1
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Zhao M, Zhang Y, Sun G. Identifying the genetic association between common rheumatic diseases and vitiligo. Skin Res Technol 2024; 30:e13846. [PMID: 38967217 PMCID: PMC11224917 DOI: 10.1111/srt.13846] [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: 05/25/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Although observational studies have suggested a correlation between vitiligo and rheumatic diseases, conclusive evidence supporting a causal relationship is still lacking. Therefore, this study aims to explore the potential causal relationship between vitiligo and rheumatic diseases. METHODS Using genome-wide association studies, we performed a two-sample Mendelian randomization (MR) analysis. In our analysis, the random-effects inverse variance weighted (IVW) method was predominantly employed, followed by several sensitivity analyses, which include heterogeneity, horizontal pleiotropy, outliers, and "leave-one-out" analyses. RESULTS The genetically predicted vitiligo was associated with an increased risk of rheumatoid arthritis (RA) (OR, 1.47; 95% confidence interval [CI], 1.29-1.68; p < 0.001), and systemic lupus erythematosus (SLE) (OR, 1.22; 95% CI, 1.06-1.39; p = 0.005). The causal associations were supported by sensitivity analyses. In Sjögren's syndrome and ankylosing spondylitis, no causal relationship with vitiligo was found in the study. CONCLUSION Our MR results support the causal effect that vitiligo leads to a higher risk of RA and SLE. Individuals with vitiligo should be vigilant for the potential development of RA and SLE. Managing and addressing this potential requires regular monitoring.
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Affiliation(s)
- Mingming Zhao
- Department of Hematology and RheumatologyThe Fourth Affiliated HospitalHarbin Medical UniversityHarbinChina
| | - Yuanyuan Zhang
- Department of Hematology and RheumatologyThe Fourth Affiliated HospitalHarbin Medical UniversityHarbinChina
| | - Guoxun Sun
- Department of Hematology and RheumatologyThe Fourth Affiliated HospitalHarbin Medical UniversityHarbinChina
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2
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Yang P, Luan M, Li W, Niu M, He Q, Zhao Y, Chen J, Mao B, Mou K, Li P. Single-cell transcriptomics reveals peripheral immune responses in non-segmental vitiligo. Front Immunol 2023; 14:1221260. [PMID: 38077333 PMCID: PMC10702986 DOI: 10.3389/fimmu.2023.1221260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Vitiligo is a common autoimmune depigmented dermatology due to destruction of melanocytes. Much evidence suggests that vitiligo is associated with systemic immune activation. Previous studies have focused on immune cell infiltration in and around lesion areas, but few studies have investigated the cell types and function of circulating immune cells in peripheral blood. Here, single cell RNA-sequencing (scRNA-seq) was used to investigate the mechanisms of peripheral immune responses in vitiligo patients. Methods Peripheral blood was collected from five patients with progressive non-segmental vitiligo and three healthy controls. Peripheral blood mononuclear cells (PBMCs) were obtained by Ficoll-Paque density gradient centrifugation, and scRNA-seq was performed on isolated cell populations to obtain single cell transcriptomes and characterize important genes and intracellular signaling pathways. The key findings were validated with qPCR and flow cytometry assays. Results We identified 10 major cell types by scRNA-seq. Among these cell types, neutrophils were specifically observed in our scRNA-seq data from PBMCs. Peripheral blood effector CD8+ T cells from vitiligo patients did not show significant differences at the transcriptome level compared with healthy controls, whereas regulatory T cells showed pro-inflammatory TH1-like properties. Innate immune cells, including natural killer cells and dendritic cells, showed increased antigen processing and presentation as well as upregulated interferon responses. B cells, monocytes, and neutrophils all showed activation. B cells, especially memory B cells, had upregulated expression of genes related to humoral immunity. Monocytes showed production of proinflammatory cytokines and chemokines. Neutrophils showed strong chemokine ligand-receptor (L-R) pair (CXCR8-CXCR2) autocrine signaling pathway. Conclusion This study revealed the genetic profile and signaling pathway characteristics of peripheral blood immune cells in vitiligo patients, providing new insights into its pathogenesis, which may facilitate identification of potential therapeutic targets.
