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Yang F, Yang L, Kuroda Y, Lai S, Takahashi Y, Sayo T, Namiki T, Nakajima K, Sano S, Inoue S, Tsuruta D, Katayama I. Disorganisation of basement membrane zone architecture impairs melanocyte residence in vitiligo. J Pathol 2024. [PMID: 38989633 DOI: 10.1002/path.6321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/22/2024] [Accepted: 05/22/2024] [Indexed: 07/12/2024]
Abstract
The basement membrane zone is the interface between the epidermis and dermis, and it is disrupted in several skin conditions. Here, we report the results of a comprehensive investigation into the structural and molecular factors of the basement membrane zone in vitiligo, a dermatological disorder characterised by depigmented patches on the skin. Using electron microscopy and immunofluorescence staining, we confirmed abnormal basement membrane zone morphology and disrupted basement membrane zone architecture in human vitiliginous skin. Furthermore, we identified elevated expression of matrix metalloproteinase 2 (MMP2) in human dermal fibroblasts as a key factor responsible for basement membrane zone matrix degradation. In our in vitro and ex vivo models, overexpression of MMP2 in fibroblasts led to basement membrane zone disruption and melanocyte disappearance. Importantly, we reveal that the loss of melanocytes in vitiligo is primarily linked to their weakened adhesion to the basement membrane, mediated by binding between integrin β1 and laminin and discoidin domain receptor 1 and collagen IV. Finally, inhibition of matrix metalloproteinase 2 expression reversed depigmentation in a mouse model of vitiligo. In conclusion, our research shows the importance of basement membrane zone integrity in melanocyte residence and offers new avenues for therapeutic interventions to address this challenging skin condition. © 2024 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Fei Yang
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Biological Science Research Laboratories, Kao Corporation, Odawara, Japan
| | - Lingli Yang
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yasutaka Kuroda
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Biological Science Research Laboratories, Kao Corporation, Odawara, Japan
| | - Sylvia Lai
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshito Takahashi
- Biological Science Research Laboratories, Kao Corporation, Odawara, Japan
| | - Tetsuya Sayo
- Biological Science Research Laboratories, Kao Corporation, Odawara, Japan
| | - Takeshi Namiki
- Department of Dermatology, Graduate School and Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shintaro Inoue
- Department of Cosmetic Health Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Ichiro Katayama
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Chen Z, Li Y, Tan X, Nie S, Chen B, Mei X, Wu Z. Dysregulated tryptophan metabolism and AhR pathway contributed to CXCL10 upregulation in stable non-segmental vitiligo. J Dermatol Sci 2024:S0923-1811(24)00133-6. [PMID: 38955622 DOI: 10.1016/j.jdermsci.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/21/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Tryptophan metabolism dysregulation has been observed in vitiligo. However, drawing a mechanistic linkage between this metabolic disturbance and vitiligo pathogenesis remains challenging. OBJECTIVE Aim to reveal the characterization of tryptophan metabolism in vitiligo and investigate the role of tryptophan metabolites in vitiligo pathophysiology. METHODS LC-MS/MS, dual-luciferase reporter assay, ELISA, qRT-PCR, small interfering RNA, western blotting, and immunohistochemistry were employed. RESULTS Kynurenine pathway activation and KYAT enzyme-associated deviation to kynurenic acid (KYNA) in the plasma of stable non-segmental vitiligo were determined. Using a public microarray dataset, we next validated the activation of kynurenine pathway was related with inflammatory-related genes expression in skin of vitiligo patients. Furthermore, we found that KYNA induced CXCL10 upregulation in keratinocytes via AhR activation. Moreover, the total activity of AhR agonist was increased while the AhR concentration per se was decreased in the plasma of vitiligo patients. Finally, higher KYAT, CXCL10, CYP1A1 and lower AhR expression in vitiligo lesional skin were observed by immunohistochemistry staining. CONCLUSION This study depicts the metabolic and genetic characterizations of tryptophan metabolism in vitiligo and proposes that KYNA, a tryptophan-derived AhR ligand, can enhance CXCL10 expression in keratinocytes.
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Affiliation(s)
- Zile Chen
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiting Li
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Tan
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shu Nie
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Chen
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingyu Mei
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhouwei Wu
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Jin S, Wan S, Xiong R, Li Y, Dong T, Guan C. The role of regulatory T cells in vitiligo and therapeutic advances: a mini-review. Inflamm Res 2024:10.1007/s00011-024-01900-w. [PMID: 38839628 DOI: 10.1007/s00011-024-01900-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Regulatory T cells (Tregs) play vital roles in controlling immune reactions and maintaining immune tolerance in the body. The targeted destruction of epidermal melanocytes by activated CD8+T cells is a key event in the development of vitiligo. However, Tregs may exert immunosuppressive effects on CD8+T cells, which could be beneficial in treating vitiligo. METHODS A comprehensive search of PubMed and Web of Science was conducted to gather information on Tregs and vitiligo. RESULTS In vitiligo, there is a decrease in Treg numbers and impaired Treg functions, along with potential damage to Treg-related signaling pathways. Increasing Treg numbers and enhancing Treg function could lead to immunosuppressive effects on CD8+T cells. Recent research progress on Tregs in vitiligo has been summarized, highlighting various Treg-related therapies being investigated for clinical use. The current status of Treg-related therapeutic strategies and potential future directions for vitiligo treatment are also discussed. CONCLUSIONS A deeper understanding of Tregs will be crucial for advancing Treg-related drug discovery and treatment development in vitiligo.
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Affiliation(s)
- Shiyu Jin
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310009, China
| | - Sheng Wan
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310009, China
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, 310009, China
| | - Renxue Xiong
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310009, China
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, 310009, China
| | - Yujie Li
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310009, China
| | - Tingru Dong
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310009, China
| | - Cuiping Guan
- Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310009, China.
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, 310009, China.
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Kim JC, Lee ES. Progression of Pre-Existing Vitiligo during Secukinumab Treatment for Psoriasis. Ann Dermatol 2023; 35:S117-S121. [PMID: 37853881 PMCID: PMC10608358 DOI: 10.5021/ad.21.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2023] Open
Abstract
Vitiligo has been considered an unexplained paradoxical phenomenon during biologics use. Herein, we report an adult case of progression of pre-existing vitiligo during secukinumab treatment for psoriasis, and we also examined the immunohistochemical changes in relation to biologics use. He was being administered monthly secukinumab of 300 mg dose for 2 years, and all psoriatic lesions were cleared, but pre-existing hypopigmented lesions became more distinct and larger than before unlike when using adalimumab. A skin biopsy of the hypopigmented lesion showed loss of epidermal melanocytes and absence of gp100 immune activities, and he was finally diagnosed with progression of pre-existing vitiligo. Immunohistochemical staining of vitiligo lesion showed decrease in interleukin-17 and tumor necrosis factor-α and increase in CD8+ T cells, interferon-γ, and CXCL10 after the use of secukinumab. In this study, we suggest that biologics-induced cytokine imbalance play a critical role in vitiligo progression in patients with chronic inflammatory diseases, including psoriasis.
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Affiliation(s)
- Jin Cheol Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Eun-So Lee
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea.
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Desai K, Kumar HK, Naveen S, Somanna P. Vitiligo: Correlation with Cytokine Profiles and its Role in Novel Therapeutic Strategies: A Case-Control Study. Indian Dermatol Online J 2023; 14:361-365. [PMID: 37266084 PMCID: PMC10231705 DOI: 10.4103/idoj.idoj_6_23] [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: 01/03/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 06/03/2023] Open
Abstract
Background The inflammatory and immune factors play a key role in the pathogenesis of vitiligo, and there are very few studies that have investigated the levels of major cytokines produced by T helper (Th) 1, Th2, and Th17 cells. This can enable better understanding of the, pathogenesis, and severity of vitiligo. Objectives To evaluate the serum levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-1β, interferon (IFN)-γ, and IL-10 in patients with vitiligo and to correlate them with the disease severity and activity and to compare them with normal healthy controls. Materials and Methods A case-control study was conducted with 100 study participants: 50 cases clinically diagnosed as vitiligo and 50 controls. All patients underwent complete evaluation with detailed demographic parameters, history, and physical examination. The severity of the disease was assessed clinically by Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA). Blood investigations performed were IL-6, TNF-α, IL-1β, IFN-γ, and IL-10. Results We observed significantly higher levels of serum IFN-γ levels in the patient group when compared with those of the normal controls (P = 0.002) and showed a positive correlation with the activity and severity of the disease with a significant VASI (P = 0.05) and VIDA score (P = < 0.001). The mean serum IL-10 (p < 0.001) in patients with vitiligo was significantly lower than that in the control group. There was no significant difference in the serum level of TNF-α level (P = 0.347), IL-6 (P = 0.365), and IL-1β (P = 0.362) between vitiligo and healthy controls. Conclusion This study proved that high serum level of IFN-γ may be a risk factor for vitiligo progression and significantly low levels of IL-10, which has an anti-inflammatory role, suggesting that they could be used as a marker for assessing vitiligo activity and may open the way for further therapeutic approaches for vitiligo.
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Affiliation(s)
- Karishma Desai
- Department of Dermatology, Rajarajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - Hari Kishan Kumar
- Department of Dermatology, Rajarajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - S Naveen
- Department of Dermatology, Rajarajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - Prabhakar Somanna
- Department of Dermatology, Rajarajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
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Zapata-Salazar NA, Kubelis-Lopez DE, Salinas-Santander MA, Sanchez-Dominguez CN, Xolalpa-Rosales AC, Gomez-Galindo ME, Ocampo-Candiani J. Association of rs4711998 of IL-17A, rs2275913 of IL-17A and rs763780 IL-17F gene polymorphisms with non-segmental vitiligo in a Mexican population. Arch Dermatol Res 2023; 315:447-454. [PMID: 35960353 DOI: 10.1007/s00403-022-02382-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/27/2022] [Accepted: 08/02/2022] [Indexed: 12/27/2022]
Abstract
Vitiligo is the most common depigmenting disease characterized by achromic macules due to selective loss of melanocytes. The pathogenesis remains poorly elucidated, and multiple hypotheses exist regarding its pathogenesis. Evidence suggests that stress on melanocytes can result in activation of the immune system, and involvement of both activated cluster of differentiation (CD8+) cytotoxic and CD4+ T cells in the dysfunction, depigmentation, and apoptosis of melanocytes. Recent studies show that the interleukin 17 (IL-17) axis plays a central role in the pathogenesis of the disease. IL-17 is an important regulatory effector cytokine in this pathway. The aim of this study was to evaluate the association of IL-17A rs4711998 (-832A/G), IL-17A rs2275913 (-197G/A), and IL-17F rs763780 (7488A/G) with vitiligo in a Northeastern Mexican population. This was a case-control study and included 116 patients with vitiligo and 116 control subjects. Genotype characterization of IL-17A rs4711998 (-832A/G), IL-17A rs2275913 (-197G/A), and IL-17F rs763780 (7488A/G) was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. A p ≤ 0.05 was considered significant. It was observed that the combination of the genotypes GG/GA for IL-17F rs763780 (7488A/G) was associated with an increased risk for the development of vitiligo (OR 2.0943, 95% Cl 1.2375-3.5445, p = 0.0056). Regarding IL-17A rs4711998 (-832A/G) and IL-17A rs2275913 (-197G/A) genotyping, no association with vitiligo development was found. In conclusion, the SNP rs763780 in the IL-17F gene appears to be a risk factor for vitiligo development in this Mexican population and it may be useful in future studies, especially for the development of new therapies.
