazmi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Taeuk Kang
- Korean Research-Based Pharma Industry Association (KRPIA), Seoul, Korea
| | - Seo Young Sohn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University College of Medicine, Myongji Hospital, Goyang, Korea
| | - Dong-Sook Kim
- Health Insurance Review and Assessment Service (HIRA), Wonju, Korea
| | - Hoo Jae Hann
- Medical Research Institute, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
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Ahn HS, Kim HJ, Kazmi SZ, Kang T, Jun JB, Kang MJ, Kim KB, Kee SH, Kim DS, Hann HJ. Familial risk of Behçet's disease among first-degree relatives: a population-based aggregation study in Korea. Rheumatology (Oxford) 2021; 60:2697-2705. [PMID: 33241295 DOI: 10.1093/rheumatology/keaa682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 09/19/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Previous studies have indicated that Behçet's disease (BD) has a genetic component, however population-level familial risk estimates are unavailable. We quantified the familial incidence and risk of BD in first-degree relatives (FDR) according to age, sex and type of family relationship. METHODS Using the Korean National Health Insurance database, which has full population coverage and confirmed FDR information, we constructed a cohort of 21 940 795 individuals comprising 12 million families, which were followed for a familial occurrence of BD from 2002 to 2017. Age- and sex-adjusted incidence risk ratios for BD were calculated in individuals with affected FDR compared with those without affected FDR. RESULTS Among the total study population, 53 687 individuals had affected FDR, of whom 284 familial cases developed BD with an incidence of 3.57/104 person-years. The familial risk (incidence) for BD was increased to 13.1-fold (2.71/104 person-years) in individuals with an affected father, 13.9-fold (3.11/104 person-years) with affected mother, 15.2-fold (4.9/104 person-years) with an affected sibling and the highest risk was 165-fold (46/104 person-years) with an affected twin. Familial risks showed age dependence, being higher in younger age groups. The sex-specific familial risk was similar in males and females. CONCLUSION This study provides quantified estimates of familial incidence and risk in FDR of BD patients in an entire population. Familial risks were higher within generation (sibling-sibling) vs between generations (parent-offspring). This implicates complex interactions between genetic factors and shared childhood environmental exposures in the pathogenesis of BD.
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Affiliation(s)
- Hyeong Sik Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sayada Zartasha Kazmi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Taeuk Kang
- Korean Research-based Industry Association (KRPIA), Seoul, Korea
| | - Jae-Bum Jun
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Min Ji Kang
- Department Public Health, Graduate School, Korea University, Seoul, Korea
| | - Kyoung-Beom Kim
- Department Public Health, Graduate School, Korea University, Seoul, Korea
| | - Sun-Ho Kee
- Department of Microbiology, College of Medicine, Korea University, Seoul, Korea
| | - Dong-Sook Kim
- Health Insurance Review and Assessment service (HIRA), Seoul, Korea
| | - Hoo Jae Hann
- Medical Research Institute, School of Medicine, Ewha Woman's University, Seoul, Korea
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Said-Fernandez SL, Sanchez-Domínguez CN, Salinas-Santander MA, Martinez-Rodriguez HG, Kubelis-Lopez DE, Zapata-Salazar NA, Vazquez-Martinez OT, Wollina U, Lotti T, Ocampo-Candiani J. Novel immunological and genetic factors associated with vitiligo: A review. Exp Ther Med 2021; 21:312. [PMID: 33717255 PMCID: PMC7885061 DOI: 10.3892/etm.2021.9743] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022] Open
Abstract
Vitiligo is a skin disorder characterized by depigmentation of the skin due to a lack of melanin. This condition affects men and woman of all ages and its incidence is not restricted by ethnicity or region. Vitiligo is a multifactorial disease, in which melanocytes, which serve important functions in skin pigmentation and immune processes, are impaired. There is sufficient evidence that immunological and genetic factors are primarily responsible for the destruction and dysfunction of melanocytes. Therefore, genetic DNA sequence variants that participate in skin homeostasis, pigmentation and immune response regulation, as well as altered expression patterns, may contribute to the risk of developing vitiligo. The current review presented an overview of the mechanism of pigmentation and of currently known factors involved in depigmentation, as well as the classification, epidemiology, associated comorbidities, risk factors, immunopathogenesis and several genetic and molecular changes associated with vitiligo.
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Affiliation(s)
- Salvador Luis Said-Fernandez
- Department of Biochemistry and Molecular Medicine, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Celia Nohemi Sanchez-Domínguez
- Department of Biochemistry and Molecular Medicine, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | | | - Herminia Guadalupe Martinez-Rodriguez
- Department of Biochemistry and Molecular Medicine, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - David Emmanuel Kubelis-Lopez
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Natalia Aranza Zapata-Salazar
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Osvaldo Tomas Vazquez-Martinez
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Uwe Wollina
- Department of Dermatology and Allergology, Skin Cancer Center, Städtisches Klinikum, D-01067 Dresden, Germany
| | - Torello Lotti
- Department of Dermatology and Venereology, University Guglielmo Marconi of Rome, I-00193 Rome, Italy
| | - Jorge Ocampo-Candiani
- Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
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Shah B, Godse K, Mahajan S, Grandhi S, Shendkar S, Sharma A, Teli C, Pathak R, Parsad D. Efficacy and safety of basic fibroblast growth factor (bFGF) related decapeptide solution plus Tacrolimus 0.1% ointment versus Tacrolimus 0.1% ointment in the treatment of stable vitiligo. Dermatol Ther 2019; 32:e13109. [DOI: 10.1111/dth.13109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Bela Shah
- Department of DermatologyB.J. Medical College & Civil Hospital Ahmedabad India
| | - Kiran Godse
- Department of DermatologyD.Y. Patil Medical College Navi Mumbai India
| | | | | | | | | | - Chirag Teli
- Medical Services, Alkem Laboratories Ltd. India
| | | | - Davinder Parsad
- Department of DermatologyPostgraduate Institute of Medical Education & Research Chandigarh India
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Ocampo-Candiani J, Salinas-Santander M, Ortiz-López R, de la Rosa-Moreno E, Trevino V, Vilata-Corell JJ, Vázquez-Martínez O, Ocampo-Garza J, Sánchez-Domínguez C, Alfonso-Sánchez JL, Villarreal-Martínez A, Garza-Rodríguez V. TSH levels, overweight, BMI, and skin expression levels of DCT and CCBL2 genes are related to vitiligo treatment response with narrow band UVB phototherapy. Dermatol Ther 2019; 32:e12893. [PMID: 30958624 DOI: 10.1111/dth.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/25/2018] [Accepted: 04/06/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Jorge Ocampo-Candiani
- Facultad de Medicina, Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, Mexico
| | - Mauricio Salinas-Santander
- Departamento de Investigación, Facultad de Medicina Unidad Saltillo, Universidad Autónoma de Coahuila, Saltillo, Coahuila, Mexico