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Affiliation(s)
- Pengju Yang
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Mei Luan
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Weizhe Li
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Mengtian Niu
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qiannan He
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yixin Zhao
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jianan Chen
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Binyue Mao
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Kuanhou Mou
- Department of Dermatology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Pan Li
- Center for Translational Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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3
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Han JH, Lee S, Ju HJ, Kim M, Choi CW, Bae JM. Automated Mass Screening for Comorbidities of Vitiligo Using the National Health Insurance Database. J Invest Dermatol 2023; 143:1717-1723. [PMID: 36958603 DOI: 10.1016/j.jid.2023.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/01/2023] [Accepted: 02/22/2023] [Indexed: 03/25/2023]
Abstract
Although the study design for identifying specific disease associations using a health insurance database has been well-established, few studies explore unknown comorbidities. We conducted a series of automated case-control studies for all International Classification of Disease, Tenth Revision, Clinical Modification diagnostic codes (A01-Z99) using the Korean National Health Insurance database from 2007 to 2017 to reveal undiscovered disease associations of vitiligo. A total of 90,297 patients with vitiligo and 90,297 age- and sex-matched controls without vitiligo were included, and disease associations for 1,265 relevant diagnostic codes were screened. A meta-analysis of the individual ORs for each International Classification of Disease, Tenth Revision code was performed to identify the possibility of selection bias. Finally, the association with vitiligo was significantly increased in 45 diseases and decreased in 6 diseases. We not only reaffirmed the positive correlation between vitiligo and other autoimmune diseases but also observed associations with obsessive-compulsive disorder and melanoma. In contrast, femur fracture showed a negative correlation. In this study, we attempted an automated mass screening and suggested a possible selection bias. In the era of large-scale databases, a systematic and comprehensive approach might be needed.
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Affiliation(s)
- Ju Hee Han
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Solam Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Miri Kim
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Won Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
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4
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Li HOY, Bailey AMJ, Pastukhova E, Tan MG, Kirchhof MG. Comorbid diagnosis of systemic lupus erythematosus in vitiligo: a systematic review and meta-analysis. Br J Dermatol 2023; 188:440-441. [PMID: 36680305 DOI: 10.1093/bjd/ljac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/29/2022] [Accepted: 11/26/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Heidi Oi-Yee Li
- Division of Dermatology, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | | | | | - Marcus G Tan
- Division of Dermatology, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | - Mark G Kirchhof
- Division of Dermatology, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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5
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Hu Z, Wang T. Beyond skin white spots: Vitiligo and associated comorbidities. Front Med (Lausanne) 2023; 10:1072837. [PMID: 36910477 PMCID: PMC9995999 DOI: 10.3389/fmed.2023.1072837] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Vitiligo is a common depigmentation disorder of an unknown origin characterized by the selective loss of melanocytes, resulting in typical white macules and patches. However, vitiligo is now recognized as more than just a skin disease, what a dermatologist observes as a white spot of skin is just the "tip of the iceberg" of the condition. We attempt to clarify the classification of comorbidities associated with vitiligo from various reviews and reports, and describe their possible pathogenesis. In conclusion, the literature provides evidence of an association between vitiligo and ocular and auditory abnormalities, autoimmune disorders, other dermatological diseases, metabolic syndrome and related disorders, and psychological diseases. These associations highlight the importance of a multidisciplinary approach in managing vitiligo patients.
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Affiliation(s)
- Zhonghui Hu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Tao Wang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
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6
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Lee JH, Ju HJ, Seo JM, Almurayshid A, Kim GM, Ezzedine K, Bae JM. Comorbidities in Patients with Vitiligo: A Systematic Review and Meta-Analysis. J Invest Dermatol 2022; 143:777-789.e6. [PMID: 36574529 DOI: 10.1016/j.jid.2022.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/29/2022]
Abstract
Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases in patients with vitiligo and quantify their associations compared with those in healthy controls. A comprehensive search of MEDLINE and EMBASE from the inception to June 2022 was conducted. Observational studies on prevalent diseases in patients with vitiligo compared with those in healthy controls were included, whereas studies limited to pediatrics or providing only laboratory results were excluded. A total of 78 studies were eligible for analyses. Patients with vitiligo showed higher risks of having comorbid autoimmune and connective tissue diseases, including alopecia areata (OR = 2.63, 95% confidence interval [CI] = 2.50‒2.78), discoid lupus erythematosus (OR = 2.54, 95% CI = 1.74‒3.72), Sjogren's syndrome (OR = 2.50, 95% CI = 1.98‒3.16), myasthenia gravis (OR = 2.30, 95% CI = 1.74‒3.02), systemic lupus erythematosus (OR = 1.96, 95% CI = 1.52‒2.52), and rheumatoid arthritis (OR = 1.82, 95% CI = 1.55‒2.15). Thyroid diseases, diabetes mellitus, metabolic syndrome, sensorineural hypoacusis, and ophthalmic abnormalities were also more prevalent in patients with vitiligo. In conclusion, vitiligo is associated with various systemic diseases. Physicians should evaluate and manage potential comorbid conditions in patients with vitiligo.