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Affiliation(s)
- Natalia Aranza Zapata-Salazar
- Department of Dermatology, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon (UANL), Av. Madero and Gonzalitos S/N, Mitras Centro, 64460, Monterrey, Nuevo Leon, Mexico
| | - David Emmanuel Kubelis-Lopez
- Department of Dermatology, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon (UANL), Av. Madero and Gonzalitos S/N, Mitras Centro, 64460, Monterrey, Nuevo Leon, Mexico
| | | | - Celia Nohemi Sanchez-Dominguez
- Department of Biochemistry and Molecular Medicine, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon (UANL), Monterrey, Nuevo Leon, Mexico
| | - Ana Cecilia Xolalpa-Rosales
- Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon (UANL), Monterrey, Nuevo Leon, Mexico
| | - Marely Eugenia Gomez-Galindo
- Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon (UANL), Monterrey, Nuevo Leon, Mexico
| | - Jorge Ocampo-Candiani
- Department of Dermatology, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon (UANL), Av. Madero and Gonzalitos S/N, Mitras Centro, 64460, Monterrey, Nuevo Leon, Mexico.
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7
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Qing M, Zhou Y, Peng J, Shang Q, Deng J, Zeng X, Xu H, Chen Q. The interleukin-6 family in tissues is closely related to the clinical outcomes of oral lichen planus. J Oral Pathol Med 2023; 52:161-168. [PMID: 36169990 DOI: 10.1111/jop.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/05/2022] [Accepted: 08/20/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We attempted to investigate the role of interleukin-6 (IL-6) family expression in local tissues as it relates to presentations and outcomes in oral lichen planus (OLP), which is a common chronic inflammatory oral disease. MATERIALS AND METHODS A clinical follow-up cohort of OLP patients was established, and a biological sample library was constructed with categorization into erosive type (EOLP) and nonerosive type (NEOLP). Transcriptome sequencing of the lesions was then performed. A multiple regression model was used to explore the differences in IL-6 family expression among patients with different clinical types and clinical outcomes. RESULTS OLP tissue transcriptome sequencing showed that IL-6 family expression in EOLP increased significantly. It was also found that IL-6 family factors in the OLP recurrent erosion group were significantly increased compared to the persistent nonerosion group. Based on the multiple regression analysis of the OLP clinical cohort, it was found that the increased expression of the IL-6 family was closely related to the clinical types and clinical outcomes of OLP. CONCLUSION The high expression of the IL-6 family is closely related to the erosion of local mucosa and poor prognosis of OLP patients. IL-6-related factors may be used as therapeutic targets for OLP patients.
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Affiliation(s)
- Maofeng Qing
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiakuan Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qianhui Shang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiaxin Deng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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8
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Karagaiah P, Schwartz RA, Lotti T, Wollina U, Grabbe S, Goldust M. Biologic and targeted therapeutics in vitiligo. J Cosmet Dermatol 2023; 22:64-73. [PMID: 35029034 DOI: 10.1111/jocd.14770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Vitiligo is a long-standing progressive autoimmune disease with depigmented macules/patches with significant psychological morbidity to the patients. From being one of the most poorly understood diseases in the past, there has been a rampant advance in determining the molecular and genetic factors influencing the disease process. More light has been shed on the complex intracellular environment and interplay between innate and adaptive immunity. Numerous cytokines and signaling pathways have been associated with disease pathogenesis in the recent past. OBJECTIVE The aim of this review the efficacy of biologic and targeted therapeutics in vitiligo. METHODS A detailed literature search was conducted on databases like PubMed, COCHRANE Central, EMBASE and Google Scholar using keywords-"biologics," "vitiligo," "treatment," "repigmentation," "JAK inhibitors,", "TNF-ꭤ inhibitors," and "IL17/23 inhibitors," Relevant studies and review articles in English were analyzed in detail and report was written. This article aimed at a comprehensive review of all the biologicals and newer targeted therapeutics tried in vitiligo and their efficacy with an insight into the potential complications arising as a result of the therapy. RESULTS Most conventional vitiligo treatment modalities are restricted to generalized nonspecific immunosuppressants like topical and oral corticosteroids, calcineurin inhibitors, phototherapy, and surgical modalities. There have been reports and studies on the usage of biologicals in treating vitiligo. JAK inhibitors have shown good efficacy in vitiligo; however, it lacks substantial evidence in the form of randomized control trials. Similarly, the use of targeted therapeutics in treating vitiligo is substantiated by limited evidence and requires more randomized trials for further evidence. CONCLUSION JAK inhibitors have shown promising results and good tolerability; Adjuvant phototherapy can achieve a superior response compared to monotherapy. Though TNF-ꭤ has been tried in a few cases, it is best used if vitiligo is present in association with other chronic autoimmune diseases for which it is indicated. More in vitro studies and clinical research are required to understand the pathogenesis clearly, and therapy has to be targeted at specific pathways for a better approach toward vitiligo. Treatment aimed at induction and differentiation of melanocytes may be added to achieve faster repigmentation.
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Affiliation(s)
- Priyanka Karagaiah
- Department of Dermatology, Bangalore Medical College and Research Institute, Bangalore, India
| | - Robert A Schwartz
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Torello Lotti
- Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy.,Department of Dermatology and Communicable Diseases, First Medical State University of Moscow I. M. Sechenev Ministry of Health, Moscow, Russia
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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9
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Beyzaee AM, Goldust M, Patil A, Rokni GR, Beyzaee S. The role of cytokines and vitamin D in vitiligo pathogenesis. J Cosmet Dermatol 2022; 21:6314-6325. [PMID: 35871394 DOI: 10.1111/jocd.15272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
Vitiligo is a pigment-related disease with a global prevalence of 0.2% to 1.8% associated with considerable burden on quality of life. The treatment is still a challenge because of relapses and/or incomplete re-pigmentation. Although the exact cause is still unclear, its pathogenesis seems to be justifiable with the autoimmune theory, supported by the results of clinical research. In this narrative review, we aimed to summarize the evidence related to cytokines and vitiligo development. This review is consisted of English articles published in PubMed and Google Scholar concerning levels of inflammatory mediators, especially interleukins, in vitiligo patients over the last 20 years. References of relevant articles were also considered for review. Crucial role of dysregulated levels of interleukins and their synergistic function to each other, in the onset or progression of the disease is evident. The theory of autoimmune vitiligo is reinforced by the results of the studies in the literature, due to the association of pathogenesis with increased secretion of pro-inflammatory mediators and reduction of anti-inflammatory mediators. Decreased vitamin D levels may have a considerable role in vitiligo development by affecting Th1- and Th17-related immune responses. Cytokines play an important role in the pathogenesis or progression of the disease. Moreover, we believe that decreased vitamin D level has a considerable role in vitiligo development by affecting Th1- and Th17-related immune responses.
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Affiliation(s)
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Ghasem Rahmatpour Rokni
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samira Beyzaee
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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10
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Kovacs D, Bastonini E, Briganti S, Ottaviani M, D’Arino A, Truglio M, Sciuto L, Zaccarini M, Pacifico A, Cota C, Iacovelli P, Picardo M. Altered epidermal proliferation, differentiation, and lipid composition: Novel key elements in the vitiligo puzzle. SCIENCE ADVANCES 2022; 8:eabn9299. [PMID: 36054352 PMCID: PMC10848961 DOI: 10.1126/sciadv.abn9299] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Vitiligo is an acquired skin depigmentation disease involving multiple pathogenetic mechanisms, which ultimately direct cytotoxic CD8+ cells to destroy melanocytes. Abnormalities have been described in several cells even in pigmented skin as an expression of a functional inherited defect. Keratinocytes regulate skin homeostasis by the assembly of a proper skin barrier and releasing and responding to cytokines and growth factors. Alterations in epidermal proliferation, differentiation, and lipid composition as triggers for immune response activation in vitiligo have not yet been investigated. By applying cellular and lipidomic approaches, we revealed a deregulated keratinocyte differentiation with altered lipid composition, associated with impaired energy metabolism and increased glycolytic enzyme expression. Vitiligo keratinocytes secreted inflammatory mediators, which further increased following mild mechanical stress, thus evidencing immune activation. These findings identify intrinsic alterations of the nonlesional epidermis, which can be the prime instigator of the local inflammatory milieu that stimulates immune responses targeting melanocytes.
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Affiliation(s)
- Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Emanuela Bastonini
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Monica Ottaviani
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Andrea D’Arino
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Lorenzo Sciuto
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Marco Zaccarini
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Alessia Pacifico
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Paolo Iacovelli
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
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11
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Wang D, Min S, Lin X, Jiang G. Association Among MIF, IFIH1, and IL6 Gene Polymorphisms and Non-Segmental Vitiligo in a Chinese Han Population. Clin Cosmet Investig Dermatol 2022; 15:1597-1609. [PMID: 35983127 PMCID: PMC9380431 DOI: 10.2147/ccid.s369418] [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: 04/06/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to investigate the association of single-nucleotide polymorphisms (SNPs) in the macrophage migration inhibiting factor (MIF), interferon-induced Helicase C domain 1 (IFIH1), interleukin-6 (IL6) genes, circulating levels with non-segmental vitiligo (NSV) susceptibility in the Chinese population, and to analyze the relationships between gene polymorphisms and clinical characteristics of vitiligo. Methods In this study, genotyping was conducted in 155 patients with NSV and 117 unaffected controls using polymerase chain reaction and snapshot technique. Serum concentrations were determined by ELISA kit. Results There were strong associations between IFIH1 H843R and IL6-572G/C polymorphisms and NSV susceptibility (p = 0.013; p = 0.009). In contrast to previous studies, we found no significant difference in the MIF-173G/C polymorphism between the two groups. In addition, the frequency of allelic distribution for MIF-173G/C in patients with active NSV was significantly higher than stable NSV (p = 0.011), and IFIH1 H843R with early-onset (≤ 20), active or family history of NSV was significantly higher than late-onset (> 20), stable or no family history of NSV (p = 0.033; p = 0.045; p = 0.039). Serum concentrations of MIF were higher in patients with active NSV, serum IFIH1 and IL6 concentrations were related to the presence of polymorphisms in patients with NSV (p = 0.009; p = 0.011). Conclusion Our results suggested that IFIH1 H843R and IL6-572G/C gene polymorphisms and expression levels are obviously correlated with the onset of NSV. MIF-173G/C allele and serum concentrations may be associated with active NSV, and IFIH1 H843R allele may be associated with youth, active or family history of NSV.
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Affiliation(s)
- Danfeng Wang
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.,First Clinical Medical College, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Shuhui Min
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.,First Clinical Medical College, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Xiao Lin
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.,First Clinical Medical College, Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Guan Jiang
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.,First Clinical Medical College, Xuzhou Medical University, Xuzhou, People's Republic of China
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12
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Assessment of stem cell factor expression and its c-KIT receptor in patients with vitiligo. Postepy Dermatol Alergol 2022; 39:762-767. [PMID: 36090724 PMCID: PMC9454355 DOI: 10.5114/ada.2021.110266] [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: 02/07/2021] [Accepted: 06/25/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Melanocytes show antigen expressions characteristic for the immune response effector cells, and the immune reactions in the skin, especially those with inflammation background, significantly affect the function of melanocytes. Among the cytokines produced by keratinocytes, the stem cell factor (SCF) plays a leading role in stimulating melanogenesis. Aim To compare the expression level of stem cell factor (mSCF, pSCF) and the c-Kit receptor in the centre of the vitiligo patch and in the area of healthy skin adjacent to the vitiligo patch. Material and methods The research material consisted of skin samples from a vitiligo lesion and from non-lesional skin adjacent to the vitiligo patch. Real Time PCR analysis (Applied Biosystems 7900HT) was performed to determine the expression level of the studied genes. Results The studies showed a statistically significant increase in the amount of mSCF within the vitiligo patch compared to both healthy skin of patients with vitiligo and controls. In patients with vitiligo, c-Kit receptor expression was significantly decreased in the area of the lesional skin compared to the healthy skin of the same patient and the skin of the control group. Conclusions The membrane-bound form of the SCF is overexpressed within the vitiligo skin, which may indicate the participation of mSCF in the stimulation of melanogenesis in response to melanocyte damage. Decreased expression of C-Kit receptor by melanocytes in the vitiligo patch disrupts the ligand-receptor interaction and may therefore be related to melanocytes dysfunction and/or loss.