| | | | - Eduardo de la Rosa-Moreno
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Victor Trevino
- Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Mexico
| | - Juan José Vilata-Corell
- Departamento de Dermatología, Universitat de València, Hospital General Universitario de Valencia, Valencia, Spain
| | - Osvaldo Vázquez-Martínez
- Facultad de Medicina, Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, Mexico
| | - Jorge Ocampo-Garza
- Facultad de Medicina, Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, Mexico
| | - Celia Sánchez-Domínguez
- Departamento de Bioquímica y Medicina Molecular, Universidad Autónoma de Nuevo León, Facultad de Medicina, Monterrey, Nuevo León, Mexico
| | - José Luis Alfonso-Sánchez
- Departamento de Medicina Preventiva y Salud Pública, Universitat de València, Hospital General Universitario de Valencia, Valencia, Spain
| | - Alejandra Villarreal-Martínez
- Facultad de Medicina, Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, Mexico
| | - Verónica Garza-Rodríguez
- Facultad de Medicina, Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, Mexico
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13
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Ocampo-Candiani J, Salinas-Santander M, Trevino V, Ortiz-López R, Ocampo-Garza J, Sanchez-Dominguez CN. Evaluation of skin expression profiles of patients with vitiligo treated with narrow-band UVB therapy by targeted RNA-seq. An Bras Dermatol 2019; 93:843-851. [PMID: 30484529 PMCID: PMC6256230 DOI: 10.1590/abd1806-4841.20187589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 10/20/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Vitiligo is characterized by a lack of pigmentation in the skin. To date, there are no studies that analyze the changes in gene expression in the skin of vitiligo patients in response to narrow-band ultraviolet B (nb-UVB) phototherapy treatment. OBJECTIVE Explore the usefulness of new generation RNA sequencing in the identification of gene expression changes in the skin of vitiligo patients treated with nb-UVB phototherapy. METHODS Four skin biopsies (4mm in diameter) were collected from 45 Mexican vitiligo vulgaris patients, 2 specimens before and 2 after treatment with nb-UVB phototherapy, obtained from pigmented and non-pigmented tissue. RNA extracted from the biopsies was analyzed using the Illumina TruSeq Targeted RNA Expression protocol to study the expression of genes that participate in pathways of skin homeostasis. The 2 groups were compared using Student's t-test and the Mann-Whitney U-test. RESULTS The expression analysis identified differences in 12 genes included in this study after comparing the samples obtained before and after treatment: 5 genes involved in skin pigmentation, 2 genes involved in apoptosis, 2 genes involved in cell survival, 2 genes involved in oxidative stress responses and 1 gene involved in signal transduction mechanisms (p<0.05). STUDY LIMITATIONS The small size of skin biopsies limits the amount of RNA obtained, the number of genes to be analyzed and the use of conventional techniques such as RT-qPCR. CONCLUSION We demonstrated usefulness of new generation RNA sequencing in the identification of gene expression changes, in addition to identifying new targets in the study of vitiligo.
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Affiliation(s)
- Jorge Ocampo-Candiani
- Dermatology Service, Hospital Universitario Dr. José
Eleuterio González, Facultad de Medicina, Universidad Autónoma de
Nuevo León, Nuevo León, México
| | - Mauricio Salinas-Santander
- Department of Investigation, Facultad de Medicina Unidad Saltillo,
Universidad Autónoma de Coahuila, Saltillo, México
| | - Victor Trevino
- Escuela de Medicina y Ciencias de la Salud, Tecnológico de
Monterrey, Tecnológico de Monterrey, México
| | - Rocio Ortiz-López
- Escuela de Medicina y Ciencias de la Salud, Tecnológico de
Monterrey, Tecnológico de Monterrey, México
| | - Jorge Ocampo-Garza
- Dermatology Service, Hospital Universitario Dr. José
Eleuterio González, Facultad de Medicina, Universidad Autónoma de
Nuevo León, Nuevo León, México
| | - Celia Nohemi Sanchez-Dominguez
- Department of Biochemistry and Molecular Medicine, Facultad de
Medicina, Universidad Autónoma de Nuevo León, Nuevo León,
México
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14
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Graziano M, Rossi M. An update on the cutaneous manifestations of coeliac disease and non-coeliac gluten sensitivity. Int Rev Immunol 2018; 37:291-300. [PMID: 30516407 DOI: 10.1080/08830185.2018.1533008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Coeliac disease is a gluten-induced immune-mediated enteropathy, characterised by the expression of specific genotypes and the production of autoantibodies. The inflammatory process specifically targets the intestinal mucosa, but gastrointestinal and extraintestinal signs and symptoms can also be present. Non-coeliac gluten sensitivity (NCGS) can be diagnosed in individuals who have intestinal and/or extraintestinal symptoms related to the ingestion of gluten, but do not have autoantibodies and do not suffer from lesions in the duodenal mucosa. Among the extraintestinal manifestations, cutaneous manifestations are the most common for both diseases. PURPOSE We conducted this review to illustrate the common and uncommon features underlying the association of coeliac disease and NCGS with cutaneous manifestations related to gluten ingestion. Areas covered: The roles of innate and adaptive immunity in the cutaneous appearance of gluten sensitivity will be discussed.
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Affiliation(s)
- Mario Graziano
- a Department of Medicine, Surgery and Odontology "Scuola Medica Salernitana" , University of Salerno , Salerno , Italy
| | - Mauro Rossi
- b Institute of Food Sciences, CNR , Avellino , Italy
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15
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Pregnancy outcomes in patients with vitiligo: A nationwide population-based cohort study from Korea. J Am Acad Dermatol 2018; 79:836-842. [PMID: 29477741 DOI: 10.1016/j.jaad.2018.02.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/31/2018] [Accepted: 02/10/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Vitiligo is a chronic autoimmune skin disorder affecting 1% of populations worldwide. Few large-scale studies have explored adverse pregnancy outcomes in patients with vitiligo. OBJECTIVE To investigate adverse pregnancy outcomes in patients with vitiligo. METHODS We performed a retrospective cohort study on 4738 pregnancies of women with vitiligo and 47,380 pregnancies of age-matched controls without vitiligo using the Korean National Health Insurance Claims database from 2007 to 2016. Multivariate logistic regression models were used to evaluate the associations between vitiligo and pregnancy outcomes, including live births, spontaneous abortion, cesarean delivery, preterm delivery, gestational diabetes mellitus, stillbirth, pre-eclampsia/eclampsia, and intrauterine growth retardation. RESULTS Patients with vitiligo exhibited a significantly lower live birth rate (odds ratio, 0.870; 95% confidence interval, 0.816-0.927) and a higher incidence of spontaneous abortion (odds ratio, 1.250; 95% confidence interval, 1.148-1.362) than the control group. LIMITATION The Korean National Health Insurance Claims database lacks detailed clinical information on individual patients. CONCLUSION Vitiligo was significantly associated with an increased risk of spontaneous abortion. Further studies are needed to determine whether systemic autoimmunity explains our finding.