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Affiliation(s)
- Ji Hae Lee
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ji Min Seo
- Department of Dermatology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Abdurrahman Almurayshid
- Department of Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj City, Saudi Arabia
| | - Gyong Moon Kim
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Khaled Ezzedine
- Department of Dermatology, Henry Mondor Hospital, Paris Est Créteil University, Créteil, France
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
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7
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Ma SH, Wu PC, Chang JY, Chang YT, Dai YX. Ocular Abnormalities in Patients with Vitiligo: A Systematic Review and Meta-Analysis. Dermatology 2022; 238:813-822. [PMID: 35378530 DOI: 10.1159/000522601] [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: 06/11/2021] [Accepted: 02/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vitiligo is a skin depigmentation disorder that results from the autoimmune destruction of cutaneous melanocytes. Several ocular abnormalities, including uveitis, dry eye, glaucoma, and retinal diseases, have been reported in patients with vitiligo. The aim of our study was to investigate the association of ocular abnormalities with vitiligo. METHODS This meta-analysis was registered in PROSPERO (CRD42021224167) and adhered to MOOSE checklist and PRISMA guidance for all processes. PubMed, Embase, Web of Science, and Cochrane databases were searched for studies examining the association between ocular abnormalities and vitiligo from inception to December 10, 2020. Studies recruiting patients with Sjogren's syndrome or Vogt-Koyanagi-Harada syndrome were excluded. The primary outcomes were the Schirmer test, tear film break-up time (TBUT), and ocular surface disease index (OSDI) of vitiligo patients compared to the controls. The risk of bias of the selected studies was assessed using the Newcastle-Ottawa Scale (NOS) of case-control studies. RESULTS This meta-analysis of 16 case-control studies showed that patients with vitiligo had significantly lower Schirmer test values (mean difference [MD], -1.65; 95% CI, -2.81 to -0.49), shorter TBUTs (MD, -4.66; 95% CI, -7.05 to -2.26), higher ocular surface disease indices (MD, 18.02; 95% CI, 5.7-30.35), and thinner subfoveal choroidal thicknesses (MD, -53.10; 95% CI, -69.84 to -36.36). No significant differences were found in the prevalence of glaucoma and the level of intraocular pressure. CONCLUSIONS Our study supports an association between dry eye and thinner subfoveal choroidal thickness in patients with vitiligo. Dermatologists should be aware of these possible comorbidities and refer vitiligo patients with ocular symptoms to ophthalmologists for further management.
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Affiliation(s)
- Sheng-Hsiang Ma
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Chien Wu
- School of Medicine, Taipei Medical University, Taipei, Taiwan, .,Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan,
| | - Jin-Yu Chang
- School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
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8
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Cao L, Zhang R, Wang Y, Hu X, Yong L, Li B, Ge H, Chen W, Zhen Q, Yu Y, Mao Y, Li Z, Fan W, Sun L. Fine Mapping Analysis of the MHC Region to Identify Variants Associated With Chinese Vitiligo and SLE and Association Across These Diseases. Front Immunol 2022; 12:758652. [PMID: 35082778 PMCID: PMC8784546 DOI: 10.3389/fimmu.2021.758652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
The important role of MHC in the pathogenesis of vitiligo and SLE has been confirmed in various populations. To map the most significant MHC variants associated with the risk of vitiligo and SLE, we conducted fine mapping analysis using 1117 vitiligo cases, 1046 SLE cases and 1693 healthy control subjects in the Han-MHC reference panel and 1000 Genomes Project phase 3. rs113465897 (P=1.03×10-13, OR=1.64, 95%CI =1.44–1.87) and rs3129898 (P=4.21×10-17, OR=1.93, 95%CI=1.66–2.25) were identified as being most strongly associated with vitiligo and SLE, respectively. Stepwise conditional analysis revealed additional independent signals at rs3130969(p=1.48×10-7, OR=0.69, 95%CI=0.60–0.79), HLA-DPB1*03:01 (p=1.07×10-6, OR=1.94, 95%CI=1.49–2.53) being linked to vitiligo and HLA-DQB1*0301 (P=4.53×10-7, OR=0.62, 95%CI=0.52-0.75) to SLE. Considering that epidemiological studies have confirmed comorbidities of vitiligo and SLE, we used the GCTA tool to analyse the genetic correlation between these two diseases in the HLA region, the correlation coefficient was 0.79 (P=5.99×10-10, SE=0.07), confirming their similar genetic backgrounds. Our findings highlight the value of the MHC region in vitiligo and SLE and provide a new perspective for comorbidities among autoimmune diseases.