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13
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Boyajian JL, Ghebretatios M, Schaly S, Islam P, Prakash S. Microbiome and Human Aging: Probiotic and Prebiotic Potentials in Longevity, Skin Health and Cellular Senescence. Nutrients 2021; 13:nu13124550. [PMID: 34960102 PMCID: PMC8705837 DOI: 10.3390/nu13124550] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 02/07/2023] Open
Abstract
The role of the microbiome in human aging is important: the microbiome directly impacts aging through the gastrointestinal system. However, the microbial impact on skin has yet to be fully understood. For example, cellular senescence is an intrinsic aging process that has been recently associated with microbial imbalance. With age, cells become senescent in response to stress wherein they undergo irreversible growth arrest while maintaining high metabolic activity. An accumulation of senescent cells has been linked to various aging and chronic pathologies due to an overexpression of the senescence-associated secretory phenotype (SASP) comprised of proinflammatory cytokines, chemokines, growth factors, proteases, lipids and extracellular matrix components. In particular, dermatological disorders may be promoted by senescence as the skin is a common site of accumulation. The gut microbiota influences cellular senescence and skin disruption through the gut-skin axis and secretion of microbial metabolites. Metabolomics can be used to identify and quantify metabolites involved in senescence. Moreover, novel anti-senescent therapeutics are warranted given the poor safety profiles of current pharmaceutical drugs. Probiotics and prebiotics may be effective alternatives, considering the relationship between the microbiome and healthy aging. However, further research on gut composition under a senescent status is needed to develop immunomodulatory therapies.
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14
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Singh M, Vaishnav J, Shah A, Begum R. Expression analysis of candidate genes in vitiligo patients & effect of oxidative stress on melanocytes. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Ranjkesh MR, Partovi MR, Pashazadeh M. The Study of Serum Level of Interleukin-2, Interleukin-6, and Tumor Necrosis Factor-alpha in Stable and Progressive Vitiligo Patients from Sina Hospital in Tabriz, Iran. Indian J Dermatol 2021; 66:366-370. [PMID: 34759394 PMCID: PMC8530078 DOI: 10.4103/ijd.ijd_300_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Vitiligo is an acquired depigmenting disorder characterized by the loss of functional melanocytes from the epidermis. Although the etiology of vitiligo is unknown, over the last few years, substantial data from clinical research have greatly supported the "Autoimmune theory." Vitiligo has two major forms: progressive and stable. As cytokines are important mediators of immunity, the most important of them are IL-2, IL-6, and tumor necrosis factor-α (TNF-α). Objectives: We aimed to study the serum level of IL-2, IL-6, and TNF-α in stable and progressive vitiligo and compared them to find a useful lab test to determine the form of vitiligo for diagnose and treatment. Materials and Methods: Serum IL-2, IL-6, and TNF-α were done by the indirect enzyme-linked immunosorbent assay (ELISA) in 40 cases of stable and progressive vitiligo. Results: Twenty patients had progressive vitiligo and 20 patients were stable vitiligo. In every group, there were seven male patients. Twenty-one patients had a positive family history of vitiligo and four patients had other autoimmune diseases. The average age and familial history between two groups and two genders were not meaningful. The mean serum TNF-α level was significantly higher in progressive than stable vitiligo. No significant difference was observed in the serum levels of IL-2, IL-6 between stable and progressive vitiligo. The mean serum IL-6 and TNF-α had higher levels in male patients. Conclusion: Analysis of TNF-α levels in every age or gender can show us the type of vitiligo, stable or progressive and we can choose the best form of treatment for patients.
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Affiliation(s)
| | | | - Mehrdad Pashazadeh
- Department of Immunology, Faculty of Medicine, Tabriz University, Tabriz, Iran
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16
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Elbendary A, Abdel-Halim MRE, Youssef R, Abdel Halim D, Elmasry MF, Gad A, El Sharkawy DA. Hypopigmented lesions in pityriasis lichenoides chronica patients: Are they only post-inflammatory hypopigmentation? Australas J Dermatol 2021; 63:68-73. [PMID: 34751445 DOI: 10.1111/ajd.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/11/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVES Pityriasis lichenoides chronica (PLC) lesions are reported to subside with post-inflammatory hypopigmentation (PIH); hence, the most widely perceived nature of hypopigmented macules in PLC is PIH. However, to the best of our knowledge, no studies describing histopathological findings in these lesions are reported in literature. The aim of this study is to evaluate the hypopigmented lesions encountered in PLC patients and to shed light on their histopathological features. METHODS A cross-sectional observational study included twenty-one patients with PLC recruited in a period of twelve months. Clinical characteristics of each patient were collected. A skin biopsy from hypopigmented lesions whenever present was taken and assessed with routine haematoxylin and eosin stain. RESULTS Seventeen patients (81%) were less than 13 years old. Most patients (85.7%) demonstrated diffuse distribution of lesions. Hypopigmented lesions were present on the face in 12 (57.14%) patients. Histopathologically, hypopigmented lesions showed features of post-inflammatory hypopigmentation in 19% of patients, residual PLC in 52.4% and active PLC 28.6% of patients. CONCLUSION Hypopigmented lesions in PLC were noted mainly in younger ages, histopathologically they may show features of active or residual disease, beyond post-inflammatory hypopigmentation. Consequently active treatment for patients presenting predominantly with hypopigmented lesions could be required to control the disease.
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Affiliation(s)
- Amira Elbendary
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona R E Abdel-Halim
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Randa Youssef
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Abdel Halim
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Fathy Elmasry
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abdallah Gad
- Lowell General Hospital, Lowell, MA, USA.,Biostatistics and Cancer Epidemiology Department, National Cancer Institute, Cairo University, Cairo, Egypt
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17
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Yu H, Cen J, Lin X, Cheng H, Seifert O. Imiquimod induced vitiligo-like lesions-A consequence of modified melanocyte function. IMMUNITY INFLAMMATION AND DISEASE 2021; 10:70-77. [PMID: 34614305 PMCID: PMC8669695 DOI: 10.1002/iid3.543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Imiquimod plays an important role in the management of condyloma and premalignant lesions. Successively, an increase of hypopigmented lesions following imiquimod application has been reported. However, the mechanisms of imiquimod on melanocytes remain unclear. This study was designed to assess the effect of Imiquimod on the functions of melanocytes in vitro. METHODS Primary cultured melanocytes were isolated from normal control skin tissue. After incubation with imiquimod for 48 h in vitro, cell viability was analyzed by cell counting kit-8 assay. Apoptosis was detected using the Annexin V-fluorescein-5-isothiocyanate flow cytometry assay. Melanin content and tyrosinase activity in melanocytes were measured by colorimetric method and the modified dopachrome method. The production of inflammatory cytokine interleukin 8 (IL-8), IL-6, and soluble ICAM-1 (soluble Intercellular Adhesion Molecule-1[sICAM-1]) in melanocytes were measured by enzyme-linked immunosorbent assay (ELISA). Toll-like receptor 7 (TLR7), toll-like receptor 9 (TLR9) protein, and autophagy-related proteins microtubule-associated protein 1A/1B-light chain 3 (LC3-II), p62, mechanistic target of rapamycin (mTOR), and Atg5 were assessed using western blot analysis. RESULTS Imiquimod significantly inhibited the activity of tyrosinase activity and decreased melanin content in melanocytes and significantly increased apoptosis and IL-6, IL-8, and sICAM-1 production in melanocytes. Moreover, the expression of TLR7 and TLR9 proteins were significantly increased, and the expression of mTOR, p62 protein were markedly decreased, but the expression of LC3II/I and Atg5 protein were significantly increased in melanocytes after incubating with imiquimod. CONCLUSIONS This study shows that imiquimod directly inhibits melanogenesis and increases melanocyte apoptosis rates. These effects combined with the upregulation of TLR7 and TLR9 together with increased autophagy activity and inflammatory cytokines production, might be the main reasons leading to hypopigmented lesions after imiquimod application.
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Affiliation(s)
- Haiyan Yu
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, Zhejiang, China
| | - Jianping Cen
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, Zhejiang, China
| | - Xiaoxia Lin
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, Zhejiang, China
| | - Hao Cheng
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, Zhejiang, China
| | - Oliver Seifert
- Division of Dermatology and Venereology, Ryhov Hospital, Jönköping, Sweden.,Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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18
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Kuroda Y, Yang L, Lai S, Guo J, Sayo T, Takahashi Y, Tsuruta D, Katayama I. A Lower Irradiation Dose of 308 nm Monochromatic Excimer Light Might Be Sufficient for Vitiligo Treatment: A Novel Insight Gained from In Vitro and In Vivo Analyses. Int J Mol Sci 2021; 22:ijms221910409. [PMID: 34638746 PMCID: PMC8508796 DOI: 10.3390/ijms221910409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
A 308 nm monochromatic excimer light (MEL) is widely used to treat patients with vitiligo. However, dose optimization still needs to be clarified. This study aimed to obtain objective evidence regarding various doses of MEL irradiation, induced cell level changes in vitro, and skin level alterations in vivo. Cultured human keratinocytes were irradiated with MEL using various doses. After irradiation at low doses, stem cell factor, endothelin-1, and glycoprotein nonmetastatic melanoma protein B, factors that activate and protect melanocytes, were found to be significantly elevated in keratinocytes. After irradiation using medium and high doses, inflammatory cytokines were induced. The amount of ATP released and the level of inflammasome activation, which are known to be related to interleukin-1β activation, were also increased. The back skin of guinea pigs and mice were irradiated with MEL at varying doses. After irradiation, an increase of epidermal melanin and epidermal melanocytes was confirmed, using the minimal erythemal dose or less. In rhododendrol-induced leukoderma guinea pigs, a much lower dose of MEL irradiation was effective, when compared with the effective dose for control guinea pigs. Our results suggest that a lower irradiation dose of MEL might be sufficient and more suitable for repigmentation in vitiligo treatment.
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Affiliation(s)
- Yasutaka Kuroda
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
- Biological Science Research Laboratories, Kao Corporation, Odawara 2500002, Japan
| | - Lingli Yang
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
- Correspondence: ; Tel.: +81-6-6556-7618
| | - Sylvia Lai
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
| | - Jiao Guo
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
| | - Tetsuya Sayo
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
- Biological Science Research Laboratories, Kao Corporation, Odawara 2500002, Japan
| | - Yoshito Takahashi
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
- Biological Science Research Laboratories, Kao Corporation, Odawara 2500002, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka 5458585, Japan;
| | - Ichiro Katayama
- Department of Pigmentation Research and Therapeutics, Graduate School of Medicine, Osaka City University, Osaka 5450051, Japan; (Y.K.); (S.L.); (J.G.); (T.S.); (Y.T.); (I.K.)
