Tumour necrosis factor-α antagonists as therapies for vitiligo

Exploring the roles and potential therapeutic strategies of inflammation and metabolism in the pathogenesis of vitiligo: a mendelian randomization and bioinformatics-based investigation

Introduction

Vitiligo, a common autoimmune acquired pigmentary skin disorder, poses challenges due to its unclear pathogenesis. Evidence suggests inflammation and metabolism's pivotal roles in its onset and progression. This study aims to elucidate the causal relationships between vitiligo and inflammatory proteins, immune cells, and metabolites, exploring bidirectional associations and potential drug targets.

Methods

Mendelian Randomization (MR) analysis encompassed 4,907 plasma proteins, 91 inflammatory proteins, 731 immune cell features, and 1400 metabolites. Bioinformatics analysis included Protein-Protein Interaction (PPI) network construction, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Subnetwork discovery and hub protein identification utilized the Molecular Complex Detection (MCODE) plugin. Colocalization analysis and drug target exploration, including molecular docking validation, were performed.

Results

MR analysis identified 49 proteins, 39 immune cell features, and 59 metabolites causally related to vitiligo. Bioinformatics analysis revealed significant involvement in PPI, GO enrichment, and KEGG pathways. Subnetwork analysis identified six central proteins, with Interferon Regulatory Factor 3 (IRF3) exhibiting strong colocalization evidence. Molecular docking validated Piceatannol's binding to IRF3, indicating a stable interaction.

Conclusion

This study comprehensively elucidates inflammation, immune response, and metabolism's intricate involvement in vitiligo pathogenesis. Identified proteins and pathways offer potential therapeutic targets, with IRF3 emerging as a promising candidate. These findings deepen our understanding of vitiligo's etiology, informing future research and drug development endeavors.

Changes in sICAM-1 and GM-CSF levels in skin tissue fluid and expression of IL-6, IL-17 and TNF-α in blood of patients with vitiligo

Changes in the levels of soluble intercellular adhesion molecule-1 (sICAM-1) and granulocyte-macrophage colony stimulating factor (GM-CSF) in the skin tissue fluid, and the expression of interleukin (IL)-6, IL-17 and tumor necrosis factor-α (TNF-α) in the blood of patients with vitiligo were investigated. One hundred and twenty patients diagnosed with vitiligo and treated in Daqing Long Nan Hospital from March 2014 to March 2016 were selected, including 88 patients with vitiligo vulgaris and 32 patients with segmental vitiligo. Comparative analyses were performed for research indexes. Another 80 healthy volunteers receiving physical examination were selected as healthy controls. The levels of GM-CSF in tissue fluid were detected via radioimmunoassay (RIA). The levels of sICAM-1 in tissue fluid and IL-6, IL-17 and TNF-α in the blood were detected via enzyme-linked immunosorbent assay (ELISA). The expression levels of IL-6, IL-17 and TNF-α in patients with progressive vitiligo were significantly higher than those in patients with stable vitiligo (P<0.05). The levels of sICAM-1 and GM-CSF in the skin tissue fluid at white spots of patients with vitiligo vulgaris were significantly higher than those in the skin tissue fluid at non-white spots (P<0.05). sICAM-1 levels had significant positive correlations with the levels of IL-6, IL-17 and TNF-α in the blood (P<0.05). The levels of sICAM-1 in the skin tissue fluid and IL-6 in the blood of patients with vitiligo were negatively correlated with the course of disease (P<0.05). The levels of sICAM-1 in the skin tissue fluid and IL-6 and IL-17 in the blood of patients with vitiligo were positively correlated with the skin lesion area of patients (P<0.05). The levels of sICAM-1 and GM-CSF in the skin tissue fluid, and the expression levels of IL-6, IL-17 and TNF-α in the blood of patients with vitiligo are abnormal.