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Affiliation(s)
- Lu Cao
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Ruixue Zhang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Yirui Wang
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Xia Hu
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Liang Yong
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Bao Li
- The Comprehensive Lab, College of Basic Medicine, Anhui Medical University, Hefei, China
| | - Huiyao Ge
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Weiwei Chen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Qi Zhen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Yafen Yu
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Yiwen Mao
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Zhuo Li
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Wencheng Fan
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
| | - Liangdan Sun
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Dermatology, Anhui Medical University, Hefei, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, China
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9
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Bae JM, Kim M, Han JH, Lee S, Ju HJ, Kim JW, Almurayshid A, Choi CW. Preventive effect of levodopa on vitiligo development: a nationwide case-control study. Br J Dermatol 2022; 187:259-261. [PMID: 35157304 DOI: 10.1111/bjd.21054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Miri Kim
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ju Hee Han
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Solam Lee
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine
| | - Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jee Woo Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Abdurrahman Almurayshid
- Department of Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, City, Saudi Arabia
| | - Chong Won Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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10
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Saleh AA, Shehata WA, Abd-Elhafiz HI, Soliman SE. Potential impact of TNFAIP3 rs6920220 and DEFB1 rs1800972 gene polymorphisms on vitiligo in Egyptian patients. Meta Gene 2022. [DOI: 10.1016/j.mgene.2021.101002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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11
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Romão VC, Fonseca JE. Etiology and Risk Factors for Rheumatoid Arthritis: A State-of-the-Art Review. Front Med (Lausanne) 2021; 8:689698. [PMID: 34901047 PMCID: PMC8661097 DOI: 10.3389/fmed.2021.689698] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 11/04/2021] [Indexed: 12/24/2022] Open
Abstract
Rheumatoid arthritis (RA) is the most common systemic inflammatory rheumatic disease. It is associated with significant burden at the patient and societal level. Extensive efforts have been devoted to identifying a potential cause for the development of RA. Epidemiological studies have thoroughly investigated the association of several factors with the risk and course of RA. Although a precise etiology remains elusive, the current understanding is that RA is a multifactorial disease, wherein complex interactions between host and environmental factors determine the overall risk of disease susceptibility, persistence and severity. Risk factors related to the host that have been associated with RA development may be divided into genetic; epigenetic; hormonal, reproductive and neuroendocrine; and comorbid host factors. In turn, environmental risk factors include smoking and other airborne exposures; microbiota and infectious agents; diet; and socioeconomic factors. In the present narrative review, aimed at clinicians and researchers in the field of RA, we provide a state-of-the-art overview of the current knowledge on this topic, focusing on recent progresses that have improved our comprehension of disease risk and development.
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Affiliation(s)
- Vasco C Romão
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - João Eurico Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Centre and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Mahmoud Marie RES, Adel AZM, Abd El-Fadeal NM, Eyada MMK. Interleukin 38 serum level is increased in patients with vitiligo, correlated with disease severity, and associated with signs of disease activity. J Cosmet Dermatol 2021; 21:3515-3521. [PMID: 34783147 DOI: 10.1111/jocd.14612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/12/2021] [Accepted: 11/03/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Vitiligo is an acquired cutaneous depigmenting disease caused by a T helper (Th) 1-cytotoxic T cells driven autoimmune attack against melanocytes, in which Th17 is also involved. Interleukin (IL)-38 belongs to the IL-1 family of cytokines and suppresses Th1 and Th17 activation. IL-38 protein and mRNA levels have been found to be elevated in various autoimmune disorders and correlated with disease severity and activity, including psoriasis, systemic sclerosis, rheumatoid arthritis, and atopic dermatitis. No previous studies have been performed to investigate the expression of IL-38 in patients with vitiligo. AIM To evaluate IL-38 serum level in patients with vitiligo compared to healthy controls (Hcs) and examine the association between IL-38 level and severity and activity of vitiligo. PATIENTS AND METHODS The study comprised 21 patients with vitiligo and 21 Hcs. Vitiligo severity and activity were evaluated via Vitiligo Extent Score (VES) and Vitiligo Disease Activity (VIDA) Score, respectively. IL-38 serum level was evaluated by enzyme-linked immunosorbent assay. RESULTS Vitiligo patients had significantly higher serum level of IL-38 than Hcs (p < 0.001). This level was significantly higher among patients with signs of vitiligo activity (p = 0.048), correlated positively with VES (p < 0.001), and correlated negatively with the age of patients (p = 0.001) and the age of disease onset (p = 0.022). CONCLUSION IL-38 serum level was higher in patients with vitiligo than in Hcs and was related to vitiligo severity and signs of activity.
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Affiliation(s)
- Radwa El-Sayed Mahmoud Marie
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Al-Zahraa Mohamed Adel
- Department of Dermatology, Medical Services Administration, Suez Canal University, Ismailia, Egypt
| | - Noha M Abd El-Fadeal
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.,Oncology Diagnostic Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Moustafa Mohamad Kamel Eyada
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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13
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Park JS, Choi S, Kim K, Chang J, Kim SM, Kim SR, Lee G, Son JS, Kim KH, Lee EY, Park SM. Association of particulate matter with autoimmune rheumatic diseases among adults in South Korea. Rheumatology (Oxford) 2021; 60:5117-5126. [PMID: 33560298 PMCID: PMC8566218 DOI: 10.1093/rheumatology/keab127] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The primary objective of this study was to investigate adverse effects of ambient particulate matter of various sizes on the incidence of the prevalent autoimmune rheumatic diseases (AIRDs): RA, AS and SLE. METHODS We investigated 230 034 participants in three metropolitan cities of South Korea from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Starting from January 2010, subjects were followed up until the first event of prevalent AIRDs, death, or December 2013. The 2008-2009 respective averages of particulate matter2.5 (<2.5 μm) and particulate mattercoarse (2.5 μm to 10 μm) were linked with participants' administrative district codes. Adjusted hazard ratios (aHRs) and 95% CIs were estimated using Cox regression analysis in one- and two-pollutant models. RESULTS Adjusted for age, sex, region, and household income, in the two-pollutant model, RA incidence was positively associated with the 10 μg/m³ increment of particulate matter2.5 (aHR = 1.74, 95% CI: 1.06, 2.86), but not with particulate mattercoarse (aHR = 1.27, 95% CI: 0.87, 1.85). In the one-pollutant model, the elevated incidence rate of RA was slightly attenuated (particulate matter2.5 aHR = 1.61, 95% CI: 0.99, 2.61; particulate mattercoarse aHR = 1.13, 95% CI: 0.80, 1.61), with marginal statistical significance for particulate matter2.5. The RA incidence was also higher in the 4th quartile group of particulate matter2.5 compared with the first quartile group (aHR = 1.83, 95% CI: 1.07, 3.11). Adverse effects from particulate matter were not found for AS or SLE in either the one- or two-pollutant models. CONCLUSION The important components of particulate matter10 associated with RA incidence were the fine fractions (particulate matter2.5); no positive association was found between particulate matter and AS or SLE.