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19
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D’Arino A, Picardo M, Truglio M, Pacifico A, Iacovelli P. Metabolic Comorbidities in Vitiligo: A Brief Review and Report of New Data from a Single-Center Experience. Int J Mol Sci 2021; 22:ijms22168820. [PMID: 34445526 PMCID: PMC8396221 DOI: 10.3390/ijms22168820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 12/21/2022] Open
Abstract
Among disorders of pigmentation, vitiligo is the most common, with an estimated prevalence between 0.5% and 1%. The disease has gathered increased attention in the most recent years, leading to a better understanding of the disease’s pathophysiology and its implications and to the development of newer therapeutic strategies. A better, more integrated approach is already in use for other chronic inflammatory dermatological diseases such as psoriasis, for which metabolic comorbidities are well-established and part of the routine clinical evaluation. The pathogenesis of these might be linked to cytokines which also play a role in vitiligo pathogenesis, such as IL-1, IL-6, TNF-α, and possibly IL-17. Following the reports of intrinsic metabolic alterations reported by our group, in this brief review, we analyze the available data on metabolic comorbidities in vitiligo, accompanied by our single-center experience. Increased awareness of the metabolic aspects of vitiligo is crucial to improving patient care.
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Affiliation(s)
- Andrea D’Arino
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.D.); (M.T.)
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.D.); (M.T.)
- Correspondence: ; Tel.: +39-0652666257
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.D.); (M.T.)
| | - Alessia Pacifico
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.P.); (P.I.)
| | - Paolo Iacovelli
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.P.); (P.I.)
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20
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Sivasaththivel M, Lee S, Gupta S. A Case of hypopigmented sarcoidosis masquerading as Vitiligo in a Caucasian individual. Australas J Dermatol 2021; 63:124-126. [PMID: 34398468 DOI: 10.1111/ajd.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Malini Sivasaththivel
- Department of Dermatology Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Senhong Lee
- Department of Dermatology Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Shally Gupta
- Department of Dermatology Northern Health, Northern Hospital, Epping, Victoria, Australia
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21
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Shah F, Patel S, Begum R, Dwivedi M. Emerging role of Tissue Resident Memory T cells in vitiligo: From pathogenesis to therapeutics. Autoimmun Rev 2021; 20:102868. [PMID: 34118458 DOI: 10.1016/j.autrev.2021.102868] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/20/2021] [Indexed: 02/07/2023]
Abstract
Vitiligo is an acquired depigmenting disorder which affects both skin and mucous membranes and autoimmunity has been strongly suggested to play a role in loss of melanocytes. The recurrence of skin macules at the same sites where they were observed prior to the treatment, suggests the existence of Tissue Resident Memory T cells (TRMs) that persist within the skin or peripheral tissues with a longer survivability. Emerging studies have shown that reactivation of these skin TRMs results into autoreactive TRM cells in various autoimmune diseases including vitiligo. This review focuses on different subsets (CD8+ TRMs and CD4+ TRMs) of TRM cells, their retention and survivability in the skin along with their pathomechanisms leading to melanocyte death and progression of vitiligo. In addition, the review describes the TRM cells as potential targets for developing effective therapeutics of vitiligo.
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Affiliation(s)
- Firdosh Shah
- C. G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Tarsadi, Surat 394350, Gujarat, India
| | - Shivani Patel
- C. G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Tarsadi, Surat 394350, Gujarat, India
| | - Rasheedunnisa Begum
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Mitesh Dwivedi
- C. G. Bhakta Institute of Biotechnology, Uka Tarsadia University, Tarsadi, Surat 394350, Gujarat, India.
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22
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Upadhyay PR, Ho T, Abdel-Malek ZA. Participation of keratinocyte- and fibroblast-derived factors in melanocyte homeostasis, the response to UV, and pigmentary disorders. Pigment Cell Melanoma Res 2021; 34:762-776. [PMID: 33973367 DOI: 10.1111/pcmr.12985] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022]
Abstract
Human epidermal melanocytes play a central role in sensing the environment and protecting the skin from the drastic effects of solar ultraviolet radiation and other environmental toxins or inflammatory agents. Melanocytes survive in the epidermis for decades, which subjects them to chronic environmental insults. Melanocytes have a poor self-renewal capacity; therefore, it is critical to ensure their survival with genomic stability. The function and survival of melanocytes is regulated by an elaborate network of paracrine factors synthesized mainly by epidermal keratinocytes and dermal fibroblasts. A symbiotic relationship exists between epidermal melanocytes and keratinocytes on the one hand, and between melanocytes and dermal fibroblasts on the other hand. Melanocytes protect epidermal keratinocytes and dermal fibroblasts from the damaging effects of solar radiation, and the latter cells synthesize biochemical mediators that maintain the homeostasis, and regulate the stress response of melanocytes. Disruption of the paracrine network results in pigmentary disorders, due to abnormal regulation of melanin synthesis, and compromise of melanocyte survival or genomic stability. This review provides an update of the current knowledge of keratinocyte- and fibroblast-derived paracrine factors and their contribution to melanocyte physiology, and how their abnormal production is involved in the pathogenesis of common pigmentary disorders.
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Affiliation(s)
- Parth R Upadhyay
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - Tina Ho
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Zalfa A Abdel-Malek
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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23
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Inoue S, Katayama I, Suzuki T, Tanemura A, Ito S, Abe Y, Sumikawa Y, Yoshikawa M, Suzuki K, Yagami A, Masui Y, Ito A, Matsunaga K. Rhododendrol-induced leukoderma update II: Pathophysiology, mechanisms, risk evaluation, and possible mechanism-based treatments in comparison with vitiligo. J Dermatol 2021; 48:969-978. [PMID: 33951216 PMCID: PMC8360127 DOI: 10.1111/1346-8138.15878] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/29/2021] [Accepted: 03/18/2021] [Indexed: 12/14/2022]
Abstract
A small proportion of individuals utilizing cosmetics containing rhododendrol developed leukoderma with various pathological conditions, in some cases indistinguishable from vitiligo. In this review, we investigate and evaluate the major considerations for developing rhododendrol‐induced leukoderma based on data from original or review articles published in the literature to provide a wide range of information regarding the pathophysiology, mechanisms, risk evaluation, and possible mechanism‐based treatments. We compile and discuss the latest information, including data related to the cytotoxicity of rhododendrol, cytoprotective functions, and involvement of the immune system, and consider the possibility of novel treatments based on the differences between individual patients and on the mechanism underlying the onset of the condition. Understanding the pathophysiology of rhododendrol‐induced leukoderma helps not only elucidate the mechanisms of non‐segmental vitiligo onset and progression, but also suggests prevention and treatment.
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Affiliation(s)
- Shintaro Inoue
- Department of Cosmetic Health Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Ichiro Katayama
- Department of Pigmentation Research and Therapeutics, Osaka City University, Osaka, Japan
| | - Tamio Suzuki
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Atsushi Tanemura
- Department of Dermatology Course of Integrated Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shosuke Ito
- Department of Chemistry, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Yuko Abe
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yasuyuki Sumikawa
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan.,Sumikawa Dermatology and Allergy Clinic, Sapporo, Japan
| | - Momoko Yoshikawa
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kayoko Suzuki
- Department of Allergology, Fujita Health University School of Medicine, Nagoya, Japan
| | - Akiko Yagami
- Department of Allergology, Fujita Health University School of Medicine, Nagoya, Japan
| | - Yukiko Masui
- Departent of Dermatology, Nagata Clinic, Niigata, Japan
| | - Akiko Ito
- Departent of Dermatology, Nagata Clinic, Niigata, Japan.,Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
| | - Kayoko Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
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Singh M, Mansuri MS, Kadam A, Palit SP, Dwivedi M, Laddha NC, Begum R. Tumor Necrosis Factor-alpha affects melanocyte survival and melanin synthesis via multiple pathways in vitiligo. Cytokine 2021; 140:155432. [PMID: 33517195 DOI: 10.1016/j.cyto.2021.155432] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
Tumor necrosis factor-α (TNF-α) is a major mediator of inflammation and its increased levels have been analyzed in vitiligo patients. Vitiligo is a depigmentary skin disarray caused due to disapperance of functional melanocytes. The aim of the study was to investigate the role of TNF-α in melanocyte biology, analyzing candidate molecules of melanocytes and immune homeostasis. Our results showed increased TNF-α transcripts in vitiligenous lesional and non-lesional skin. Melanocytes upon exogenous stimulation with TNF-α exhibited a significant reduction in cell viability with elevated cellular and mitochondrial ROS and compromised complex I activity. Moreover, we observed a reduction in melanin content via shedding of dendrites, down-regulation of MITF-M, TYR and up-regulation of TNFR1, IL6, ICAM1 expression, whereas TNFR2 levels remain unaltered. TNF-α exposure stimulated cell apoptosis at 48 h and autophagy at 12 h, elevating ATG12 and BECN1 transcripts. Our novel findings establish the functional link between autophagy and melanocyte destruction. Overall, our study suggests a key function of TNF-α in melanocyte homeostasis and autoimmune vitiligo pathogenesis.
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Affiliation(s)
- Mala Singh
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Mohmmad Shoab Mansuri
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Ashlesha Kadam
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Sayantani P Palit
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Mitesh Dwivedi
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Naresh C Laddha
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India
| | - Rasheedunnisa Begum
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara 390 002, Gujarat, India.
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25
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Pervaiz N, Kaur H, Parsad D, Kumar R. Immune-modulatory effects of lenalidomide inhibited the progression of lesions in a vitiligo mouse model. Pigment Cell Melanoma Res 2021; 34:918-927. [PMID: 33522688 DOI: 10.1111/pcmr.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/30/2020] [Accepted: 01/21/2021] [Indexed: 11/29/2022]
Abstract
Vitiligo, an autoimmune disorder, is associated with altered cytokine levels and T lymphocytes. Lenalidomide modulates immune system components by altering cytokine production and regulating T-cell stimulation. In this study, effect of lenalidomide was checked on the development of vitiligo lesions, level of various cytokines, and T lymphocytes in the mouse model. The vitiligo mouse model was developed by immunizing C57BL/6 mouse with anti-mouse tyrosine-related protein 2. Lenalidomide was orally given to mice daily, and the effect was observed on the development of vitiligo lesions. The level of T lymphocytes in blood was checked by flow cytometry. Serum cytokine levels were checked by enzyme-linked immunosorbent assay. Vitiligo lesions were found significantly smaller in lenalidomide-treated mice models. It significantly decreased the serum levels of IFN-γ, TNF-α, IL-1β, and IL-6 but elevated the levels of IL-4 and IL-10. It non-significantly elevated CD4+ /CD8+ T-cell ratio. Lenalidomide had an inhibitory effect on the development of vitiligo lesions in mice models by suppressing the serum level of pro-inflammatory cytokines and increasing anti-inflammatory cytokine levels. It modulated the immune response in vitiligo mice models toward an anti-inflammatory profile suggesting its use in the management of vitiligo.
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Affiliation(s)
- Naveed Pervaiz
- Department of Zoology, Panjab University, Chandigarh, India
| | - Harjot Kaur
- Department of Zoology, Panjab University, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravinder Kumar
- Department of Zoology, Panjab University, Chandigarh, India
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26
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Mukhatayev Z, Ostapchuk YO, Fang D, Le Poole IC. Engineered antigen-specific regulatory T cells for autoimmune skin conditions. Autoimmun Rev 2021; 20:102761. [PMID: 33476816 DOI: 10.1016/j.autrev.2021.102761] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 12/15/2022]
Abstract
Regulatory T cells (Tregs) are a subset of T cells responsible for the regulation of immune responses, thereby maintaining immune homeostasis and providing immune tolerance to both self and non-self-antigens. An increasing number of studies revealed Treg numbers and functions in a variety of autoimmune diseases. Treg deficiency can cause the development of several autoimmune skin diseases including vitiligo, alopecia areata, pemphigoid and pemphigus, psoriasis, and systemic sclerosis. Many clinical trials have been performed for autoimmune conditions using polyclonal Tregs, but efficiency can be significantly improved using antigen-specific Tregs engineered using T cell receptor (TCR) or chimeric antigen receptor (CAR) constructs. In this review, we systematically reviewed altered frequencies, impaired functions, and phenotypic features of Tregs in autoimmune skin conditions. We also summarized new advances in TCR and CAR based antigen-specific Tregs tested both in animal models and in clinics. The advantages and limitations of each approach were carefully discussed emphasizing possible clinical relevance to patients with autoimmune skin diseases. Moreover, we have reviewed potential approaches for engineering antigen-specific Tregs, and strategies for overcoming possible hurdles in clinical applications. Thereby, antigen-specific Tregs can be infused using autologous adoptive cell transfer to restore Treg numbers and to provide local immune tolerance for autoimmune skin disorders.
