1
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Giri P, Desai D, Dwivedi M. Animal models unraveling the complexity of vitiligo pathogenesis. Autoimmun Rev 2024; 23:103515. [PMID: 38185189 DOI: 10.1016/j.autrev.2024.103515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
Vitiligo is a chronic skin condition marked by the gradual loss of pigmentation, leading to the emergence of white or depigmented patches on the skin. The exact cause of vitiligo remains not entirely understood, although it is thought to involve a blend of genetic, autoimmune, and environmental factors. While there is currently no definitive cure for vitiligo, diverse treatments exist that may assist in managing the condition and fostering repigmentation in specific instances. Animal models play a pivotal role in comprehending the intricate mechanisms that underlie vitiligo, providing valuable insights into the progression and onset of the disease, as well as potential therapeutic interventions. Although induced experimental models lack the nuanced characteristics observed in natural experimental models, relying solely on a single animal model might not fully capture the intricate pathogenesis of vitiligo. Different animal models simulate specific aspects of human vitiligo pathogenesis to varying degrees. This review extensively explores the array of animal models utilized in vitiligo research, shedding light on their respective advantages, disadvantages, and applications.
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Affiliation(s)
- Prashant Giri
- C. G. Bhakta Institute of Biotechnology, Faculty of Science, Uka Tarsadia University, Bardoli, Surat 394 350, Gujarat, India
| | - Dharm Desai
- C. G. Bhakta Institute of Biotechnology, Faculty of Science, Uka Tarsadia University, Bardoli, Surat 394 350, Gujarat, India
| | - Mitesh Dwivedi
- C. G. Bhakta Institute of Biotechnology, Faculty of Science, Uka Tarsadia University, Bardoli, Surat 394 350, Gujarat, India.
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2
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Chellapandian N, Boopathi D. Oral vitiligo: a predominant spread from oral mucosa. BMJ Case Rep 2023; 16:e257609. [PMID: 37821146 PMCID: PMC10583097 DOI: 10.1136/bcr-2023-257609] [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] [Indexed: 10/13/2023] Open
Abstract
Depigmented lesions of the oral cavity have been rarely reported. Vitiligo has been defined as an acquired, slowly progressive loss of cutaneous pigment which occurs as irregular, sharply defined patches which may or may not be surrounded by macroscopic hyperpigmentation. Though vitiligo is a common condition affecting the skin having global a prevalence of 0.5%-2% the same affecting the oral mucosal tissue is a rare scenario. Literature review yields only a dearth of cases of oral vitiligo until now. Here we report a case of oral vitiligo involving the entire oral mucosal tissues with anaemic stomatitis. This case is unique as it had entire oral mucosal involvement and the skin involvement being minimal.
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Affiliation(s)
- Naveenaa Chellapandian
- Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, Pondicherry, India
| | - Durgadevi Boopathi
- Oral Medicine and Maxillofacial Radiology, Indira Gandhi Institute of Dental Sciences, Pondicherry, India
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3
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Domaszewska-Szostek A, Polak A, Słupecka-Ziemilska M, Krzyżanowska M, Puzianowska-Kuźnicka M. Current Status of Cell-Based Therapies for Vitiligo. Int J Mol Sci 2023; 24:ijms24043357. [PMID: 36834766 PMCID: PMC9964504 DOI: 10.3390/ijms24043357] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Vitiligo is a chronic pigmentary disease with complex etiology, the signs of which are caused by the destruction of melanocytes in the epidermis, leading to the lack of melanin pigment responsible for skin coloration. The treatment of vitiligo, which aims at repigmentation, depends both on the clinical characteristics of the disease as well as on molecular markers that may predict the response to treatment. The aim of this review is to provide an overview of the clinical evidence for vitiligo cell-based therapies taking into account the required procedures and equipment necessary to carry them out as well as their effectiveness in repigmentation, assessed using the percentage of repigmentation of the treated area. This review was conducted by assessing 55 primary clinical studies published in PubMed and ClinicalTrails.gov between 2000 and 2022. This review concludes that the extent of repigmentation, regardless of the treatment method, is highest in stable localized vitiligo patients. Moreover, therapies that combine more than one cell type, such as melanocytes and keratinocytes, or more than one method of treatment, such as the addition of NV-UVB to another treatment, increase the chances of >90% repigmentation. Lastly, this review concludes that various body parts respond differently to all treatments.