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16
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Salinas-Santander M, Trevino V, De la Rosa-Moreno E, Verduzco-Garza B, Sánchez-Domínguez CN, Cantú-Salinas C, Ocampo-Garza J, Lagos-Rodríguez A, Ocampo-Candiani J, Ortiz-López R. CAPN3, DCT, MLANA and TYRP1 are overexpressed in skin of vitiligo vulgaris Mexican patients. Exp Ther Med 2018; 15:2804-2811. [PMID: 29456684 PMCID: PMC5795480 DOI: 10.3892/etm.2018.5764] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/05/2018] [Indexed: 12/18/2022] Open
Abstract
Vitiligo is a disorder causing skin depigmentation, in which several factors have been proposed for its pathogenesis: Environmental, genetic and biological aspects of melanocytes, even those of the surrounding keratinocytes. However, the lack of understanding of the mechanisms has complicated the task of predicting the development and progression. The present study used microarray analysis to characterize the transcriptional profile of skin from Vitiligo Vulgaris (VV) patients and the identified transcripts were validated using targeted high-throughput RNA sequencing in a broader set of patients. For microarrays, mRNA was taken from 20 skin biopsies of 10 patients with VV (pigmented and depigmented skin biopsy of each), and 5 biopsies of healthy subjects matched for age and sex were used as a control. A signature was identified that contains the expression pattern of 722 genes between depigmented vitiligo skin vs. healthy control, 1,108 between the pigmented skin of vitiligo vs. healthy controls and 1,927 between pigmented skin, depigmented vitiligo and healthy controls (P<0.05; false discovery rate, <0.1). When comparing the pigmented and depigmented skin of patients with vitiligo, which reflects the real difference between both skin types, 5 differentially expressed genes were identified and further validated in 45 additional VV patients by RNA sequencing. This analysis showed significantly higher RNA levels of calpain-3, dopachrome tautomerase, melan-A and tyrosinase-related protein-1 genes. The data revealed that the pigmented skin of vitiligo is already affected at the level of gene expression and that the main differences between pigmented and non-pigmented skin are explained by the expression of genes associated with pigment metabolism.
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Affiliation(s)
- Mauricio Salinas-Santander
- Departamento de Bioquímica y Medicina Molecular, Universidad Autónoma de Nuevo León, Facultad de Medicina, Monterrey, Nuevo León 64460, México.,Departamento de Investigación, Facultad de Medicina Unidad Saltillo, Universidad Autónoma de Coahuila, Saltillo, Coahuila 25000, México
| | - Víctor Trevino
- Grupo de Investigación en Bioinformática, Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Nuevo León 64849, México
| | - Eduardo De la Rosa-Moreno
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Bárbara Verduzco-Garza
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Celia N Sánchez-Domínguez
- Departamento de Bioquímica y Medicina Molecular, Universidad Autónoma de Nuevo León, Facultad de Medicina, Monterrey, Nuevo León 64460, México
| | - Cristina Cantú-Salinas
- Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Facultad de Medicina, Monterrey, Nuevo León 64460, México
| | - Jorge Ocampo-Garza
- Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Facultad de Medicina, Monterrey, Nuevo León 64460, México
| | - Armando Lagos-Rodríguez
- Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Facultad de Medicina, Monterrey, Nuevo León 64460, México
| | - Jorge Ocampo-Candiani
- Servicio de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Facultad de Medicina, Monterrey, Nuevo León 64460, México
| | - Rocio Ortiz-López
- Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México.,Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Nuevo León 64849, México
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17
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Doppalapudi S, Mahira S, Khan W. Development and in vitro assessment of psoralen and resveratrol co-loaded ultradeformable liposomes for the treatment of vitiligo. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 174:44-57. [PMID: 28753523 DOI: 10.1016/j.jphotobiol.2017.07.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 07/05/2017] [Accepted: 07/09/2017] [Indexed: 12/01/2022]
Abstract
Vitiligo is a de-pigmenting skin disorder characterized by white patches on skin due to partial or complete loss of melanocytes. Psoralen in combination with ultraviolet-A (PUVA) acts by stimulation of melanin content and tyrosinase activity in melanocytes. Resveratrol, a sirtuin activator and a potential anti-oxidant reduce oxidative stress which is one of the triggering factors for initiation of vitiligo. Despite their therapeutic activity, weak percutaneous permeability of psoralen and poor solubility of resveratrol hinders their effective topical administration. The aim of present study is to formulate ultradeformable liposomes (UDL) co-loaded with psoralen and resveratrol for evaluation of PUVA and anti-oxidant combination in vitiligo treatment. For this purpose, UDL composed of DC-Chol, cholesterol and sodium deoxy cholate were prepared for their co-delivery. Liposomal carriers were characterized and evaluated for their efficacy using B16F10 cell line. Free radical scavenging potential was also determined for these carriers by in vitro anti-oxidant assays. Optimal co-loaded UDL with particle size ranging from 120 to 130nm, zeta potential of +46.2mV, entrapment efficiency of 74.09% (psoralen) and 76.91% (resveratrol) were obtained. Compared to control, co-loaded UDL showed significant stimulation of melanin and tyrosinase activity with major contribution of psoralen. Further, co-loaded UDL also exhibited potential free radical scavenging activity where resveratrol played a key role. Hence, psoralen and resveratrol co-loaded UDL acts in vitiligo through dual mechanisms of action viz., stimulation of melanin and tyrosinase activity as well as by anti-oxidant activity. These findings indicate that psoralen and resveratrol co-loaded UDL has the promising therapeutic potential for the treatment of vitiligo.
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Affiliation(s)
- Sindhu Doppalapudi
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500037, India
| | - Shaheen Mahira
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500037, India
| | - Wahid Khan
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500037, India.
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18
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miRNA signatures and transcriptional regulation of their target genes in vitiligo. J Dermatol Sci 2016; 84:50-58. [DOI: 10.1016/j.jdermsci.2016.07.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/05/2016] [Accepted: 07/04/2016] [Indexed: 12/18/2022]
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Meta-Analysis of the Association between Vitiligo and Human Leukocyte Antigen-A. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5412806. [PMID: 27689083 PMCID: PMC5027303 DOI: 10.1155/2016/5412806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/22/2016] [Accepted: 08/04/2016] [Indexed: 11/17/2022]
Abstract
Objective. The objective of this study was to systematically evaluate the association between vitiligo and human leukocyte antigen- (HLA-) A. Methods. PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure, and reference lists were searched for relevant original articles. Results. Nineteen case-control studies comprising 3042 patients and 5614 controls were included, in which 33 HLA-A alleles were reported. Overall, three alleles (HLA-A⁎02, A⁎33, and Aw⁎31) were significantly associated with increased risk of vitiligo, two (HLA-A⁎09 and Aw⁎19) were associated with decreased risk, and the remaining 28 were unassociated. Twelve alleles, seven alleles, and 19 alleles were common to three ethnicities, both types of vitiligo, and both typing methods, respectively. In the subgroup analysis by ethnicity and typing methods, the association of six alleles and five alleles was inconsistent in three populations and both typing methods, respectively. In the subgroup analysis by clinical type, the association of all seven alleles was consistent in both types of vitiligo. Conclusion. The meta-analysis suggests that HLA-A⁎02, A⁎33, and Aw⁎31 are associated with increased risk of vitiligo, while HLA-A⁎09 and Aw⁎19 are associated with decreased risk of vitiligo. The association of some alleles varies in terms of ethnicity and typing methods.