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Affiliation(s)
- Zhussipbek Mukhatayev
- Department of Dermatology, Northwestern University, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA; Department of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty, Kazakhstan; M.A. Aitkhozhin's Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | | | - Deyu Fang
- Department of Pathology, Northwestern University, Chicago, IL, USA
| | - I Caroline Le Poole
- Department of Dermatology, Northwestern University, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.
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27
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Seneschal J, Boniface K, D'Arino A, Picardo M. An update on Vitiligo pathogenesis. Pigment Cell Melanoma Res 2020; 34:236-243. [PMID: 33278065 DOI: 10.1111/pcmr.12949] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
Vitiligo, the most common depigmenting disorder of the skin, is undergoing a period of intense advances in both disease understanding and therapeutic possibilities leading the way to the beginning of a new era for the disorder. Its pathophysiology has gathered the attention of researchers for years, and many advances have been made in the clarification of the interaction between different factors that result in depigmented macule formation. The complex interplay between non-immunological and immunological factors in vitiligo is key for the development of the disease, and the participation of cells other than melanocytes, such as keratinocytes, fibroblasts, natural killer cells, and innate lymphoid cells, has been shown. Recent advances have also brought to the understanding of the complex part played by a specific subtype of T cells: T-resident memory cells. This review analyzes some of the most recent insights in vitiligo pathogenesis underlining the interactions between different cell types, which are the basis for the therapeutic approaches under development.
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Affiliation(s)
- Julien Seneschal
- INSERM U1035, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers (BMGIC), Immunodermatology ATIP-AVENIR, University of Bordeaux, FHU ACRONIM, Bordeaux, France.,Department of Dermatology and Pediatric Dermatology and National Reference Center for Rare Skin Disorders, Hôpital Saint-André, Bordeaux, France
| | - Katia Boniface
- INSERM U1035, Biotherapy of Genetic Diseases, Inflammatory Disorders and Cancers (BMGIC), Immunodermatology ATIP-AVENIR, University of Bordeaux, FHU ACRONIM, Bordeaux, France
| | - Andrea D'Arino
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Mauro Picardo
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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28
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Pervaiz N, Kaur H, Parsad D, Kumar R. Immune modulatory effects of lenalidomide on the cultured peripheral blood mononuclear cells from vitiligo patients. Dermatol Ther 2020; 33:e14473. [PMID: 33124184 DOI: 10.1111/dth.14473] [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: 07/07/2020] [Revised: 09/30/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022]
Abstract
Vitiligo is a depigmentary disease in which epidermal melanocytes are lost. It is considered to be an autoimmune disease. Lenalidomide, an immunomodulatory drug is being employed in the treatment of various autoimmune and inflammatory disorders. In the present manuscript, the effect of lenalidomide on T cells and major cytokines in the cultured peripheral blood mononuclear cells (PBMCs) derived from vitiligo patients was checked. Eight patients with a clinical diagnosis of active vitiligo volunteered for the study. Blood was collected from them and PBMCs were isolated, cultured, and treated with lenalidomide. After 72 hours, PBMCs were harvested and checked for CD8+ and CD4+ T cells by flow cytometry. Further supernatant was collected and the levels of cytokines namely tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-10 (IL-10), and interleukin-4 (IL-4) were checked using ELISA kits. Lenalidomide nonsignificantly decreased the level of CD8+ T cells but increased CD4+ T cells leading to increased CD4+ /CD8+ T cell ratio. It declined the level of pro-inflammatory cytokines, that is, TNF-α and IFN-γ whereas elevated anti-inflammatory cytokines, that is, IL-10 and IL-4, thus ultimately decreasing the ratio of pro-inflammatory to anti-inflammatory cytokines. Lenalidomide suppressed the proliferation of T lymphocytes and modulated the cytokines secretion toward an anti-inflammatory profile.
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Affiliation(s)
- Naveed Pervaiz
- Department of Zoology, Panjab University, Chandigarh, India
| | - Harjot Kaur
- Department of Zoology, Panjab University, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravinder Kumar
- Department of Zoology, Panjab University, Chandigarh, India
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29
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Yu H, Lin X, Cen J, Cheng H, Seifert O. Increased expression of Toll-like receptor 7 and 9 in vitiligo melanocytes: a pilot study. Clin Exp Dermatol 2020; 46:89-95. [PMID: 32945011 DOI: 10.1111/ced.14374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/10/2020] [Accepted: 07/09/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Toll-like receptors (TLRs) are expressed on human melanocytes, and play an important role in innate and acquired immunity. The role of TLRs in the pathogenesis of vitiligo has not been fully described. AIM To investigate the expression of TLRs in melanocytes from patients with vitiligo and healthy controls (HCs). METHODS Primary cultured vitiligo and control melanocytes were obtained from perilesional normal skin of patients with generalized vitiligo and HCs. TLRs mRNA expression in melanocytes were determined by real-time reverse transcription PCR and protein expression by western blotting. Apoptosis was analysed using an annexin V-fluorescein isothiocyanate apoptosis detection kit, and tyrosinase activity and melanin content were measured by a modified dopachrome and colorimetric method. Interleukin (IL)-6, IL-8 and soluble cell adhesion molecule (sICAM)-1 expression were measured by ELISA. RESULTS In vitiligo melanocytes, compared with control melanocytes, apoptosis rate, expression of TLR7 and TLR9 mRNA and protein, and production of IL-8, IL-6 and sICAM-1 were significantly increased, whereas tyrosinase activity and melanin content were significantly decreased. CONCLUSIONS Our results suggest that the increased expression of TLR7 and TLR9 might correlate with melanocyte dysfunction in vitiligo.
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Affiliation(s)
- H Yu
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, China
| | - X Lin
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, China
| | - J Cen
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, China
| | - H Cheng
- Department of Dermatology, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, China
| | - O Seifert
- Division of Dermatology and Venereology, Ryhov Hospital, Jönköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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30
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Singh M, Jadeja SD, Vaishnav J, Mansuri MS, Shah C, Mayatra JM, Shah A, Begum R. Investigation of the Role of Interleukin 6 in Vitiligo Pathogenesis. Immunol Invest 2020; 51:120-137. [PMID: 32865069 DOI: 10.1080/08820139.2020.1813756] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Interleukin-6 (IL6) is involved in pathogenesis of several autoimmune disorders including vitiligo. Hence, we aimed to investigate the association of IL6 -174 G/C and -572 G/C polymorphisms and its transcript levels with vitiligo; to evaluate the effect of IL-6 on normal human melanocyte (NHM) viability and expression of IL6R, MITF and TYR. IL6 -174 G/C and -572 G/C polymorphisms were genotyped by ARMS-PCR and PCR-RFLP respectively in 343 controls and 322 vitiligo patients. IL6 transcript levels were estimated from PBMCs (96 controls and 77 patients) and skin samples (15 controls and 15 patients) by qPCR. NHM viability was assessed by MTT; IL6R, MITF and TYR transcript and protein levels were monitored by qPCR and ICC respectively. Genetic analyses revealed no association of IL6 -174 G/C polymorphism (p> .05) with vitiligo. Analysis of IL6 -572 G/C revealed reduced risk of vitiligo in individuals with GC/CC genotypes compared to GG genotype (p = .010). IL6 expression was significantly increased (p = .0197) in PBMCs of patients. Further, IL6 expression was significantly higher in non-lesional skin compared to controls (p = .009). In-vitro NHM viability was decreased upon IL-6 exposure (10-50 ng/ml; p< .05), with significantly increased IL6R transcript (p = .042) and protein levels (p = .003) however, MITF transcript (p = .0003) and protein levels (p = .016), and TYR transcript levels (p = .001) were significantly decreased. The results suggest that IL6 -572 G/C polymorphism might be associated with vitiligo susceptibility in Gujarat population. Moreover, increased IL6 expression in vitiligo patients and its effect on NHM suggest a potential role in melanocyte biology. CONCLUSION The results suggest that IL6 - 572 G/C polymorphism might be associated with vitiligo susceptibility in Gujarat population. Moreover, increased IL6 expression in vitiligo patients and its effect on NHM suggest a potential role in melanocyte biology.
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Affiliation(s)
- Mala Singh
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
| | - Shahnawaz D Jadeja
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
| | - Jayvadan Vaishnav
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
| | - Mohmmad Shoab Mansuri
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
| | - Chandni Shah
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
| | - Jay M Mayatra
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
| | - Atul Shah
- Department of Reconstructive Surgery, Solace Hospital, Vadodara, India
| | - Rasheedunnisa Begum
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Gujarat, Vadodara, India
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31
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Bellei B, Papaccio F, Filoni A, Caputo S, Lopez G, Migliano E, Picardo M. Extracellular fraction of adipose tissue as an innovative regenerative approach for vitiligo treatment. Exp Dermatol 2020; 28:695-703. [PMID: 31066942 DOI: 10.1111/exd.13954] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 04/15/2019] [Accepted: 04/29/2019] [Indexed: 12/26/2022]
Abstract
Vitiligo is a common, disfiguring autoimmune disease that negatively affects patients' self-esteem and quality of life. Current treatments are moderately effective in reversing disease and promoting melanocyte regeneration. Thus, therapeutic advanced strategies are emerging from regenerative medicine. It has recently emerged that adipose tissue secretome may be used as a cell-free therapy in skin regeneration since paracrine functions of adipose-derived stem cells alone are responsible for most of the therapeutic effect of stem cells in several animal disease models. In this study, we tested the effect of adipose tissue extracellular fraction (AT-Ex) isolated from lipoaspirates on dermal and epidermal vitiligo cells in vitro. Using this experimental model, we demonstrated that molecules secreted by adipose tissue ameliorate the capability to counteract oxidative stress by a physiological stimulation of intracellular antioxidant enzymes and positively impact on cell proliferation. Due to the presence of Wnt-secreted factors, AT-Ex treatment promotes glycogen synthase kinase 3β inactivation and consequently Wnt/β-catenin pathway activation. Collectively, our findings show that AT-Ex could be useful as a natural approach to improve treatment of vitiligo.
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Affiliation(s)
- Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Federica Papaccio
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Angela Filoni
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Silvia Caputo
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Gianluca Lopez
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Emilia Migliano
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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32
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Srivastava DSL, Aggarwal K, Singh G. Is NAT2 Gene Polymorphism Associated with Vitiligo? Indian J Dermatol 2020; 65:173-177. [PMID: 32565555 PMCID: PMC7292445 DOI: 10.4103/ijd.ijd_388_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: N-acetyltransferase-2 (NAT2) is a phase II xenobiotic enzyme that plays an important role against oxidative stress-mediated reactive oxygen species protection. Polymorphism in specific genotypes of NAT2 may lead to increase an imbalance in antioxidant systems and may influence the pathogenesis of vitiligo. We conducted this study to see the association between NAT2 gene polymorphism and risk of vitiligo. We looked into whether single-nucleotide polymorphisms (SNP) at positions 857, 481 and 590 of the coding region of the NAT2 gene play as a risk factor for vitiligo among north Indian people. Methods: In this study, we assessed 100 patients with vitiligo and 160 healthy individuals as controls. Genomic DNA was extracted from human peripheral blood and polymerase chain reaction–restricted fragment length polymorphism was done to identify the single nucleotide polymorphism at positions 857, 481, and 590 of the coding region of the NAT2 gene. Results: In this study, we observed a significant higher risk with slow acetylator genotypes of NAT2 (OR = 2.85; 95% CI = 1.68-4.84, P value < 0.001) for the vitiligo. Furthermore, in the association between NAT2 acetylator genotypes with percentage of body surface area (BSA) of disease, we observed that slow acetylator genotypes of NAT2 has significant higher risk with low grade of disease (1%–10% >11%–30% >30% of BSA). Limitations: A major limitation of this study was the small sample size and warrants further investigation on a large epidemiological study to confirm these findings. Conclusions: Our preliminary data indicate that NAT2 slow acetylator genotype exhibits significant association for the risk of vitiligo, especially in disease predisposition and initiation.