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Affiliation(s)
- Jun Seok Park
- College of Medicine, Seoul National University Hospital
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul
| | - Kyuwoong Kim
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul
| | - Seong Rae Kim
- College of Medicine, Seoul National University Hospital
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital
| | - Joung Sik Son
- Department of Family Medicine, Seoul National University Hospital
| | - Kyae Hyung Kim
- Department of Family Medicine, Seoul National University Hospital
| | - Eun Young Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul.,Department of Family Medicine, Seoul National University Hospital
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14
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Lee YB, Kim HS. Height and Risk of Vitiligo: A Nationwide Cohort Study. J Clin Med 2021; 10:jcm10173958. [PMID: 34501405 PMCID: PMC8432081 DOI: 10.3390/jcm10173958] [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: 08/06/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
Adult height is linked to the risk of several diseases, but its association with vitiligo has not been established. This study aimed to investigate the relationship between adult height and vitiligo incidence. Korean nationwide claims data from 15,980,754 individuals (20 years of age or older) who received a health checkup during the period 2005–2008, were examined. Subjects were categorized into age- and gender-specific height quintiles. Participants were followed until vitiligo diagnosis or until the end of 2015. The Cox proportional-hazards model for cumulative risk was computed for height categories. During the follow-up period, 29,196 cases (136,020,214 person-years) of newly diagnosed vitiligo were reported. A positive association was found between height and risk of vitiligo in which the hazard ratio between the highest and lowest quintiles of height was 1.36 (95% confidence interval: 1.31–1.42). While more diverse cohort studies are needed, our findings suggest that taller stature increases the risk of vitiligo.
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Affiliation(s)
- Young-Bok Lee
- Department of Dermatology, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hei-Sung Kim
- Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-32-280-5100
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15
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Seok SH, Kim DH. Pathogenesis of vitiligo. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.12.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vitiligo is an autoimmune disease in which CD8+ T-cells target and destroy melanocytes, leaving areas of skin without pigment production. Nonsegmental vitiligo, the classical form of the disease, results in symmetrical, bilateral white patches. Vitiligo is a chronic, unpredictable disease, characterized by flares, with depigmentation and periods of disease arrest alternating. This process can be stressful and negatively impact one’s quality of life. Various hypotheses have been offered, including cellular stress causing degeneration of melanocytes, chemical toxicity causing melanocyte death, and neural changes that influence melanocytes or their ability to produce melanin. Recently, the interaction between oxidative stress and autoimmune-mediated melanocyte loss has been proposed as the primary pathogenesis of vitiligo. It is now well accepted that interferon-γ and/or C-X-C motif chemokine ligand 10 axis is functionally required for both progression and maintenance of vitiligo, making this pathway a potential therapeutic target. Most therapeutic interventions in the management of vitiligo have been developed based on this immunopathogenesis. This article aims to review the current understanding of the vitiligo pathogenesis.
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16
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Choi CW. Non-surgical treatment of vitiligo. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.12.741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Vitiligo is an acquired depigmenting skin disorder that affects 0.5% to 2% of the population. Skin lesions from vitiligo, white macules and patches on the skin, can pose a substantial psychological burdencan, causing a significant decrease in one’s quality of life. Recent basic and clinical studies have found that vitiligo is an autoimmune disorder, mediated by CD8+ T-cell and interferon-γ-mediated cytokine/chemokines. Although no treatment modality presents a complete cure for vitiligo, current treatment modalities have a modest effect on vitiligo by reversing the disease’s progression, inducing its stabilization, and promoting melanocyte regeneration. Current non-surgical treatment modalities include topical corticosteroids, topical calcineurin inhibitors, systemic corticosteroids, and phototherapy such as narrowband ultraviolet B phototherapy and excimer laser. In addition, clinicians have used and combined non-surgical treatment modalities based on the activity and extent of vitiligo. Moreover, considering the high risk of vitiligo relapse, maintenance therapy for re-pigmented lesions has also been introduced. Lastly, based on the results of recent translational research, new and emerging treatment modalities have been introduced, such as Janus kinase inhibitors. This review presents an overview of the current non-surgical treatment modalities for vitiligo and discusses emerging treatments.