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20
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Spontaneous Coronary Artery Dissection: Report of 3 Cases and Literature Review Hormonal, Autoimmune, Morphological Factors. Am J Forensic Med Pathol 2016; 36:188-92. [PMID: 26010056 DOI: 10.1097/paf.0000000000000167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The number of cases with spontaneous coronary artery dissection (SCAD) is considered to be being underestimated because of a large amount of SCAD leading to sudden death without previous diagnosis. Besides, not only in clinics but also in autopsy practice, correct diagnosis of SCAD is important to prevent forensic malpractice.The article is intended to discuss the pathological findings through the forensic point of view for improving the malpractice expertise in scope of clinicians' timely antemortem diagnosis according to risk factors and in scope of forensic pathologists' the cause of death determination ability according to macroscopical and microscopical findings of the autopsy.In 3 cases reported, the main characteristics were the female sex, pregnancy history and a sudden death without any trauma. However, although there are many women giving birth or using oral contraceptives, only some of them are facing with SCAD. This suggests the possibility of some hereditary factors, whereas hereditary characteristics may be understood in many different ways like hormone-releasing regulating mechanisms as well as immunity, morphology, or any other mechanism. For instance, autoimmunity has been also a hereditary underlying factor for vessel injury considered in presented cases.
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21
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Allam M, Riad H. Concise review of recent studies in vitiligo. Qatar Med J 2013; 2013:1-19. [PMID: 25003059 PMCID: PMC4080492 DOI: 10.5339/qmj.2013.10] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 10/20/2013] [Indexed: 12/12/2022] Open
Abstract
Vitiligo is an acquired pigmentry disorder of the skin and mucous membranes which manifests as white macules and patches due to selective loss of melanocytes. Etiological hypotheses of vitiligo include genetic, immunological, neurohormonal, cytotoxic, biochemical, oxidative stress and newer theories of melanocytorrhagy and decreased melanocytes survival. There are several types of vitiligo which are usually diagnosed clinically and by using a Wood's lamp; also vitiligo may be associated with autoimmune diseases, audiological and ophthalmological findings or it can be a part of polyendocrinopathy syndromes. Several interventions are available for the treatment for vitiligo to stop disease progression and/or to attain repigmentation or even depigmentation. In this article, we will present an overall view of current standing of vitiligo research work especially in the etiological factors most notably the genetic components, also, types and associations and various and newer treatment modalities.
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Affiliation(s)
- Mohamed Allam
- Dermatology Department, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Riad
- Dermatology Department, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
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22
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Anbar T, Hay RA, Abdel-Rahman AT, Moftah NH, Al-Khayyat MA. Clinical study of nail changes in vitiligo. J Cosmet Dermatol 2013; 12:67-72. [PMID: 23438144 DOI: 10.1111/jocd.12022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2012] [Indexed: 11/30/2022]
Abstract
Both vitiligo and alopecia areata (AA) are associated together, associated with other autoimmune diseases, and autoimmunity is one of the important theories in their etiology. Nail changes are a known association with AA, thus we hypothesized that nail changes can be found in vitiligo patients. On revising the literature, only two types of nail changes were described in association with vitiligo. Our aim was to study the frequency and types of nail changes among vitiligo patients in comparison with normal healthy volunteers. This multi-centric study was carried on 91 patients with vitiligo, as well as 91 normal healthy control subjects who were age- and sex-matched. Nails were examined for changes in nail plates as regards striations, texture, curvature, dystrophy, and pigmentation. The presence or absence of the thumb lunula was also reported. Nail changes were observed in 62 patients (68.1%) and 46 (50.5%) control subjects with a statistically significant difference (P = 0.016). Longitudinal ridging and absent lunula were significantly higher in patients than in the controls (P = 0.001 and 0.037, respectively). Other reported nail abnormalities in the current study included punctate leukonychia, pitting, flag sign, and Terry's nails. Awareness of this association will widen the clinician's perspective to carefully examine the nail changes in vitiligo patients and conversely examine patients with nail changes for vitiligo.
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Affiliation(s)
- Tag Anbar
- Dermatology Department, Al-Minya University, Al-Minya, Egypt.
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23
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Kanwar AJ, Mahajan R, Parsad D. Effect of Age at Onset on Disease Characteristics in Vitiligo. J Cutan Med Surg 2013; 17:253-8. [DOI: 10.2310/7750.2013.12075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Vitiligo is a multifactorial disease in which genetic, immunologic, and environmental factors play an important part. Late-onset vitiligo is a poorly defined entity. Materials and Methods: Case records of patients who attended the pigmentary clinic at our institute from January 2001 to December 2010 were reviewed. Patients with a diagnosis of vitiligo were analyzed with respect to their demographic characteristics with special reference to their age at onset. Results: Patients with disease onset after 30 years had a significantly higher association with precipitating factors such as trauma, stress, and drugs in comparison with early-onset vitiligo ( p < .004). However, the difference did not reach statistical significance when these factors were analyzed individually. There was a significantly higher association with other nonautoimmune diseases ( p = .05), a higher incidence of positive family history ( p < .0001), and a higher association with leukotrichia ( p < .002) in late-onset disease. Early-onset nonsegmental vitiligo was associated with a higher incidence of photosensitivity and pruritus compared to early-onset segmental vitiligo. Conclusion: Late-onset vitiligo has certain distinguishing features compared to early-onset vitiligo.