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Affiliation(s)
- Daya Shankar Lal Srivastava
- Department of BTMM and Biochemistry, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Kamal Aggarwal
- Department of Skin and VD, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Gajendra Singh
- College of Pharmacy, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India
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33
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Abstract
Phototherapeutic modalities induce apoptosis of keratinocytes and immune cells, impact cytokine production, downregulate the IL-23/Th17 axis, and induce regulatory T cells. As in anti-IL-17 or anti-IL-23 antibody treatment, the dual action of phototherapy on skin and the immune system is likely responsible for sustained resolution of lesions in diseases such as psoriasis. In cutaneous T cell lymphoma, phototherapy may function by causing tumor cell apoptosis and eliminating the neoplastic and inflammatory infiltrate. Further research on phototherapeutic mechanisms will help advance, optimize, and refine dermatologic treatments and may open up novel avenues for treatment strategies in dermatology and beyond.
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Affiliation(s)
- Zizi Yu
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Peter Wolf
- Department of Dermatology, Research Unit for Photodermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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34
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Anthony N, Bourneau-Martin D, Ghamrawi S, Lagarce L, Babin M, Briet M. Drug-induced vitiligo: a case/non-case study in Vigibase ® , the WHO pharmacovigilance database. Fundam Clin Pharmacol 2020; 34:736-742. [PMID: 32246859 DOI: 10.1111/fcp.12558] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/26/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023]
Abstract
Vitiligo is a common depigmenting disorder ensuing the loss of epidermal melanocytes. It is a multifactorial disease with immunological, genetic and environmental factors including drug exposure. The purpose of the study was to investigate the drugs and therapeutic subclasses associated with vitiligo occurrence reported in VigiBase® , the WHO pharmacovigilance database. A case/non-case study was carried out by defining cases as vitiligo reports and non-cases as all other reports. The reporting odds ratio (ROR) was calculated for the 'suspected' drugs and drug classes according to ATC level 4. During the study period, 741 cases of vitiligo were registered. Mean age was 49 ± 20 years. The disproportionality analysis showed an association between vitiligo and pembrolizumab (ROR 116.9, 95% Confidence Interval (CI) 94.8, 144.3), nivolumab (ROR 22.6, 95% CI 15.8, 32.4), ipilimumab (ROR 41.7, 95% CI 25.0, 69.7), imiquimod (ROR 152.8, 95% CI 103.0, 226.7), adalimumab (ROR 3.8, 95% CI 2.5,5.8), infliximab (ROR 2.6, 95% CI 1.65, 4.01), alemtuzumab (ROR 27.8, 95% CI 17.6, 43.9), and ustekinumab (ROR 9.3, 95% CI 5.6, 15.6). Concerning the pharmacological classes ATC level 4, a significant association was found with monoclonal antibodies, interferons, selective immunosuppressants, TNF-alpha inhibitors, interleukin inhibitors, and topical antivirals. This study confirmed the expected associations between vitiligo and immune checkpoint inhibitors and strengthened the emerging signal about the association between vitiligo and imiquimod, TNF-alpha inhibitors and interferons. New signals were shown with selective immunosuppressants including alemtuzumab and interleukin inhibitors.
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Affiliation(s)
- Norah Anthony
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre hospitalo-Universitaire d'Angers, 4 rue larrey, 49100, Angers, France
| | - Delphine Bourneau-Martin
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre hospitalo-Universitaire d'Angers, 4 rue larrey, 49100, Angers, France
| | - Sarah Ghamrawi
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre hospitalo-Universitaire d'Angers, 4 rue larrey, 49100, Angers, France
| | - Laurence Lagarce
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre hospitalo-Universitaire d'Angers, 4 rue larrey, 49100, Angers, France
| | - Marina Babin
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre hospitalo-Universitaire d'Angers, 4 rue larrey, 49100, Angers, France
| | - Marie Briet
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre hospitalo-Universitaire d'Angers, 4 rue larrey, 49100, Angers, France.,Université d'Angers, Angers, France.,Laboratoire MitoVasc, UMR CNRS 6214 INSERM 1083, Angers, France
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35
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Abdel-Malek ZA, Jordan C, Ho T, Upadhyay PR, Fleischer A, Hamzavi I. The enigma and challenges of vitiligo pathophysiology and treatment. Pigment Cell Melanoma Res 2020; 33:778-787. [PMID: 32198977 DOI: 10.1111/pcmr.12878] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/03/2020] [Accepted: 03/12/2020] [Indexed: 12/20/2022]
Abstract
Vitiligo is the most common acquired pigmentary disorder, which afflicts 0.5%-1% of the world population, and is characterized by depigmented skin patches resulting from melanocyte loss. Vitiligo has a complex etiology and varies in its manifestations, progression, and response to treatment. It presents as an autoimmune disease, evidenced by circulating melanocyte-specific antibodies, and association with other autoimmune diseases. However, autoimmunity may be secondary to the high oxidative stress in vitiligo skin and to intrinsic defects in melanocytes and their microenvironment, which contribute to aberrant stress response, neo-antigenicity, and susceptibility of melanocytes to immune attack and apoptosis. There is also a genetic predisposition to vitiligo, which sensitizes melanocytes to environmental agents, such as phenolic compounds. Currently, there are different treatment modalities for re-pigmenting vitiligo skin. However, when repigmentation is achieved, the major challenge is maintaining the pigmentation, which is lost in 40% of cases. In this review, we present an overview of the clinical aspects of vitiligo, its pathophysiology, the intrinsic defects in melanocytes and their microenvironment, and treatment strategies. Based on lessons from the biology of human melanocytes, we present our perspective of how repigmentation of vitiligo skin can be achieved and sustained.
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Affiliation(s)
| | - Christian Jordan
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio
| | - Tina Ho
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio
| | - Parth Rajendrakumar Upadhyay
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio.,Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
| | - Alan Fleischer
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio
| | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan
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Aida Maranduca M, Liliana Hurjui L, Constantin Branisteanu D, Nicolae Serban D, Elena Branisteanu D, Dima N, Lacramioara Serban I. Skin - a vast organ with immunological function (Review). Exp Ther Med 2020; 20:18-23. [PMID: 32508987 DOI: 10.3892/etm.2020.8619] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 02/12/2020] [Indexed: 02/06/2023] Open
Abstract
The skin is an organ with multiple functions, where important inflammatory and immunological processes take place. The integrity of the skin barrier is necessary for it to fulfill its roles. An intact skin barrier requires a physiological keratinization process, but also a normal cutaneous microbial flora. Any change in the proliferation and differentiation of keratinocytes entails the disruption of the skin barrier and the triggering of inflammatory and immunological processes at this level, in response to the aggression of external pathogens. Also, there are several specialised immune cells in the skin (Langerhans cells, T regulator cells, T helper cells), that maintain a balance between pro-inflammatory and anti-inflammatory processes at this level. Disturbing the immune homeostasis causes inflammation and allergic skin reaction. Psoriasis and atopic dermatitis are two inflammatory diseases of the skin, characterized by perturbation of the mechanisms of skin barrier formation. The immune system of the skin is also involved in the pathophysiology of vitiligo and pemphigus. The aim of this review is to offer a brief presentation of the inflammatory and immunological processes that occur in the skin.
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Affiliation(s)
- Minela Aida Maranduca
- Department of Physiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Loredana Liliana Hurjui
- Department of Physiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Dragomir Nicolae Serban
- Department of Physiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daciana Elena Branisteanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Nicoleta Dima
- Department of Internal Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ionela Lacramioara Serban
- Department of Physiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Rajendiran KS, Rajappa M, Chandrashekar L, Thappa DM, Devaraju P. Association Analysis of Tumor Necrosis Factor Alpha Promoter Polymorphisms and Vitiligo Susceptibility in South Indian Tamils. Dermatology 2020; 236:554-564. [PMID: 32074604 DOI: 10.1159/000505544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/19/2019] [Indexed: 11/19/2022] Open
Abstract
Tumor necrosis factor alpha (TNF-α) has been associated with the pathogenesis of several autoimmune diseases. Also, various studies in different ethnics showed an association between TNF-α gene polymorphisms and susceptibility to vitiligo. The paucity of genetic data led us to undertake this study to evaluate the association of five TNF-α SNPs (rs1799964, rs1800630, rs1799724, rs1800629, and rs361525) with the development of vitiligo in South Indian Tamils. A total of 264 vitiligo patients and 264 healthy controls were recruited and TNF-α genotyping was performed using amplification-refractory mutation system polymerase chain reaction and TaqMan allele discrimination assay. Circulatory TNF-α levels were measured by enzyme-linked immunosorbent assay. We observed that a single polymorphic allele A in the promoter region -308 (rs1800629) conferred significant risk to develop vitiligo (p = 0.0002, OR = 1.70, 95% CI = 1.28-2.25), whereas the other polymorphisms failed to contribute to disease risk (p > 0.05). From the constructed haplotypes, TCCAG was found to be a significant risk factor for vitiligo (p < 0.05). Also, a strong linkage disequilibrium was observed between the following SNPs: (1) rs1799964 and rs1800629 (2) rs1800630 and rs1799724 (D' = 0.90). Analysis of the influence of genotype on phenotypes revealed that the A allele of rs361525 was a risk factor for vitiligo in females (p = 0.04, OR = 0.45, 95% CI = 0.21-0.95), whilst the rs1800629 allele conferred protection against early disease onset (p < 0.05). A statistically significant difference in plasma TNF-α levels was found between cases and controls (p < 0.05). The TNF-α -308A allele and TCCAG haplotype were identified as genetic risk factors for vitiligo susceptibility in South Indian Tamils.
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Affiliation(s)
- Kalai Selvi Rajendiran
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Medha Rajappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Laxmisha Chandrashekar
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India,
| | - Devinder Mohan Thappa
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Panneer Devaraju
- Unit of Microbiology and Molecular Biology, Indian Council of Medical Research-Vector Control Research Centre, Puducherry, India
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Fu C, Chen J, Lu J, Yi L, Tong X, Kang L, Pei S, Ouyang Y, Jiang L, Ding Y, Zhao X, Li S, Yang Y, Huang J, Zeng Q. Roles of inflammation factors in melanogenesis (Review). Mol Med Rep 2020; 21:1421-1430. [PMID: 32016458 PMCID: PMC7002987 DOI: 10.3892/mmr.2020.10950] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 09/24/2019] [Indexed: 12/12/2022] Open
Abstract
The occurrence of hyperpigmentation or hypopigmentation after inflammation is a common condition in dermatology and cosmetology. Since the exact mechanism of its occurrence is not yet known, prevention and treatment are troublesome. Previous studies have confirmed that α-melanocyte-stimulating hormone, stem cell factor and other factors can promote melanogenesis-related gene expression through the activation of signaling pathways. Recent studies have revealed that a variety of inflammatory mediators can also participate in the regulation of melanogenesis in melanocytes. In this review, we summarized that interleukin-18, interleukin-33, granulocyte-macrophage colony stimulating factor, interferon-γ, prostaglandin E2 have the effect of promoting melanogenesis, while interleukin-1, interleukin-4, interleukin-6, interleukin-17 and tumor necrosis factor can inhibit melanogenesis. Further studies have found that these inflammatory factors may activate or inhibit melanogenesis-related signaling pathways (such as protein kinase A and mitogen activated protein kinase) by binding to corresponding receptors, thereby promoting or inhibiting the expression of melanogenesis-related genes and regulating skin pigmentation processes. This suggests that the development of drugs or treatment methods from the perspective of regulating inflammation can provide new ideas and new targets for the treatment of pigmented dermatosis. This review outlines the current understanding of the inflammation factors' roles in melanogenesis.