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17
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Bae JM, Jeong K, Choi CW, Park JH, Lee HJ, Kim HJ, Lee SH, Oh SH, Shin J, Kang HY, Lee WJ, Ju HJ, Kim DH, Chang SE, Lee DY, Kim YC, Choi GS, Kim K, Kim TH, Lee SC, Lee A, Hann S, Lee M, Park CJ. Development of evidence‐based consensus on critical issues in the management of patients with vitiligo: A modified Delphi study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2020; 37:3-11. [DOI: 10.1111/phpp.12598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/25/2020] [Accepted: 08/02/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Jung Min Bae
- Department of Dermatology College of Medicine, The Catholic University of Korea Seoul Korea
| | - Ki‐Heon Jeong
- Department of Dermatology College of Medicine, Kyung Hee University Seoul South Korea
| | - Chong Won Choi
- Department of Dermatology Chungnam National University School of Medicine Daejeon South Korea
| | - Ji Hun Park
- Drs Woo and Hann’s Skin Center Seoul South Korea
| | - Hee Jung Lee
- Department of Dermatology Cha University Bundang Cha Medical Center School of Medicine Bundang South Korea
| | - Hee Jung Kim
- YK Park Yoon Kee's Dermatology Clinic Seoul South Korea
| | - Sang Hoon Lee
- Department of Dermatology Soon Chun Hyang University Hospital Bucheon South Korea
| | - Sang Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine Seoul South Korea
| | - Jeonghyun Shin
- Department of Dermatology Inha University School of Medicine Incheon South Korea
| | - Hee Young Kang
- Department of Dermatology Ajou University School of Medicine Suwon South Korea
| | - Weon Ju Lee
- Department of Dermatology Kyungpook National University School of Medicine Daegu South Korea
| | - Hyun Jeong Ju
- Department of Dermatology College of Medicine, The Catholic University of Korea Seoul Korea
| | - Dong Hyun Kim
- Department of Dermatology Cha University Bundang Cha Medical Center School of Medicine Bundang South Korea
| | - Sung Eun Chang
- Department of Dermatology Asan Medical Center, University of Ulsan College of Medicine Seoul Korea
| | - Dong Youn Lee
- Department of Dermatology SungKyunKwann University School of Medicine Seoul South Korea
| | - You Chan Kim
- Department of Dermatology Ajou University School of Medicine Suwon South Korea
| | - Gwang Seong Choi
- Department of Dermatology Inha University School of Medicine Incheon South Korea
| | - Ki‐Ho Kim
- Department of Dermatology Dong‐A University School of Medicine Busan South Korea
| | | | - Seung Chul Lee
- Department of Dermatology Chonnam National University School of Medicine Gwangju South Korea
| | - Ai‐Young Lee
- Department of Dermatology Dongkuk University School of Medicine Ilsan Korea
| | | | - Mu‐Hyoung Lee
- Department of Dermatology College of Medicine, Kyung Hee University Seoul South Korea
| | - Chul Jong Park
- Department of Dermatology College of Medicine, The Catholic University of Korea Seoul Korea
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18
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Kim J, Chun J, Lee C, Han K, Choi S, Lee J, Soh H, Choi K, Park S, Kang EA, Lee HJ, Im JP, Kim JS. Increased risk of idiopathic pulmonary fibrosis in inflammatory bowel disease: A nationwide study. J Gastroenterol Hepatol 2020; 35:249-255. [PMID: 31420894 DOI: 10.1111/jgh.14838] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/27/2019] [Accepted: 08/12/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM The relationship between inflammatory bowel disease (IBD) and idiopathic pulmonary fibrosis (IPF) remains unclear. We evaluated the risk for developing IPF in patients with IBD using a nationwide population-based study. METHODS Using claims data from the National Health Insurance service in Korea, patients with IBD, including Crohn's disease (CD) and ulcerative colitis (UC), were identified through both the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and rare and intractable disease program codes from January 2010 to December 2013. We compared 38 921 IBD patients with age-matched and sex-matched individuals without IBD in a ratio of 1:3. Patients with newly diagnosed IPF were identified by both the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and rare and intractable disease registration codes. RESULTS During a mean 4.9-year follow-up, the incidence of IPF in patients with IBD was 33.21 per 100 000 person-years. The overall risk of IPF was significantly higher in IBD patients than in non-IBD controls (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.20-2.20; P = 0.003). In patients with CD, the incidence (per 100 000 person-years) of IPF was 26.04; in controls, the incidence was 9.15 (HR, 2.89; 95% CI, 1.46-5.72; P = 0.002). The incidence of IPF in patients with UC tended to be higher than in controls (36.66 vs 26.54 per 100 000 person-years; 95% CI, 0.99-1.99; HR, 1.41; P = 0.066). The risk of developing IPF in patients with IBD was higher in male patients than in female patients (P = 0.093 in CD; P = 0.147 in UC by interaction analysis). CONCLUSIONS Patients with IBD, especially CD, have an increased risk of developing IPF.