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Affiliation(s)
- Amrinder J. Kanwar
- From the Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- From the Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- From the Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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24
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Huang Y, Yi X, Jian Z, Wei C, Li S, Cai C, Zhang P, Li K, Guo S, Liu L, Shi Q, Gao T, Li C. A single-nucleotide polymorphism of miR-196a-2 and vitiligo: an association study and functional analysis in a Han Chinese population. Pigment Cell Melanoma Res 2013; 26:338-47. [PMID: 23433405 DOI: 10.1111/pcmr.12081] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 02/11/2013] [Indexed: 12/30/2022]
Affiliation(s)
| | - Xiuli Yi
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Zhe Jian
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Chao Wei
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Shuli Li
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | | | - Ping Zhang
- Department of Dermatology; General Hospital of Air Force; Beijing; China
| | - Kai Li
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Sen Guo
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Ling Liu
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Qiong Shi
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Tianwen Gao
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
| | - Chunying Li
- Department of Dermatology Xijing Hospital; Fourth Military Medical University; Xi'an; China
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Saleh HMA, Abdel Fattah NSA, Hamza HTMM. Evaluation of serum 25-hydroxyvitamin D levels in vitiligo patients with and without autoimmune diseases. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2013; 29:34-40. [DOI: 10.1111/phpp.12016] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/03/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Hanan M. A. Saleh
- Department of Dermatology and Venereology, Faculty of Medicine; Ain Shams University; Cairo; Egypt
| | | | - Heba-Tullah M. M. Hamza
- Department of Dermatology and Venereology, Faculty of Medicine; Ain Shams University; Cairo; Egypt
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Rodríguez-Martín M, Sáez M, Merino de Paz N, Ferrer PC, Eliche MP, Rodríguez-Martín B, Cabrera AN. When are laboratory tests indicated in patients with vitiligo? DERMATO-ENDOCRINOLOGY 2012; 4:53-7. [PMID: 22870353 PMCID: PMC3408993 DOI: 10.4161/derm.19200] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Vitiligo has been associated with multiple endocrine and immune conditions. Several laboratory tests have been assessed in this disease with controversial results.
Objective: The aim of this study is to analyze the levels autoantibodies, basal glycaemia, vitamin B12, folic acid and thyroid function and its association with the diagnosis and outcome of vitiligo patients through a case-control study.
Material and methods: This case-control study was performed on 196 consecutive patients with vitiligo referred to our Dermatology Department. As a control group, 160 healthy individuals without vitiligo or known history of immunologic/endocrine disease were included. Data were analyzed using the SPSS 17.0 statistical software package.
Results: Clinical, analytical and demographic data have been recorded. Our results showed that anti-thyroid peroxidase antibody and anti-parietal gastric cell antibody could be useful laboratory markers in a subpopulation of vitiligo patients. However, testing anti-nuclear antibody, anti-thyroglobulin antibody, folic acid and vitamin B12 seems to have limited clinical implication and diagnostic relevance in our routine clinical practice.
Limitations: This study addressed a selected population of vitiligo patients in Spain and may not generalize to different clinical settings or regions. The study of a wider sample would confirm these findings and allow a detailed analysis of the above factors as a function of the clinical subtype of vitiligo.
Conclusion: We have determined the more efficient serological markers to order in vitiligo patients. Our findings suggest that anti-thyroid peroxidase antibody and anti-parietal gastric cell could be useful tests for the characterization of specific subpopulations of vitiligo patients in terms of severity and co-morbidity, so their determination could have a prognostic value.
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Kara M, Yılmaz S, Kara Ö, Şenol MG, Özdağ F, Özçakar L. Segmental vitiligo in a patient with thoracic outlet syndrome. Rheumatol Int 2012; 32:2941-3. [DOI: 10.1007/s00296-011-2024-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 07/10/2011] [Indexed: 11/29/2022]
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Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol 2012; 51:1206-12. [DOI: 10.1111/j.1365-4632.2011.05377.x] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Miniati A, Weng Z, Zhang B, Stratigos A, Nicolaidou E, Theoharides T. Neuro-Immuno-Endocrine Processes in Vitiligo Pathogenesis. Int J Immunopathol Pharmacol 2012; 25:1-7. [DOI: 10.1177/039463201202500101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Vitiligo is a cutaneous disorder of depigmentation, clinically characterized by well-demarcated, white macules of varying size and distribution. It can affect up to 2% of the population, especially younger ages. In spite of recent findings implicating genetic, immune and oxidative stress factors, the exact pathogenesis of vitiligo remains obscure. Here, we briefly discuss the prevailing theories, and offer new suggestions that could explain in part the damage of melanocyte in the vitiliginous lesions. Our emerging hypothesis is that neuropeptides released from peripheral nerve endings could synergize with new cytokines to adversely affect melanocyte function and viability. These may include corticotropin-releasing hormone (CRH) and neurotensin (NT), as well as interleukin 33 (IL-33) and thymic stromal lymphopoietin (TSLP). Such interactions could serve the basis for further research, possibly leading to new treatments.
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Affiliation(s)
- A. Miniati
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, MA, USA
- Department of Dermatology, Andreas Sygros Hospital, Athens Medical School, Athens, Greece
| | - Z. Weng
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, MA, USA
- Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, USA
| | - B. Zhang
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, MA, USA
- Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, USA
| | - A.J. Stratigos
- Department of Dermatology, Andreas Sygros Hospital, Athens Medical School, Athens, Greece
| | | | - T.C. Theoharides
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, MA, USA
- Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, USA
- Department of Biochemistry, Tufts University School of Medicine, Boston, MA, USA
- Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, MA, USA
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Narita T, Oiso N, Fukai K, Kabashima K, Kawada A, Suzuki T. Generalized vitiligo and associated autoimmune diseases in Japanese patients and their families. Allergol Int 2011; 60:505-8. [PMID: 21778811 DOI: 10.2332/allergolint.11-oa-0303] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 03/09/2011] [Indexed: 11/20/2022] Open
Abstract
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.
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Affiliation(s)
- Tomohiko Narita
- Department of Dermatology, Kinki University Faculty of Medicine, Osaka, Japan
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Akay BN, Bozkir M, Anadolu Y, Gullu S. Epidemiology of vitiligo, associated autoimmune diseases and audiological abnormalities: Ankara study of 80 patients in Turkey. J Eur Acad Dermatol Venereol 2011; 24:1144-50. [PMID: 20202047 DOI: 10.1111/j.1468-3083.2010.03605.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recent clinical studies suggest that the pathogenetic mechanisms of vitiligo could be of systemic origin as vitiligo is associated with auditory abnormalities as well as other autoimmune disorders. OBJECTIVES To investigate clinical, genetic characteristics and laboratory findings of vitiligo as well as auditory abnormalities and the association of the disease with the other autoimmune disorders. MATERIALS AND METHODS From January to December 2008, we collected-data from 80 vitiligo patients to establish the clinical and epidemiological profile of vitiligo in Turkey. RESULTS Thirty patients were men and 50 were women, with a mean age of 37 years and a mean onset age of 10 years. Vitiligo vulgaris was the most common type, followed by focal, acrofacial, segmental and universal types. Forty-four (55%) patients had an associated autoimmune disease. These associated diseases were Hashimoto thyroiditis in 25, alopecia areata in 10, pernicious anaemia in seven and diabetes mellitus in two patients. Statistically significant changes in human leukocyte antigen in patients with vitiligo were HLA A24,-30, B63, CW6, DR15, DR51, DQ5,-6. Auditory problems were observed in 37.7% patients. Nine of the 20 patients showed unilateral minimal hearing loss (>30 dB), while the other 11 demonstrated bilateral hearing loss (>30 dB) over a large range of frequencies (2000-8000 Hz). CONCLUSION Our study demonstrates that vitiligo is a part of systemic autoimmune process. Audiological examination should be performed in all patients for auditory problems which are commonly presented as hypoacusis.