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Affiliation(s)
- Chuhan Fu
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Jing Chen
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Jianyun Lu
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Lu Yi
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Xiaoliang Tong
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Liyang Kang
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Shiyao Pei
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Yujie Ouyang
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Ling Jiang
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Yufang Ding
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Xiaojiao Zhao
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Si Li
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Yan Yang
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Jinhua Huang
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Qinghai Zeng
- Department of Dermatology, Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
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The impact of NBUVB on microbial community profiling in the lesional skin of vitiligo subjects. Microb Pathog 2020; 140:103943. [PMID: 31917273 DOI: 10.1016/j.micpath.2019.103943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/10/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The impact of NBUVB on the cutaneous microbiota of vitiligo patients remains to be fully elucidated. METHODS To characterize the cutaneous microbiota in vitiligo patients, cutaneous samples from 60 patients with vitiligo and after NBUVB irradiation were profiled using the Illumina MiSeq platform. Alpha diversity estimations revealed higher microbiota diversity in samples from patients with lesional skin. Beta diversity (Principal Component Analysis (PCA)) analysis showed that the bacterial community structure segregated differently between different groups. RESULTS There was a statistically significant increase in the Sobs, ACE, and Chao indices in the NB group compared with NF group, as determined by t-test. The alpha diversity have no significant difference between NF and DB group. At the phylum level, Firmicutes, Proteobacteria and Actinobacteria were the most predominant phyla. Propionibacterium and Pseudomonas were the most predominant genera in each group. In addition, Staphylococcus, Bacillus and Prevotella were enriched in DF group compared to DB group. Propionibacterium was enriched in DB group compared to DF group. CONCLUSIONS Our studies indicate differences in microbial community dynamics of the lesional and non-lesional sites of vitiligo subjects, with greater diversity and higher association between microbial communities of the unaffected site. And NBUVB irradiation might eliminate these differences.
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Jimbo H, Nagai H, Fujiwara S, Shimoura N, Nishigori C. Fas-FasL interaction in cytotoxic T cell-mediated vitiligo: The role of lesional expression of tumor necrosis factor-α and interferon-γ in Fas-mediated melanocyte apoptosis. Exp Dermatol 2019; 29:61-70. [PMID: 31675451 DOI: 10.1111/exd.14053] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/22/2022]
Abstract
Vitiligo is an acquired skin depigmentation disorder resulting from the selective loss of epidermal melanocytes, and previous studies have suggested that a T lymphocyte-mediated mechanism has a role in melanocyte loss. Although Fas-Fas ligand (FasL) interactions are important for T lymphocytes to mediate cytotoxicity, there are only few reports examining the involvement of the Fas-FasL pathway in vitiligo using in vivo mouse models. In addition, there have been no reports concerning Fas-mediated apoptosis in human melanocytes in vitro. In this study, we found that the Fas-mediated pathway is involved in cytotoxic T lymphocyte (CTL)-dependent vitiligo in a mouse model and FasL-induced apoptosis of human melanocytes. Tumor necrosis factor (TNF)-α and interferon (IFN)-γ, the expression levels of which have been reported to be elevated in lesional skin of patients with vitiligo, synergistically upregulated Fas expression on human melanocytes but inhibited the Fas-mediated apoptosis. Treatment with TNF-α and IFN-γ synergistically upregulated the expression of the anti-apoptotic genes, c-IAP2, c-FLIP and MCL1. A siRNA knock-down study showed that c-FLIP and MCL1, but not c-IAP2, were involved in inducing synergistic inhibitory effects on Fas-mediated apoptosis. Furthermore, we found that FasL and TNF-related apoptosis-inducing ligand (TRAIL) synergistically induced apoptosis on human melanocytes. In conclusion, our results suggest that the Fas-FasL pathway is involved in CTL-dependent vitiligo and the elevated expression levels of TNF-α and IFN-γ in lesional skin may act synergistically on melanocytes to suppress Fas-mediated apoptosis.
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Affiliation(s)
- Haruki Jimbo
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Nagai
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Susumu Fujiwara
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noriko Shimoura
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chikako Nishigori
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
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Zhang B, Li T, Tang Y, Lin M, Tu C, Lang Y, Zhang D, Feng D. The effects of 308-nm excimer laser on the infiltration of CD4+, CD8+ T-cells, and regulatory T cells in the lesional skin of patients at active and stable stages of nonsegmental vitiligo. J DERMATOL TREAT 2019; 32:580-584. [PMID: 31670995 DOI: 10.1080/09546634.2019.1687825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND To explore the associations between this treatment and CD4+, CD8+ T-cells, and regulatory T cells (Treg). METHODS We collected the skin biopsies from 295 patients with nonsegmental vitiligo treated with or without 308-nm excimer laser. We revealed that patients at stable stage showed a better response to 308-nm excimer laser than those at active stage. RESULTS In comparison with untreated patients, CD4+ and CD8+ T cells were both reduced while Foxp3+ Treg cells, TGF-β, and IL-10 were elevated in the lesional sites of patients who showed effective reaction to the treatment. In the treated patients at active stage, the infiltration of CD4+ and CD8+ T cells was significantly declined but Foxp3+ Treg cells, TGF-β, and IL-10 were increased compared to those in untreated patients at active stage. These changes of cell infiltration were more obvious in the treated patients at stable stage, explaining why there were more patients at stable stage response better than patients at active stage. CONCLUSIONS 308-nm excimer laser is effective to reduce the infiltration of CD4+ and CD8+ T cells but promote the infiltration Treg cells and secretion of TGF-β and IL-10 in the lesion skin of vitiligo patients, especially at stable stage.
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Affiliation(s)
- Baoxiang Zhang
- Department of Dermatology, Yidu Central Hospital, Weifang Medical University, Qingzhou, China
| | - Tingting Li
- Department of Dermatology, Yidu Central Hospital, Weifang Medical University, Qingzhou, China
| | - Yuanyuan Tang
- Department of Division of Rheumatology, Yidu Central Hospital, Weifang Medical University, Qingzhou, China
| | - Mao Lin
- Department of Dermatology, Chongqing Chinese Medicine Hospital, Chongqing, China
| | - Caixia Tu
- Department of Dermatology, The 2nd Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yong Lang
- Department of Dermatology, Gaomi People's Hospital, Gaomi, China
| | - Diancai Zhang
- Department of Dermatology, Yidu Central Hospital, Weifang Medical University, Qingzhou, China
| | - Dianqin Feng
- Department of Dermatology, Yidu Central Hospital, Weifang Medical University, Qingzhou, China
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Malhotra AG, Singh S, Jha M, Pandey KM. A Parametric Targetability Evaluation Approach for Vitiligo Proteome Extracted through Integration of Gene Ontologies and Protein Interaction Topologies. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2019; 16:1830-1842. [PMID: 29994537 DOI: 10.1109/tcbb.2018.2835459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Vitiligo is a well-known skin disorder with complex etiology. Vitiligo pathogenesis is multifaceted with many ramifications. A computational systemic path was designed to first propose candidate disease proteins by merging properties from protein interaction networks and gene ontology terms. All in all, 109 proteins were identified and suggested to be involved in the onset of disease or its progression. Later, a composite approach was employed to prioritize vitiligo disease proteins by comparing and benchmarking the properties against standard target identification criteria. This includes sequence-based, structural, functional, essentiality, protein-protein interaction, vulnerability, secretability, assayability, and druggability information. The existing information was seamlessly integrated into efficient pipelines to propose a novel protocol for assessment of targetability of disease proteins. Using the online data resources and the scripting, an illustrative list of 68 potential drug targets was generated for vitiligo. While this list is broadly consistent with the research community's current interest in certain specific proteins, and suggests novel target candidates that may merit further study, it can still be modified to correspond to a user-specific environment, either by adjusting the weights for chosen criteria (i.e., a quantitative approach) or by changing the considered criteria (i.e., a qualitative approach).
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Li L, Ma Q, Li H. Effect of vitiligo treatment using compound glycyrrhizin combined with fractional carbon dioxide laser and topical triamcinolone acetonide on serum interleukin-17 and tissue growth factor- β levels. J Int Med Res 2019; 47:5623-5631. [PMID: 31550958 PMCID: PMC6862872 DOI: 10.1177/0300060519871382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective Vitiligo is a common pigmentation disorder of the skin, and its pathogenesis remains unclear. We evaluated the effectiveness of compound glycyrrhizin combined with fractional carbon dioxide (CO2) laser and triamcinolone acetonide solution in patients with vitiligo. Methods Patients with stable vitiligo treated at our hospital between May 2016 and August 2017 were randomized to a control group or an observation group. Both groups were treated with fractional CO2 laser and triamcinolone acetonide solution, while the observation group also received compound glycyrrhizin. Clinical effectiveness, serum IL-17 and TGF-β levels, and adverse drug reactions were compared between the groups. Results Following treatment, the clinical effective rate was significantly higher in the observation group than in the control group (75.00% vs. 52.50%). Furthermore, IL-17 decreased in both groups but was significantly lower in the observation group, while TGF-β increased in both groups but was significantly higher in the observation group. The incidence of adverse drug reactions was not significantly different between the groups. Conclusion Compound glycyrrhizin in combination with fractional CO2 laser and triamcinolone acetonide solution can be used to treat vitiligo and appears to modulate cytokine levels. Trial registration: Hebei Provincial Administration of Traditional Chinese Medicine (no. 2019366; http://www.hebwst.gov.cn/index.do?templet=cs_zyj)
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Affiliation(s)
- Ling Li
- Department of Dermatology, Baoding First Central Hospital, Baoding, Hebei, China
| | - Qiushuang Ma
- Department of Dermatology, Baoding First Central Hospital, Baoding, Hebei, China
| | - Haiyan Li
- Department of Dermatology, Baoding First Central Hospital, Baoding, Hebei, China
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Bastonini E, Bellei B, Filoni A, Kovacs D, Iacovelli P, Picardo M. Involvement of non‐melanocytic skin cells in vitiligo. Exp Dermatol 2019; 28:667-673. [DOI: 10.1111/exd.13868] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/23/2018] [Accepted: 12/19/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Emanuela Bastonini
- Cutaneous Physiopathology and Integrated Center of Metabolomics ResearchSan Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Barbara Bellei
- Cutaneous Physiopathology and Integrated Center of Metabolomics ResearchSan Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Angela Filoni
- Cutaneous Physiopathology and Integrated Center of Metabolomics ResearchSan Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Daniela Kovacs
- Cutaneous Physiopathology and Integrated Center of Metabolomics ResearchSan Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Paolo Iacovelli
- Cutaneous Physiopathology and Integrated Center of Metabolomics ResearchSan Gallicano Dermatological Institute, IRCCS Rome Italy
| | - Mauro Picardo
- Cutaneous Physiopathology and Integrated Center of Metabolomics ResearchSan Gallicano Dermatological Institute, IRCCS Rome Italy
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Sushama S, Dixit N, Gautam RK, Arora P, Khurana A, Anubhuti A. Cytokine profile (IL-2, IL-6, IL-17, IL-22, and TNF-α) in vitiligo-New insight into pathogenesis of disease. J Cosmet Dermatol 2019; 18:337-341. [PMID: 29504235 DOI: 10.1111/jocd.12517] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune disease associated with alteration in levels of various cytokines. However, there are very few studies in this regard. OBJECTIVES To assess the serum levels of cytokines secreted by Th1 (IL-2, TNF-α), Th2 (IL-6), and Th17 cells (IL-17, IL-22) in patients with localized vitiligo and generalized vitiligo and to correlate their levels with the extent, duration, and activity of disease. MATERIAL AND METHODS Sixty patients of vitiligo (30 each of localized and generalized) and 30 controls were recruited in the study. Serum IL-2, -6, -17, -22, and TNF-α levels were measured by enzyme-linked immunosorbent assay (ELISA) in all patients and healthy controls, and their levels were correlated with the extent, duration, and activity of vitiligo. RESULTS We observed significantly raised levels of IL-2, -6, -17, -22, and TNF-α in both localized vitiligo and generalized vitiligo (P < .05). IL-2 was significantly raised (P = .028) in localized vitiligo, whereas IL-17 and IL-22 were significantly raised in generalized vitiligo (P = .00 and P = .019, respectively). Activity of disease showed positive correlation with serum TNF-α levels (P = .015) in localized vitiligo. Positive correlation of IL-17 (R = .238) with body surface area (BSA) was observed in patients with generalized vitiligo. CONCLUSIONS Our study shows that cytokines secreted by Th17 cells play an important role in maintenance and spread of vitiligo as they increase in line with extent of disease. Also TNF-α increases in proportion with activity of disease, hence may act as biomarker for identifying patient with aggressive disease.