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Affiliation(s)
- Anna Domaszewska-Szostek
- Department of Human Epigenetics, Mossakowski Medical Research Institute, PAS, 02-106 Warsaw, Poland
| | - Agnieszka Polak
- Faculty of Biology, University of Cambridge, Cambridge CD2 1TN, UK
| | - Monika Słupecka-Ziemilska
- Department of Human Epigenetics, Mossakowski Medical Research Institute, PAS, 02-106 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-60-86-401
| | - Marta Krzyżanowska
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University in Toruń, 85-168 Bydgoszcz, Poland
| | - Monika Puzianowska-Kuźnicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, PAS, 02-106 Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
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4
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Friedmann Angeli JP, Meierjohann S. NRF2-dependent stress defense in tumor antioxidant control and immune evasion. Pigment Cell Melanoma Res 2020; 34:268-279. [PMID: 33205526 DOI: 10.1111/pcmr.12946] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/23/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
The transcription factor NRF2 is known as the master regulator of the oxidative stress response. Tumor entities presenting oncogenic activation of NRF2, such as lung adenocarcinoma, are associated with drug resistance, and accumulating evidence demonstrates its involvement in immune evasion. In other cancer types, the KEAP1/NRF2 pathway is not commonly mutated, but NRF2 is activated by other means such as radiation, oncogenic activity, cytokines, or other pro-oxidant triggers characteristic of the tumor niche. The obvious effect of stress-activated NRF2 is the protection from oxidative or electrophilic damage and the adaptation of the tumor metabolism to changing conditions. However, data from melanoma also reveal a role of NRF2 in modulating differentiation and suppressing anti-tumor immunity. This review summarizes the function of NRF2 in this tumor entity and discusses the implications for current tumor therapies.
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Affiliation(s)
- José Pedro Friedmann Angeli
- Rudolf-Virchow Center for Integrative and Translational Bioimaging, University of Würzburg, Würzburg, Germany
| | - Svenja Meierjohann
- Institute of Pathology, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
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5
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Is Hyperpigmentation in Systemic Sclerosis a Perivascular Dermal Tattoo? J Invest Dermatol 2020; 140:2308-2312.e2. [PMID: 32234458 DOI: 10.1016/j.jid.2020.03.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 11/23/2022]
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6
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The relationship between stress and vitiligo: Evaluating perceived stress and electronic medical record data. PLoS One 2020; 15:e0227909. [PMID: 31986193 PMCID: PMC6984686 DOI: 10.1371/journal.pone.0227909] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/22/2019] [Indexed: 02/06/2023] Open
Abstract
Vitiligo is a T-cell mediated skin disorder characterized by progressive loss of skin color. In individuals genetically predisposed to the disease, various triggers contribute to the initiation of vitiligo. Precipitating factors can stress the skin, leading to T-cell activation and recruitment. Though hereditary factors are implicated in the pathogenesis of vitiligo, it is unknown whether precipitating, stressful events play a role in vitiligo. To understand this, we utilized a validated perceived stress scale (PSS) to measure this parameter in vitiligo patients compared to persons without vitiligo. Additionally, we probed a clinical database, using a knowledge linking software called ROCKET, to gauge stress-related conditions in the vitiligo patient population. From a pool of patients in an existing database, a hundred individuals with vitiligo and twenty-five age- and sex-matched comparison group of individuals without vitiligo completed an online survey to quantify their levels of perceived stress. In parallel, patients described specifics of their disease condition, including the affected body sites, the extent, duration and activity of their vitiligo. Perceived stress was significantly higher among vitiligo individuals compared to those without vitiligo. ROCKET analyses suggested signs of metabolic-related disease (i.e., ‘stress’) preceding vitiligo development. No correlation was found between perceived stress and the stage or the extent of disease, suggesting that elevated stress may not be a consequence of pigment loss alone. The data provide further support for stress as a precipitating factor in vitiligo development.