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Affiliation(s)
- B N Akay
- Department of Dermatology, University of Ankara School of Medicine, Ankara, Turkey.
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Vafaee T, Rokos H, Salem MMAEL, Schallreuter KU. In vivo and in vitro evidence for epidermal H2O2-mediated oxidative stress in piebaldism. Exp Dermatol 2011; 19:883-7. [PMID: 19758321 DOI: 10.1111/j.1600-0625.2009.00966.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Piebaldism is characterised by the absence of pigment in patches on the skin, usually present at birth. Mutations in the kit gene are documented. Clinically this disorder can mimic vitiligo. Here, we show for the first time the presence of oxidised pteridine-induced fluorescence in association with H2O2-mediated stress in piebald patches employing Wood's light and in vivo FT-Raman spectroscopy. In situ immunofluorescence data revealed low catalase and methionine sulphoxide reductase A (MSRA) levels whereas thioredoxin reductase and methionine sulphoxide reductase B (MSRB) are not affected. We also show low superoxide dismutase levels in these patients. The presence of thioredoxin reductase provides capacity to reduce H2O2, a mechanism which is absent in vitiligo. Importantly, this enzyme reduces biopterin back to the functioning cofactor 6-tetrahydrobiopterin. The absence of MSRA indicates deficient methionine sulphoxide repair in the cytosol, meanwhile the presence of MSRB is helpful to protect the nucleus. Taken together, we have identified H2O2-mediated stress in piebald skin with distinct differences to vitiligo.
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Affiliation(s)
- Tayyebeh Vafaee
- Institute for Pigmentary Disorders in association with EM Arndt University of Greifswald, Germany
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Zhao M, Gao F, Wu X, Tang J, Lu Q. Abnormal DNA methylation in peripheral blood mononuclear cells from patients with vitiligo. Br J Dermatol 2010; 163:736-42. [PMID: 20560952 DOI: 10.1111/j.1365-2133.2010.09919.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vitiligo is a skin disorder characterized by the destruction of melanocytes by autoreactive lymphocytes. The genetic and environmental factors that trigger the autoimmune response are poorly understood. However, alterations to epigenetic DNA methylation patterns contribute to many other autoimmune diseases. OBJECTIVES To investigate genomic and gene-specific DNA methylation levels in peripheral blood mononuclear cells (PBMCs) of patients with vitiligo and to relate any changes to the expression of genes that regulate methylation, as well as the autoimmune-related gene IL10. METHODS We quantified global methylcytosine levels in PBMCs from 20 patients with vitiligo and 20 healthy controls. mRNA levels of DNA methyltransferases (DNMTs), methyl-DNA binding domain proteins (MBDs) and interleukin (IL)-10 were measured by real-time reverse transcriptase-polymerase chain reaction. Methylation of an IL10 regulatory element domain was determined by bisulphite genomic sequencing. RESULTS Genomic DNA methylation in PBMCs of patients with vitiligo was increased relative to healthy controls (P = 0·012). DNMT1, MBD1, MBD3, MBD4 and MeCP2 expression was significantly higher than in control PBMCs (P = 0·013, 0·001, 0·005, 0·001 and 0·001, respectively). MBD1 and MBD3 expression correlated positively with global DNA methylation in vitiligo PBMCs (MBD1: r = 0·519, P = 0·019; MBD3: r = 0·529, P = 0·016). IL10 expression was significantly decreased (P = 0·030), and an IL-10 enhancer region was hypermethylated in vitiligo PBMCs compared with controls (P = 0·014). CONCLUSIONS These data show that levels of DNA methylation are altered in PBMCs of patients with vitiligo, and this may contribute to disease activity by affecting the expression of autoimmunity-related genes.
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Affiliation(s)
- M Zhao
- Department of Dermatology, Epigenetic Research Center, Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011, China
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Khodadadi L, Shafieyan S, Sotoudeh M, Dizaj AV, Shahverdi A, Aghdami N, Baharvand H. Intraepidermal injection of dissociated epidermal cell suspension improves vitiligo. Arch Dermatol Res 2010; 302:593-9. [PMID: 20364383 DOI: 10.1007/s00403-010-1034-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Revised: 01/21/2010] [Accepted: 01/25/2010] [Indexed: 11/30/2022]
Abstract
This study was initiated to evaluate the safety and effectiveness of intraepidermal injection of dissociated epidermal cells into the lesions of stable vitiligo patients. Autologous dissociated epidermal cell suspensions were injected intraepidermally into 10 stable vitiligo patients. None of the patients received adjuvant therapy. The response was evaluated as: marked (76-100%), moderate (51-75%), mild (26-50%) and minimal repigmentation (0-25%). Transmission electron microscopy was used to evaluate the transplanted cells and immunohistochemical staining with HMB-45 was performed to assess the repigmentation in vivo. In all cases, repigmentation started during the 4-week period after transplantation. Six months after transplantation, a marked repigmentation in four (40%), moderate repigmentation in two (20%) and mild repigmentation in two (20%) patients were observed. Two (20%) patients with white patches on their lids showed minimal repigmentation. No side effects were observed in any patients. Interestingly, repigmentation of gray hair in one patient, 4 months post transplantation was observed. Analysis of the ultrastructure of transplanted cells showed 1.5% of the cells had melanocyte morphology. HMB-45 positive cells were observed after cell transplantation. This method is an effective, simple and safe therapeutic option for stable vitiligo lesions.
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Affiliation(s)
- Laleh Khodadadi
- Department of Regenerative Medicine, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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Amin E, Saboury AA, Mansuri-Torshizi H, Moosavi-Movahedi AA. Potent inhibitory effects of benzyl and p-xylidine-bis dithiocarbamate sodium salts on activities of mushroom tyrosinase. J Enzyme Inhib Med Chem 2010. [DOI: 10.3109/14756360903179351] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E. Amin
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - A. A. Saboury
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
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Birlea SA, Costin GE, Norris DA. New insights on therapy with vitamin D analogs targeting the intracellular pathways that control repigmentation in human vitiligo. Med Res Rev 2009; 29:514-46. [DOI: 10.1002/med.20146] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Heath CR, Burk CJ, Lawley LP, Mancini AJ, Connelly EA. Severe combined immunodeficiency (SCID)-associated dyschromia with subsequent repigmentation: a report of two patients. Pediatr Dermatol 2009; 26:162-8. [PMID: 19419463 DOI: 10.1111/j.1525-1470.2009.00876.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Severe combined immunodeficiency (SCID) often presents with mucosal infections, cutaneous infections and eczematous rashes. We present two patients with history of SCID diagnosed at an early age who experienced diffuse dyschromia associated with their bone marrow and stem cell transplants. Dyschromias may be caused by numerous factors including medications, genetics, environmental contacts, or as a sequela of underlying chronic disease. These case reports describe progressive repigmentation to original skin color after the occurrence of dyschromia in two patients with SCID.