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Affiliation(s)
- Sushama Sushama
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
| | - Niharika Dixit
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
| | - Ram Krishna Gautam
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
| | - Pooja Arora
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, Dr. Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
| | - Anubhuti Anubhuti
- Department of Biochemistry, Dr. Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
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Singh M, Kotnis A, Jadeja SD, Mondal A, Mansuri MS, Begum R. Cytokines: the yin and yang of vitiligo pathogenesis. Expert Rev Clin Immunol 2018; 15:177-188. [DOI: 10.1080/1744666x.2019.1550358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mala Singh
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Ashwin Kotnis
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, India
| | - Shahnawaz D. Jadeja
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Anushree Mondal
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Mohmmad S. Mansuri
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
| | - Rasheedunnisa Begum
- Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, India
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Raam L, Kaleviste E, Šunina M, Vaher H, Saare M, Prans E, Pihlap M, Abram K, Karelson M, Peterson P, Rebane A, Kisand K, Kingo K. Lymphoid Stress Surveillance Response Contributes to Vitiligo Pathogenesis. Front Immunol 2018; 9:2707. [PMID: 30515176 PMCID: PMC6255962 DOI: 10.3389/fimmu.2018.02707] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/01/2018] [Indexed: 11/13/2022] Open
Abstract
Vitiligo is a chronic multifactorial depigmentation disorder characterized by the destruction and functional loss of melanocytes. Although a direct cytotoxic T cell attack is thought to be responsible for melanocyte damage, the events leading to the loss of self-tolerance toward melanocytic antigens are not understood. This research aimed to identify novel cellular and molecular factors that participate in vitiligo pathogenesis through the application of gene expression and immunofluorescence analysis of skin biopsy samples along with immunophenotyping of circulating cells. Our study provides insights into the mechanisms involved in melanocyte destruction. The upregulation of stress-ligand MICA/MICB, recognized by activating receptors on innate and innate-like T cells, imply involvement of lymphoid stress surveillance responses in vitiligo lesions. A simultaneous increase in the expression of transcription factor EOMES that is characteristic for innate-like virtual memory T cells, suggest a similar scenario. Local lymphoid stress surveillance has been previously associated with the amplification of systemic humoral responses that were mirrored in our study by increased T follicular helper cells and switched memory B cell proportions in patients with active vitiligo. In addition, microtubule-associated protein light chain 3 staining was compatible with the activation of autophagy in keratinocytes and in the remaining melanocytes of vitiligo lesional skin.
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Affiliation(s)
- Liisi Raam
- Department of Dermatology, University of Tartu, Tartu, Estonia.,Dermatology Clinic, Tartu University Hospital, Tartu, Estonia
| | - Epp Kaleviste
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Marina Šunina
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Helen Vaher
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Mario Saare
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Ele Prans
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Maire Pihlap
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Kristi Abram
- Department of Dermatology, University of Tartu, Tartu, Estonia.,Dermatology Clinic, Tartu University Hospital, Tartu, Estonia
| | - Maire Karelson
- Department of Dermatology, University of Tartu, Tartu, Estonia.,Dermatology Clinic, Tartu University Hospital, Tartu, Estonia
| | - Pärt Peterson
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Ana Rebane
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Kai Kisand
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Külli Kingo
- Department of Dermatology, University of Tartu, Tartu, Estonia.,Dermatology Clinic, Tartu University Hospital, Tartu, Estonia
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48
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Bhardwaj S, Bhatia A, Kumaran MS, Parsad D. Role of IL-17A receptor blocking in melanocyte survival: A strategic intervention against vitiligo. Exp Dermatol 2018; 28:682-689. [PMID: 30120811 DOI: 10.1111/exd.13773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/26/2018] [Accepted: 08/07/2018] [Indexed: 12/15/2022]
Abstract
Cytokines regulate immune response and inflammation and play an important role in depigmentation process of an autoimmune disease, vitiligo. We sought to determine how inflammatory cytokines influence the progression of vitiligo, and based on that, we develop a logical therapeutic intervention using primary melanocyte culture. Melanocytes were cultured and exposed to IL-17A, IL-1β, IFN-γ and TGF-β for 4 days. Melanocytes proliferation, tyrosinase assay and melanin content were measured. Real-Time PCR was used to analyse mRNA expression of genes specific for melanocytes growth and pigmentation. Anti-IL-17A receptor antibody was used to block IL-17A receptors expressed on melanocytes. Protein expression of MITF and TYR was assessed by immunofluorescence and Western blotting. A gradual decline in the melanocyte population, melanin content and tyrosinase activity was observed after different cytokine treatment. The expression of MITF and its downstream genes after blocking with anti-IL-17RA, an increased melanin content, increased expression of TYR, MITF along with its downstream genes, and cell proliferation was observed.
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Affiliation(s)
- Supriya Bhardwaj
- Departmet of Dermatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Alka Bhatia
- Department of Experimental Medicine & Biotechnology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Departmet of Dermatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Davinder Parsad
- Departmet of Dermatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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49
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Hypopigmented Interface T-Cell Dyscrasia and Hypopigmented Mycosis Fungoides: A Comparative Study. Am J Dermatopathol 2018; 40:727-735. [PMID: 30188378 DOI: 10.1097/dad.0000000000001187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Hypopigmented interface T-cell dyscrasia (HITCD) is a distinct form of lymphoid dyscrasia that may progress to hypopigmented mycosis fungoides (HMF). We compared both diseases as regards their CD4/CD8 phenotype and expression of granzyme B and tumor necrosis factor-alpha (TNF-α) and how these are affected by narrow-band UVB (nb-UVB). The study included 11 patients with HITCD and 9 patients with HMF. They received nb-UVB thrice weekly until complete repigmentation or a maximum of 48 sessions. Pretreatment and posttreatment biopsies were stained using anti CD4, CD8, TNF-α, and granzyme B monoclonal antibodies. Epidermal lymphocytes were CD8 predominant in 54.5% and 66.7% of HITCD and HMF cases, respectively, whereas dermal lymphocytes were CD4 predominant in 63.6% and 66.7%, respectively. Significantly, more dermal infiltrate was encountered in HMF (P = 0.041). In both diseases, granzyme B was only expressed in the dermis, whereas TNF-α was expressed both in the epidermis and dermis. No difference existed as regards the number of sessions needed to achieve repigmentation or cumulative nb-UVB dose reached at end of study. (P > 0.05). Narrow-band UVB significantly reduced only the epidermal lymphocytes in both diseases (P ≤ 0.05) with their complete disappearance in 8 (72.7%) HITCD and 6 (66.7%) HMF cases. In both diseases, nb-UVB did not affect granzyme B or TNF-α expression (P > 0.05). In conclusion, both diseases share the same phenotype, with HITCD being a milder form of T-cell dysfunction. In both diseases, epidermal lymphocytes are mainly CD8-exhausted cells lacking cytotoxicity, whereas dermal cells are mostly reactive cells exerting antitumor cytotoxicity. Tumor necrosis factor-alpha mediates hypopigmentation in both diseases and prevents disease progression. Repigmentation after nb-UVB in both diseases occurs before and independently from disappearance of the dermal infiltrate.
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50
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Gomes IA, de Carvalho FO, de Menezes AF, Almeida FM, Shanmugam S, de Souza Siqueira Quintans J, Quintans-Júnior LJ, de Moura TR, Oliveira PD, de Souza Araújo AA. The role of interleukins in vitiligo: a systematic review. J Eur Acad Dermatol Venereol 2018; 32:2097-2111. [PMID: 29704266 DOI: 10.1111/jdv.15016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/20/2018] [Indexed: 12/30/2022]
Abstract
Vitiligo is a disorder of the skin that causes depigmentation and asymptomatic macules whose exact cause is still unclear. Although its aetiology is not fully elucidated, the main theory of its pathomechanism is that it is associated with the autoimmune process. There is few summarized information about the role of inflammatory mediators, as interleukins, in vitiligo, so our aim was to present a systematic review of the role of interleukins in vitiligo, focusing on interleukins. In this review, we included all studies assessing interleukin levels in vitiligo patients conducted up to June 2017. Quality assessment of these studies was performed using the Newcastle-Ottawa Scale (NOS). The interleukins mainly involved were IL-2, IL-4, IL-6, IL-10 and IL-17. The studies highlight the crucial role of IL-17 in the onset and progression of the disease, and its synergistic action with IL-2, IL-6 and IL-33. Dysregulated levels of the interleukins were also correlated with the stage of disease, the affected skin surface area, and indicated as the main factor for lymphocyte infiltration found in depigmented regions. These findings illustrate the growing need for new therapies targeting vitiligo and further research into the role of interleukins as an area of particular interest.
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Affiliation(s)
- I A Gomes
- Programa de Pós-Graduação em Ciências Farmacêuticas da Universidade Federal de Sergipe - UFS, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - F O de Carvalho
- Núcleo de Pós-Graduação em Medicina da Universidade Federal de Sergipe - UFS, Rua Cláudio Batista S/N Bairro Sanatório, Aracaju, SE, Brasil
| | - A F de Menezes
- Núcleo de Pós-Graduação em Medicina da Universidade Federal de Sergipe - UFS, Rua Cláudio Batista S/N Bairro Sanatório, Aracaju, SE, Brasil
| | - F M Almeida
- Departamento de Farmácia, Universidade Federal de Sergipe, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - S Shanmugam
- Programa de Pós-Graduação em Ciências Farmacêuticas da Universidade Federal de Sergipe - UFS, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - J de Souza Siqueira Quintans
- Departamento de Fisiologia, Universidade Federal de Sergipe, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - L J Quintans-Júnior
- Departamento de Fisiologia, Universidade Federal de Sergipe, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - T R de Moura
- Departamento de Fisiologia, Universidade Federal de Sergipe, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - P D Oliveira
- Programa de Pós-Graduação em Ciências Farmacêuticas da Universidade Federal de Sergipe - UFS, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
| | - A A de Souza Araújo
- Programa de Pós-Graduação em Ciências Farmacêuticas da Universidade Federal de Sergipe - UFS, Campus Universitário "Prof. Aloísio de Campos", São Cristóvão, SE, Brazil
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