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Lambert MW, Maddukuri S, Karanfilian KM, Elias ML, Lambert WC. The physiology of melanin deposition in health and disease. Clin Dermatol 2019; 37:402-417. [PMID: 31896398 DOI: 10.1016/j.clindermatol.2019.07.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Eumelanin is the major pigment responsible for human skin color. This black/brown pigment is localized in membrane-bound organelles (melanosomes) found in specialized cells (melanocytes) in the basal layer of the epidermis. This review highlights the steps involved in melanogenesis in the epidermis and the disorders in skin pigmentation that occur when specific steps critical for this process are defective. Melanosomes, which contain tyrosinase, a major enzyme involved in melanin synthesis, develop through a series of steps in the melanocyte. They are donated from the melanocyte dendrites to the surrounding keratinocytes in the epidermis. In the keratinocytes, the melanosomes are found singly or packaged into groups, and as the keratinocytes move upward in the epidermis, the melanosomes start to degrade. This sequence of events is critical for melanin pigmentation in the skin and can be influenced by genetic, hormonal, and environmental factors, which all play a role in levels of melanization of the epidermis. The effects these factors have on skin pigmentation can be due to different underlying mechanisms involved in the melanization process leading to either hypo- or hyperpigmentary disorders. These disorders highlight the importance of mechanistic studies on the specific steps involved in the melanization process.
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Affiliation(s)
- Muriel W Lambert
- Department of Pathology, Immunology, and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Division of Dermatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
| | - Spandana Maddukuri
- Division of Dermatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Katrice M Karanfilian
- Division of Dermatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Marcus L Elias
- Division of Dermatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - W Clark Lambert
- Department of Pathology, Immunology, and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Division of Dermatology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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8
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Turkowski Y, Konnikov N. Sulfasalazine-induced generalized vitiligo in a patient with dermatitis herpetiformis and celiac disease. Dermatol Ther 2019; 32:e13007. [PMID: 31237078 DOI: 10.1111/dth.13007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 05/31/2019] [Accepted: 06/19/2019] [Indexed: 01/17/2023]
Abstract
Vitiligo is an acquired idiopathic pigmentary skin disorder characterized by the development of white macules and patches due to the loss of functioning melanocytes. In this report, we describe a case of a patient with a longstanding history of dermatitis herpetiformis (DH) and celiac disease that developed rapidly progressing, biopsy-confirmed generalized vitiligo after 11 months of treatment with anti-inflammatory medication sulfasalazine, prescribed for the patient's DH. To the best of our knowledge, this is the first case report which has demonstrated the possible biochemical pathways, triggered by sulfasalazine, in the development of vitiligo.
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Affiliation(s)
- Yana Turkowski
- Department of Dermatology, VA Boston Healthcare System, Boston, Massachusetts
| | - Nellie Konnikov
- Department of Dermatology, VA Boston Healthcare System, Boston, Massachusetts.,Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts
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9
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Bishnoi A, Parsad D. Clinical and Molecular Aspects of Vitiligo Treatments. Int J Mol Sci 2018; 19:ijms19051509. [PMID: 29783663 PMCID: PMC5983813 DOI: 10.3390/ijms19051509] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 05/11/2018] [Accepted: 05/15/2018] [Indexed: 12/15/2022] Open
Abstract
Vitiligo is an asymptomatic but cosmetically disfiguring disorder that results in the formation of depigmented patches on skin and/or mucosae. Vitiligo can be segmental or non-segmental depending upon the morphology of the clinical involvement. It can also be classified as progressing or stable based on the activity of the disease. Further, the extent of involvement can be limited (localized disease) or extensive (generalized disease). The treatment of vitiligo therefore depends on the clinical classification/characteristics of the disease and usually comprises of 2 strategies. The first involves arresting the progression of active disease (to provide stability) in order to limit the area involved by depigmentation. The second strategy aims at repigmentation of the depigmented area. It is also important to maintain the disease in a stable phase and to prevent relapse. Accordingly, a holistic treatment approach for vitiligo should be individualistic and should take care of all these considerations. In this review, we shall discuss the vitiligo treatments and their important clinical and molecular aspects.