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Li M, Sun D, Li C, Zhang Z, Gao L, Li K, Li H, Gao T. Functional polymorphisms of the FAS gene associated with risk of vitiligo in Chinese populations: a case-control analysis. J Invest Dermatol 2008; 128:2820-4. [PMID: 18548110 DOI: 10.1038/jid.2008.161] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The FAS/FASLG system plays a key role in regulating apoptosis. Previous findings have shown that CD4-dependent destruction of melanocytes is partially inhibited by blocking FAS-FASLG interactions in autoimmune vitiligo. Functional polymorphisms of the FAS and FASLG genes can alter their transcriptional activities. In a hospital-based case-control study of 750 vitiligo patients and 756 controls, we genotyped the FAS-1377 G>A, FAS-670 A>G, and FASLG-844 T>C polymorphisms and assessed their association with the risk of vitiligo. We found that a significantly increased risk of vitiligo was associated with the FAS-1377 AA genotype (adjusted odds ratio (OR), 1.49; 95% confidence interval (CI), 1.07-2.08) and the FAS-1377 AG genotype (adjusted OR, 1.31; 95% CI, 1.05-1.63) when compared with the FAS-1377 GG genotype. However, no evident risk was associated with FAS-670 G>A genotypes. In the combined analysis of the two variant alleles of FAS, genotypes with 3 to 4 risk alleles were associated with an increased risk of vitiligo compared with those having 0-2 variants (adjusted OR, 2.87; 95% CI, 1.90-4.32). In conclusion, genetic variants in the FAS gene may affect the risk of vitiligo in Chinese populations.
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Affiliation(s)
- Miao Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
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Strömberg S, Björklund MG, Asplund A, Rimini R, Lundeberg J, Nilsson P, Pontén F, Olsson MJ. Transcriptional profiling of melanocytes from patients with vitiligo vulgaris. Pigment Cell Melanoma Res 2007; 21:162-71. [DOI: 10.1111/j.1755-148x.2007.00429.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Cario-André M, Pain C, Gauthier Y, Taïeb A. The melanocytorrhagic hypothesis of vitiligo tested on pigmented, stressed, reconstructed epidermis. ACTA ACUST UNITED AC 2007; 20:385-93. [PMID: 17850512 DOI: 10.1111/j.1600-0749.2007.00396.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Common generalized vitiligo is an acquired depigmenting disorder characterized by a chronic and progressive loss of melanocytes from the epidermis and hair follicles. We previously proposed a new theory that vitiligo involves the chronic detachment and transepidermal loss of melanocytes caused by autoimmune, neural and impaired redox mechanisms associated with mechanical trauma. In this study, we reconstructed epidermis on dead de-epidermized dermis with normal and/or non-segmental non-lesional vitiligo (NSV) cells and tested catecholamines or sera or hydrogen peroxide. Under unstressed conditions, the number of melanocytes located in the basal layer was significantly lower in reconstructs made with melanocytes from non-lesional NSV skin and normal keratinocytes compared with controls made with autologous normal melanocytes. The number of non-lesional NSV melanocytes was even lower in reconstructs made with keratinocytes from non-lesional NSV skin. Epinephrine and H(2)O(2) could trigger the transepidermal loss of normal and vitiligo melanocytes. Some sera induced melanocyte detachment but without any clear correlation with disease activity in the donors. In conclusion, our results are the first step to obtaining a reproducible melanocytorrhagic model in vitro with some of the stressors investigated. They support the hypothesis that NSV melanocytes have an intrinsic defect, which limits their adhesion in a reconstructed epidermis, with an enhancer effect of the vitiligo keratinocyte milieu.
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Affiliation(s)
- M Cario-André
- Department of Dermatology, National reference center for rare skin disease, Bordeaux University Hospitals, Bordeaux Cedex, France.
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Bondanza S, Maurelli R, Paterna P, Migliore E, Giacomo FD, Primavera G, Paionni E, Dellambra E, Guerra L. Keratinocyte cultures from involved skin in vitiligo patients show an impaired in vitro behaviour. ACTA ACUST UNITED AC 2007; 20:288-300. [PMID: 17630962 DOI: 10.1111/j.1600-0749.2007.00385.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vitiligo depigmentation is considered a consequence of either melanocyte disappearance or loss of functioning melanocytes in the involved areas. However, it has been reported that keratinocytes in involved vitiligo skin are damaged too. Based on this evidence, we evaluated the in vitro behaviour, in life span cultures, of involved and uninvolved vitiligo keratinocytes and their expression of proliferation, differentiation and senescence markers. An additional purpose was to investigate whether vitiligo keratinocytes from depigmented skin are able to sustain survival and growth of normal melanocytes (when added in co-culture experiments), as normal human keratinocytes manage to do. Our results demonstrate that almost all involved vitiligo keratinocytes have a shorter life span in vitro than the uninvolved cells and all of them do not maintain melanocytes in culture in a physiological ratio. Modification of proliferation and senescence marker expression also occurs. Indeed, we detected low initial expression levels of the senescence marker p16 in involved vitiligo keratinocytes, despite their shorter in vitro life span, and increased expression of proliferating cell nuclear antigen and p53. This preliminary analysis of a small number of in vitro cultured vitiligo keratinocytes suggests an impaired senescence process in lesional vitiligo keratinocytes and attempts to regulate it.
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Affiliation(s)
- Sergio Bondanza
- Tissue Engineering and Cutaneous Physiopathology Laboratory, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
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Uhm YK, Yoon SH, Kang IJ, Chung JH, Yim SV, Lee MH. Association of glutathione S-transferase gene polymorphisms (GSTM1 and GSTT1) of vitiligo in Korean population. Life Sci 2007; 81:223-7. [PMID: 17568619 DOI: 10.1016/j.lfs.2007.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2006] [Revised: 03/23/2007] [Accepted: 05/09/2007] [Indexed: 11/20/2022]
Abstract
Vitiligo is an acquired pigmentary disorder of the skin involving melanocyte dysfunction. It has been reported that melanocyte impairment could be related to increased oxidative stress. The glutathione S-transferases (GSTs) are group of polymorphic enzymes that are important in protection against oxidative stress. To find the relationship between GSTM1 and GSTT1 polymorphisms with vitiligo susceptibility, GSTM1 and GSTT1 (homozygous deletion vs. non-deleted) polymorphisms between vitiligo patients (n=310) and healthy controls (n=549) were analyzed. We observed significant association in null alleles of the GSTM1 (P<0.001, OR=2.048, 95% CI=1.529-2.743). GSTM1 null type was also statistically different between two vitiligo subtypes and controls (Focal P<0.001, OR=2.224, 95% CI=1.499-3.298; Generalized P=0.001, OR=1.974, 95% CI=1.342-2.904). However, no significant association in GSTT1 (P=0.869, OR=1.024, 95% CI=0.775-1.353) was observed with vitiligo. In combined analysis of GSTM1 and GSTT1, both null type and GSTM1/GSTT1 (null/present) group showed significant differences between controls and vitiligo patients. These results suggest that GSTM1 null type might be associated with vitiligo susceptibility in Korean population.