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Affiliation(s)
- Jihye Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Jaeyoung Chun
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Changhyun Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seungho Choi
- Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hosim Soh
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kookhwan Choi
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seona Park
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Ae Kang
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun Jung Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jong Pil Im
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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19
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Seong JM, Yee J, Gwak HS. Dipeptidyl peptidase-4 inhibitors lower the risk of autoimmune disease in patients with type 2 diabetes mellitus: A nationwide population-based cohort study. Br J Clin Pharmacol 2019; 85:1719-1727. [PMID: 30964554 DOI: 10.1111/bcp.13955] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 01/01/2023] Open
Abstract
AIMS To evaluate the real-world effect of dipeptidyl peptidase-4 inhibitor (DPP4i) on the incidence of autoimmune diseases (AD), including rheumatoid arthritis (RA), inflammatory bowel diseases, multiple sclerosis and systemic lupus erythematosus. METHODS We identified new users of DPP4i (n = 497 619) or non-DPP4i (n = 643 165) oral combination therapy between 1 January 2011 and 30 June 2015 among patients with type 2 diabetes mellitus in the Korean national health insurance claims database. Patients were followed from the date of initiation of combination therapy until AD outcome, censoring for treatment discontinuation or switching, death or end of study (31 August 2016). Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for RA, inflammatory bowel diseases, other AD (multiple sclerosis and systemic lupus erythematosus), and the composite of all outcomes were estimated using propensity score (PS)-adjusted Cox model. RESULTS In the PS-weighted and PS-matched analysis, the risk of incident RA was decreased for DPP4i initiators compared with non-DPP4i initiators (aHR 0.67 [95% CI 0.49-0.92] and aHR 0.72 [95% CI 0.51-1.01], respectively). In both analyses, the risk of incident composite AD was also decreased for DPP4i initiators compared with non-DPP4i initiators (aHR 0.82 [95% CI 0.68-0.99] and aHR 0.76 [95% CI 0.62-0.93], respectively). CONCLUSIONS In this large population-based cohort study, upfront DPP4i combination therapy was associated with a lower risk of composite AD compared with initial non-DPP4i combination therapy.
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Affiliation(s)
- Jong-Mi Seong
- College of Pharmacy and Division of Life & Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Jeong Yee
- College of Pharmacy and Division of Life & Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Hye Sun Gwak
- College of Pharmacy and Division of Life & Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
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20
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Bae JM, Chung KY, Yun SJ, Kim H, Park BC, Kim JS, Seo SH, Ahn HH, Lee DY, Kim YC, Park HJ, Kim M. Markedly Reduced Risk of Internal Malignancies in Patients With Vitiligo: A Nationwide Population-Based Cohort Study. J Clin Oncol 2019; 37:903-911. [PMID: 30785828 DOI: 10.1200/jco.18.01223] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Recent studies indicated that the autoimmunity of vitiligo exerts effects on cells other than melanocytes, which confer reduced risks of both melanoma and nonmelanoma skin cancers in patients with vitiligo. However, the risk of internal malignancy in patients with vitiligo has not been elucidated. PATIENTS AND METHODS We conducted a population-based retrospective cohort study using data from the Korean National Health Insurance claims database obtained from January 2007 to December 2016. All patients age 20 years or older with vitiligo who had at least two contacts with a physician from 2009 to 2016, during which a principal diagnosis was made, were identified (vitiligo group). Controls were randomly selected (two per patient with vitiligo) after frequency matching with the vitiligo group for age and sex during the same period (control group). RESULTS A total of 101,078 patients with vitiligo and 202,156 controls without vitiligo were included. The incidence rates of internal malignancies were 612.9 and 708.9 per 100,000 person-years in the vitiligo and control groups, respectively. Patients with vitiligo showed a significantly reduced risk of overall internal malignancies (hazard ratio [HR], 0.86; 95% CI, 0.82 to 0.89; P < .001) compared with controls without vitiligo after adjustments for age, sex, and comorbidities. With regard to organ-specific malignancies, patients with vitiligo showed a remarkably decreased risk of cancer in the colon and rectum (HR, 0.62; 95% CI, 0.55 to 0.69; P < .001), ovary (HR, 0.62; 95% CI, 0.46 to 0.83; P < .001), and lung (HR, 0.75; 95% CI, 0.65 to 0.86; P < .001). CONCLUSION Vitiligo was associated with a reduced risk of overall internal malignancies. These findings suggest that autoimmune diseases, including vitiligo, may provide immune surveillance for the development of cancer beyond the targeted organ.