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Affiliation(s)
- Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
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10
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Lu W, Zhao Y, Kong Y, Zhang W, Ma W, Li W, Wang K. Geniposide prevents H 2 O 2 -induced oxidative damage in melanocytes by activating the PI3K-Akt signalling pathway. Clin Exp Dermatol 2018. [PMID: 29512905 DOI: 10.1111/ced.13409] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Oxidative stress is one possible pathogenic event in vitiligo that induces melanocyte destruction. Geniposide exerts certain antioxidant effects on various cells by activating the phosphoinositol 3-kinase (PI3K)-Akt signalling pathway. However, researchers have not clearly determined whether geniposide protects human melanocytes from oxidative stress or identified the underlying mechanism of such protection. AIM To determine whether geniposide protects melanocytes from H2 O2 -induced oxidative damage and to explore the role of the PI3K-Akt signalling pathway in this protective effect. METHODS The antioxidant effects of geniposide on human melanocytes were examined by measuring cell viability, apoptosis rates, reactive oxygen species (ROS) production and activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT). We examined expression of Akt, phosphorylated Akt (p-Akt), Bcl-2, Bax, and cleaved caspase 3 and cleaved caspase 9 proteins to determine the involvement of the PI3K-Akt pathway. RESULTS Pretreatment with geniposide 5, 25, 125 or 625 μmol/L increased cell viability and decreased the apoptosis rate of H2 O2 -treated melanocytes. In addition, geniposide enhanced the antioxidant activity of SOD and CAT, and decreased intracellular ROS accumulation. Furthermore, geniposide increased the levels of p-Akt and regulated the expression of downstream proteins in the PI3K-Akt pathway, such as Bcl-2, Bax, and cleaved caspase 3 and 9, in H2 O2 -treated melanocytes. Notably, these effects were largely blocked by treatment with LY294002 prior to H2 O2 treatment. CONCLUSIONS Based on these results, geniposide protects human melanocytes from H2 O2 -induced oxidative damage, and the PI3K-Akt signalling pathway is involved in its antioxidant effect.
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Affiliation(s)
- W Lu
- Department of Dermatology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China.,Department of Dermatology, Qilu Hospital of Shandong University, Jinan, China
| | - Y Zhao
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan, China
| | - Y Kong
- Department of Dermatology, People's Hospital of Jiangbei, Nanjing, China
| | - W Zhang
- Department of Dermatology, Kaifeng Second People's Hospital, Kaifeng, China
| | - W Ma
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan, China
| | - W Li
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan, China
| | - K Wang
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan, China
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11
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Moghaddam AY, Sayyah M, Fini EA, Talaee R. Investigation the Relationship between Skin Involvement Severity and Hearing Loss Severity in Vitiligo Patients. Mater Sociomed 2018; 30:29-31. [PMID: 29670475 PMCID: PMC5857041 DOI: 10.5455/msm.2018.30.29-31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Vitiligo is a common acquired depigmented systemic disorder influencing the entire pigmentary system including Cochlear melanocytes and vestibular system in the inner ear. Vitiligo can leads to social negative impact and poorer quality of life among these patients. This study was conducted to investigate the relationship between skin involvement severity and hearing loss severity among vitiligo patients. Methods: This cross-sectional study was performed on 98 patients with vitiligo referred to the dermatology clinic of Shahid Beheshti Hospital of Kashan during 2012-2014. Using Vitiligo Area Severity Index (VASI), the skin involvement was evaluated by a dermatologist. Then, patients referred to an otolaryngologist, and after otoscopic examination, they underwent audiometric testing including Audiometry, Tympanometry and Auditory Brainstem Response (ABR tests. Patients aged 10-50 years old without any other underlying diseases, and after rule out of other causes of depigmentation and leukoderm were included. Patients with congenital hearing impairment and patients with history of ototoxic drugs intake such as aminoglycosides, vancomycin and thiazide were excluded. Results: No significant association was found between severity of Vitiligo with conductive hearing loss. Vitiligo has not been correlated with sensory neural hearing loss. Also, there was no relationship between the duration of clinical manifestations of vitiligo with conductive and sensory neural hearing loss. Conclusions: Our finding showed that there was no relationship between skin involvement severity and hearing loss severity in vitiligo patients. In addition, no relationship was found between the conductive and sensory neural hearing losses with the incidence duration of clinical manifestation and extent of skin involvement of vitiligo.
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Affiliation(s)
| | - Mansour Sayyah
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Elham Alian Fini
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Rezvan Talaee
- Department of Dermatology, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
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12
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Baldini E, Odorisio T, Sorrenti S, Catania A, Tartaglia F, Carbotta G, Pironi D, Rendina R, D’Armiento E, Persechino S, Ulisse S. Vitiligo and Autoimmune Thyroid Disorders. Front Endocrinol (Lausanne) 2017; 8:290. [PMID: 29163360 PMCID: PMC5663726 DOI: 10.3389/fendo.2017.00290] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022] Open
Abstract
Vitiligo represents the most common cause of acquired skin, hair, and oral depigmentation, affecting 0.5-1% of the population worldwide. It is clinically characterized by the appearance of disfiguring circumscribed skin macules following melanocyte destruction by autoreactive cytotoxic T lymphocytes. Patients affected by vitiligo usually show a poorer quality of life and are more likely to suffer from depressive symptoms, particularly evident in dark-skinned individuals. Although vitiligo is a non-fatal disease, exposure of affected skin to UV light increases the chance of skin irritation and predisposes to skin cancer. In addition, vitiligo has been associated with other rare systemic disorders due to the presence of melanocytes in other body districts, such as in eyes, auditory, nervous, and cardiac tissues, where melanocytes are thought to have roles different from that played in the skin. Several pathogenetic models have been proposed to explain vitiligo onset and progression, but clinical and experimental findings point mainly to the autoimmune hypothesis as the most qualified one. In this context, it is of relevance the strong association of vitiligo with other autoimmune diseases, in particular with autoimmune thyroid disorders, such as Hashimoto thyroiditis and Graves' disease. In this review, after a brief overview of vitiligo and its pathogenesis, we will describe the clinical association between vitiligo and autoimmune thyroid disorders and discuss the possible underlying molecular mechanism(s).