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Affiliation(s)
- Yoon Kyung Uhm
- Kohwang Medical Research Institute, Department of Pharmacology, School of Medicine, Kyung Hee University, Seoul, Korea
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Yoshida Y, Hachiya A, Sriwiriyanont P, Ohuchi A, Kitahara T, Takema Y, Visscher MO, Boissy RE. Functional analysis of keratinocytes in skin color using a human skin substitute model composed of cells derived from different skin pigmentation types. FASEB J 2007; 21:2829-39. [PMID: 17475923 DOI: 10.1096/fj.06-6845com] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Skin color is one of the most distinct features in the human race. To assess the mechanisms of skin color variation, human skin substitutes (HSS) were constructed by grafting mixtures of cultured keratinocytes and melanocytes from a combination of donor skin types, together with light skin derived fibroblasts, into chambers inserted onto the back skin of severe combined immunodeficient (SCID) mice. The resulting complexion coloration of the HSS was relatively darker and lighter when dark and light skin derived keratinocytes, respectively, were combined with melanocytes derived from either light or dark skin. The melanin content in the epidermis and the maturation stage of melanosomes in basal keratinocytes were significantly increased in the HSS composed of dark compared to light skin derived keratinocytes. In addition, the ratio of individual/clustered melanosomes in recipient keratinocytes was increased in the former as opposed to the latter HSS. The genetic expression of endothelin-1, proopiomelanocortin, microphthalmia-associated transcription factor, tyrosinase, GP100, and MART1 were increased in HSS composed of dark vs. light skin derived keratinocytes. These data suggest that our HSS is a promising melanogenic model that demonstrates the role of the keratinocyte in regulating in part both melanogenesis and distribution of transferred melanosomes.
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Affiliation(s)
- Yasuko Yoshida
- Kao Biological Science Laboratories, Haga, Tochigi, Japan
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McNeill MS, Paulsen J, Bonde G, Burnight E, Hsu MY, Cornell RA. Cell death of melanophores in zebrafish trpm7 mutant embryos depends on melanin synthesis. J Invest Dermatol 2007; 127:2020-30. [PMID: 17290233 DOI: 10.1038/sj.jid.5700710] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Transient receptor potential melastatin 7 (TRPM7) is a broadly expressed, non-selective cation channel. Studies in cultured cells implicate TRPM7 in regulation of cell growth, spreading, and survival. However, zebrafish trpm7 homozygous mutants display death of melanophores and temporary paralysis, but no gross morphological defects during embryonic stages. This phenotype implies that melanophores are unusually sensitive to decreases in Trpm7 levels, a hypothesis we investigate here. We find that pharmacological inhibition of caspases does not rescue melanophore viability in trpm7 mutants, implying that melanophores die by a mechanism other than apoptosis. Consistent with this possibility, ultrastructural analysis of dying melanophores in trpm7 mutants reveals abnormal melanosomes and evidence of a ruptured plasma membrane, indicating that cell death occurs by necrosis. Interestingly, inhibition of melanin synthesis largely prevents melanophore cell death in trpm7 mutants. These results suggest that melanophores require Trpm7 in order to detoxify intermediates of melanin synthesis. We find that unlike TRPM1, TRPM7 is expressed in human melanoma cell lines, indicating that these cells may also be sensitized to reduction of TRPM7 levels.
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Affiliation(s)
- Matthew S McNeill
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, Iowa, USA
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Dell'anna ML, Picardo M. A review and a new hypothesis for non-immunological pathogenetic mechanisms in vitiligo. ACTA ACUST UNITED AC 2006; 19:406-11. [PMID: 16965269 DOI: 10.1111/j.1600-0749.2006.00333.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vitiligo is an acquired depigmenting disorder characterized by the loss of functioning epidermal melanocytes because of multifactorial and overlapping pathogenetic mechanisms. Besides the immunological approach, the study of the metabolic deregulations leading to toxic damage of the melanocytes appears to be more and more relevant. It was only last year that the first in vitro evidence supporting the link and the temporal sequence between the immune response and the cellular oxidative stress was provided, suggesting that the intrinsic damage of the melanocytes is primitive. What can be the guide line of the multiple altered metabolisms? A compromised membrane could render the cell sensitive to the external and internal agents differently, usually ineffective on the cell activity and survival. The primitive altered arrangement of the lipids may affect the transmembrane housing of proteins with enzymatic or receptorial activities, also conferring on them antigenic properties.
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Kingo K, Philips MA, Aunin E, Luuk H, Karelson M, Rätsep R, Silm H, Vasar E, Kõks S. MYG1, novel melanocyte related gene, has elevated expression in vitiligo. J Dermatol Sci 2006; 44:119-22. [PMID: 16996721 DOI: 10.1016/j.jdermsci.2006.08.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Revised: 08/08/2006] [Accepted: 08/09/2006] [Indexed: 01/08/2023]
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Wick G, Andersson L, Hala K, Gershwin ME, Selmi C, Erf GF, Lamont SJ, Sgonc R. Avian models with spontaneous autoimmune diseases. Adv Immunol 2006; 92:71-117. [PMID: 17145302 PMCID: PMC3292797 DOI: 10.1016/s0065-2776(06)92002-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Autoimmune diseases in human patients only become clinically manifest when the disease process has developed to a stage where functional compensation by the afflicted organ or system is not possible anymore. In order to understand the initial etiologic and pathogenic events that are generally not yet accessible in humans, appropriate animal models are required. In this respect, spontaneously developing models--albeit rare--reflect the situation in humans much more closely than experimentally induced models, including knockout and transgenic mice. The present chapter describes three spontaneous chicken models for human autoimmune diseases, the Obese strain (OS) with a Hashimoto-like autoimmune thyroiditis, the University of California at Davis lines 200 and 206 (UCD-200 and -206) with a scleroderma-like disease, and the amelanotic Smyth line with a vitiligo-like syndrome (SLV). Special emphasis is given to the new opportunities to unravel the genetic basis of these diseases in view of the recently completed sequencing of the chicken genome.
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Affiliation(s)
- Georg Wick
- Division of Experimental Pathophysiology and Immunology, Biocenter, Innsbruck Medical University, A-6020 Innsbruck, Austria
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