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Affiliation(s)
- Jung Min Bae
- 1 St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Sook Jung Yun
- 3 Chonnam National University School of Medicine, Gwangju, Korea
| | - Heesu Kim
- 4 Catholic Kwandong University College of Medicine, Incheon, Korea
| | | | - Joung Soo Kim
- 6 Hanyang University College of Medicine, Guri, Korea
| | - Soo Hong Seo
- 7 Korea University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- 7 Korea University College of Medicine, Seoul, Korea
| | - Dong-Youn Lee
- 8 Sungkyunkwan University School of Medicine, Seoul, Korea
| | - You Chan Kim
- 9 Ajou University School of Medicine, Suwon, Korea
| | | | - Miri Kim
- 11 Yeouido St Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Korea
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21
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Affiliation(s)
- C.B. Bunker
- University College London Hospitals 250 Euston Road London NW1 2AF UK
| | - J. Manson
- University College London Hospitals 250 Euston Road London NW1 2AF UK
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22
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Ochoa-Ramírez LA, Becerra-Loaiza DS, Díaz-Camacho SP, Muñoz-Estrada VF, Ríos-Burgueño ER, Prado-Montes de Oca E, Rangel-Villalobos H, Velarde-Félix JS. Association of human beta-defensin 1 gene polymorphisms with nonsegmental vitiligo. Clin Exp Dermatol 2018; 44:277-282. [DOI: 10.1111/ced.13697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2018] [Indexed: 12/14/2022]
Affiliation(s)
- L. A. Ochoa-Ramírez
- Faculty of Chemical and Biological Sciences; Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
| | - D. S. Becerra-Loaiza
- Faculty of Chemical and Biological Sciences; Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
| | - S. P. Díaz-Camacho
- Faculty of Chemical and Biological Sciences; Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
| | - V. F. Muñoz-Estrada
- Center of Research and Teaching in Health Sciences (CIDOCS); Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
| | - E. R. Ríos-Burgueño
- Center of Research and Teaching in Health Sciences (CIDOCS); Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
| | - E. Prado-Montes de Oca
- Personalized Medicine National Laboratory (LAMPER); Medical and Pharmaceutical Biotechnology; Research Center in Technology and Design Assistance of Jalisco State (CIATEJ); National Council of Science and Technology (CONACYT); Jalisco Mexico
| | - H. Rangel-Villalobos
- Molecular Genetics Research Institute; University of Guadalajara (CUCI-UdeG); Ocotlan Jalisco Mexico
| | - J. S. Velarde-Félix
- Faculty of Chemical and Biological Sciences; Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
- Faculty of Biology; Autonomous University of Sinaloa; Culiacan Sinaloa Mexico
- General Hospital of Culiacan; Servicios de Salud Sinaloa; Culiacan Mexico
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Increased Risk of Vitiligo Following Anti-Tumor Necrosis Factor Therapy: A 10-Year Population-Based Cohort Study. J Invest Dermatol 2018; 138:768-774. [DOI: 10.1016/j.jid.2017.11.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/07/2017] [Accepted: 11/14/2017] [Indexed: 11/20/2022]
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24
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Pregnancy outcomes in patients with vitiligo: A nationwide population-based cohort study from Korea. J Am Acad Dermatol 2018; 79:836-842. [PMID: 29477741 DOI: 10.1016/j.jaad.2018.02.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/31/2018] [Accepted: 02/10/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Vitiligo is a chronic autoimmune skin disorder affecting 1% of populations worldwide. Few large-scale studies have explored adverse pregnancy outcomes in patients with vitiligo. OBJECTIVE To investigate adverse pregnancy outcomes in patients with vitiligo. METHODS We performed a retrospective cohort study on 4738 pregnancies of women with vitiligo and 47,380 pregnancies of age-matched controls without vitiligo using the Korean National Health Insurance Claims database from 2007 to 2016. Multivariate logistic regression models were used to evaluate the associations between vitiligo and pregnancy outcomes, including live births, spontaneous abortion, cesarean delivery, preterm delivery, gestational diabetes mellitus, stillbirth, pre-eclampsia/eclampsia, and intrauterine growth retardation. RESULTS Patients with vitiligo exhibited a significantly lower live birth rate (odds ratio, 0.870; 95% confidence interval, 0.816-0.927) and a higher incidence of spontaneous abortion (odds ratio, 1.250; 95% confidence interval, 1.148-1.362) than the control group. LIMITATION The Korean National Health Insurance Claims database lacks detailed clinical information on individual patients. CONCLUSION Vitiligo was significantly associated with an increased risk of spontaneous abortion. Further studies are needed to determine whether systemic autoimmunity explains our finding.
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Watabe A, Yamasaki K, Asano M, Kanbayashi Y, Nasu-Tamabuchi M, Terui H, Furudate S, Kakizaki A, Tsuchiyama K, Kimura Y, Ito Y, Kikuchi K, Aiba S. Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: A blinded randomized clinical trial. J Dermatol 2018; 45:456-462. [DOI: 10.1111/1346-8138.14244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Akiko Watabe
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kenshi Yamasaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Masayuki Asano
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yumi Kanbayashi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Mei Nasu-Tamabuchi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Hitoshi Terui
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Sadanori Furudate
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Aya Kakizaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kenichiro Tsuchiyama
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yutaka Kimura
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yumiko Ito
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Katsuko Kikuchi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Setsuya Aiba
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
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