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Affiliation(s)
- Enke Baldini
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Teresa Odorisio
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata-IRCCS, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Antonio Catania
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | | | - Giovanni Carbotta
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Roberta Rendina
- Department of Internal Medicine and Medical Specialties, “Sapienza” University of Rome, Rome, Italy
| | - Eleonora D’Armiento
- Department of Internal Medicine and Medical Specialties, “Sapienza” University of Rome, Rome, Italy
| | | | - Salvatore Ulisse
- Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy
- *Correspondence: Salvatore Ulisse,
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13
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Castanedo-Cázares JP, Cortés-García JD, Fuentes-Ahumada C, Martinez-Rosales K, Torres-Álvarez B. Repigmentation patterns induced by NB-UVB and their relationship with melanocytic migration and proliferation in vitiligo. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 32:269-275. [PMID: 27627998 DOI: 10.1111/phpp.12275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND/PURPOSE Vitiligo is the most commonly acquired depigmentation disorder of the skin and is characterized by the destruction of melanocytes. Ultraviolet phototherapy with narrow band (UVB-NB) induces proliferation, differentiation, maturation, and migration of melanocytes. The clinical repigmentation is featured by follicular, marginal, and diffuse patterns. The aim of this study was to observe the process involved in the melanocyte migration and proliferation among these patterns and the unresponsive lesions following UVB-NB phototherapy. The focal adhesion kinase (FAK) and c-KIT were used as markers of melanocyte migration and differentiation, respectively. METHODS A total of 17 vitiligo patients under UVB-NB therapy were selected. The patients expressed the three repigmentation patterns as well as unresponsive lesions at the conclusion of a 30-session cycle. Skin biopsies were evaluated by immunohistochemistry and qRT-PCR. RESULTS We found an increased expression of c-KIT in the follicular pattern compared to the diffuse pattern that was expressed predominantly of FAK. Marginal pattern expressed both proteins. The unresponsive achromic lesions showed poor expressions of both markers. CONCLUSION Proliferation was prominent in the follicular pattern, but migration was prominent in the diffuse pattern. For the marginal pattern, both dynamics were present. The absence of these markers in vitiligo lesions suggests a lack of response to UVB-NB.
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Affiliation(s)
- Juan Pablo Castanedo-Cázares
- Dermatology Department, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Juan Diego Cortés-García
- Laboratory of Immunology and Cellular and Molecular Biology, Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Cornelia Fuentes-Ahumada
- Dermatology Department, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Karla Martinez-Rosales
- Dermatology Department, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Bertha Torres-Álvarez
- Dermatology Department, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
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14
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Abstract
Vitiligo, an acquired depigmentation disorder, manifests as white macules on the skin and can cause significant psychological stress and stigmatization. Recent advances have shed light on key components that drive disease onset and progression as well as therapeutic approaches. Vitiligo can be triggered by stress to the melanin pigment-producing cells of the skin, the melanocytes. The triggers, which range from sunburn to mechanical trauma and chemical exposures, ultimately cause an autoimmune response that targets melanocytes, driving progressive skin depigmentation. The most significant progress in our understanding of disease etiology has been made on three fronts: (1) identifying cellular responses to stress, including antioxidant pathways and the unfolded protein response (UPR), as key players in disease onset, (2) characterizing immune responses that target melanocytes and drive disease progression, and (3) identifying major susceptibility genes. The current model for vitiligo pathogenesis postulates that oxidative stress causes cellular disruptions, including interruption of protein maturation in the endoplasmic reticulum (ER), leading to the activation of the UPR and expression of UPR-regulated chemokines such as interleukin 6 (IL-6) and IL-8. These chemokines recruit immune components to the skin, causing melanocytes to be targeted for destruction. Oxidative stress can further increase melanocyte targeting by promoting antigen presentation. Two key components of the autoimmune response that promote disease progression are the interferon (IFN)-γ/CXCL10 axis and IL-17-mediated responses. Several genome-wide association studies support a role for these pathways, with the antioxidant gene
NRF2, UPR gene
XBP1, and numerous immune-related genes including class I and class II major histocompatibility genes associated with a risk for developing vitiligo. Novel approaches to promote repigmentation in vitiligo are being investigated and may yield effective, long-lasting therapies.
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Affiliation(s)
- Prashiela Manga
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, 10016, USA
| | - Nada Elbuluk
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, 10016, USA
| | - Seth J Orlow
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, 10016, USA
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15
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Jian Z, Tang L, Yi X, Liu B, Zhang Q, Zhu G, Wang G, Gao T, Li C. Aspirin induces Nrf2-mediated transcriptional activation of haem oxygenase-1 in protection of human melanocytes from H2 O2 -induced oxidative stress. J Cell Mol Med 2016; 20:1307-18. [PMID: 26969214 PMCID: PMC4929306 DOI: 10.1111/jcmm.12812] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/15/2016] [Indexed: 11/29/2022] Open
Abstract
The removal of hydrogen peroxide (H2 O2 ) by antioxidants has been proven to be beneficial to patients with vitiligo. Aspirin (acetylsalicylic acid, ASA) has antioxidant activity and has great preventive and therapeutical effect in many oxidative stress-relevant diseases. Whether ASA can protect human melanocytes against oxidative stress needs to be further studied. Here, we investigated the potential protective effect and mechanisms of ASA against H2 O2 -induced oxidative injury in human melanocytes. Human melanocytes were pre-treated with different concentrations of ASA, followed by exposure to 1.0 mM H2 O2 . Cell apoptosis, intracellular reactive oxygen species (ROS) levels were evaluated by flow cytometry, and cell viability was determined by an Cell Counting Kit-8 assay. Total and phosphorylated NRF2 expression, NRF2 nuclear translocation and antioxidant response element (ARE) transcriptional activity were assayed with or without Nrf2-siRNA transfection to investigate the possible molecular mechanisms. Concomitant with an increase in viability, pre-treatment of 10-90 μmol/l ASA resulted in decreased rate of apoptotic cells, lactate dehydrogenase release and intracellular ROS levels in primary human melanocytes. Furthermore, we found ASA dramatically induced NRF2 nuclear translocation, enhanced ARE-luciferase activity, increased both p- NRF2 and total NRF2 levels, and induced the expression of haem oxygenase-1 (HO-1) in human melanocytes. In addition, knockdown of Nrf2 expression or pharmacological inhibition of HO-1 abrogated the protective action of ASA on melanocytes against H2 O2 -induced cytotoxicity and apoptosis. These results suggest that ASA protects human melanocytes against H2 O2 -induced oxidative stress via Nrf2-driven transcriptional activation of HO-1.
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Affiliation(s)
- Zhe Jian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Lingzhen Tang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Xiuli Yi
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Bangmin Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Qian Zhang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Guannan Zhu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Tianwen Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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16
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Immunological Parameters Associated With Vitiligo Treatments: A Literature Review Based on Clinical Studies. Autoimmune Dis 2015; 2015:196537. [PMID: 26457199 PMCID: PMC4589577 DOI: 10.1155/2015/196537] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 08/26/2015] [Indexed: 12/04/2022] Open
Abstract
Vitiligo, a depigmentary disorder, caused by the loss of melanocytes, affects approximately 1% of the world population, irrespective of skin type, with a serious psychological impact on the patient quality of life. So far, the origin of vitiligo has not been traced and the pathogenesis is complex, involving the interplay of a multitude of variables. Although there is no treatment that ensures the complete cure of the disorder, there are some pharmacological, phototherapy, and surgical therapies available. A series of variables can affect treatment outcome, such as individual characteristics, emotional issues, type of vitiligo, stability of the lesions, and immunological status. The present literature review identified the main immunological parameters associated with treatments for vitiligo. Cytotoxic CD8+ T lymphocytes are the main cell type involved in treatment success, as fewer cells in skin lesions are associated with better results. Other parameters such as cytokines and regulatory T cells may also be involved. Further clinical scientific studies are needed to elucidate the complex mechanisms underlying vitiligo and its treatments, in order to expand the range of therapeutic approaches for each individual case.
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