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Hafner C, Windpassinger M, Tretter EV, Rebernig KA, Reindl SM, Hochreiter B, Dekan S, Haider P, Kiss H, Klein KU, Wohlrab P. Role of mitochondrial DNA level in epidural-related maternal fever: a single-centre, observational, pilot study. BMC Pregnancy Childbirth 2024; 24:341. [PMID: 38702618 PMCID: PMC11067090 DOI: 10.1186/s12884-024-06551-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/28/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION Epidural analgesia has been associated with intrapartum maternal fever development. Epidural-related maternal fever (ERMF) is believed to be based on a non-infectious inflammatory reaction. Circulating cell-free mitochondrial deoxyribonucleic acid (mtDNA) is one of the possible triggers of sterile inflammatory processes; however, a connection has not been investigated so far. Therefore, this study aimed to investigate cell-free mtDNA alterations in women in labour with ERMF in comparison with non-febrile women. MATERIAL AND METHODS A total of 60 women in labour were assessed for maternal temperature every 4 h and blood samples were obtained at the beginning and after delivery. Depending on the analgesia and the development of fever (axillary temperature ≥ 37.5 °C), the women were allocated either to the group of no epidural analgesia (n = 17), to epidural analgesia no fever (n = 34) or to ERMF (n = 9). Circulating cell-free mtDNA was analysed in the maternal plasma for the primary outcome whereas secondary outcomes include the evaluation of inflammatory cytokine release, as well as placental inflammatory signs. RESULTS Of the women with epidural analgesia, 20% (n = 9) developed ERMF and demonstrated a decrease of circulating mtDNA levels during labour (p = 0.04), but a trend towards higher free nuclear DNA. Furthermore, women with maternal pyrexia showed a 1.5 fold increased level of Interleukin-6 during labour. A correlation was found between premature rupture of membranes and ERMF. CONCLUSIONS The pilot trial revealed an evident obstetric anaesthesia phenomenon of maternal fever due to epidural analgesia in 20% of women in labour, demonstrating counterregulated free mtDNA and nDNA. Further work is urgently required to understand the connections between the ERMF occurrence and circulating cell-free mtDNA as a potential source of sterile inflammation. TRIAL REGISTRATION NCT0405223 on clinicaltrials.gov (registered on 25/07/2019).
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Affiliation(s)
- Christina Hafner
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Marita Windpassinger
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Eva Verena Tretter
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Katharina Anna Rebernig
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Sophie Marie Reindl
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Beatrix Hochreiter
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Sabine Dekan
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Patrick Haider
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Herbert Kiss
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Klaus Ulrich Klein
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter Wohlrab
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Spitalgasse 23, Vienna, 1090, Austria.
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Lin Y, Ding Y, Wu Y, Yang Y, Liu Z, Xiang L, Zhang C. The underestimated role of mitochondria in vitiligo: From oxidative stress to inflammation and cell death. Exp Dermatol 2024; 33:e14856. [PMID: 37338012 DOI: 10.1111/exd.14856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 06/21/2023]
Abstract
Vitiligo is an acquired depigmentary disorder characterized by the depletion of melanocytes in the skin. Mitochondria shoulder multiple functions in cells, such as production of ATP, maintenance of redox balance, initiation of inflammation and regulation of cell death. Increasing evidence has implicated the involvement of mitochondria in the pathogenesis of vitiligo. Mitochondria alteration will cause the abnormalities of mitochondria functions mentioned above, ultimately leading to melanocyte loss through various cell death modes. Nuclear factor erythroid 2-related factor 2 (Nrf2) plays a critical role in mitochondrial homeostasis, and the downregulation of Nrf2 in vitiligo may correlate with mitochondria damage, making both mitochondria and Nrf2 promising targets in treatment of vitiligo. In this review, we aim to discuss the alterations of mitochondria and its role in the pathogenesis of vitiligo.
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Affiliation(s)
- Yi Lin
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | - Yuecen Ding
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | - Yue Wu
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | - Yiwen Yang
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | - Ziqi Liu
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | - Leihong Xiang
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital Fudan University, Shanghai, China
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Wang X, Wang M, Cai M, Shao R, Xia G, Zhao W. Miriplatin-loaded liposome, as a novel mitophagy inducer, suppresses pancreatic cancer proliferation through blocking POLG and TFAM-mediated mtDNA replication. Acta Pharm Sin B 2023; 13:4477-4501. [PMID: 37969736 PMCID: PMC10638513 DOI: 10.1016/j.apsb.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/29/2023] [Accepted: 06/13/2023] [Indexed: 11/17/2023] Open
Abstract
Pancreatic cancer is a more aggressive and refractory malignancy. Resistance and toxicity limit drug efficacy. Herein, we report a lower toxic and higher effective miriplatin (MPt)-loaded liposome, LMPt, exhibiting totally different anti-cancer mechanism from previously reported platinum agents. Both in gemcitabine (GEM)-resistant/sensitive (GEM-R/S) pancreatic cancer cells, LMPt exhibits prominent anti-cancer activity, led by faster cellular entry-induced larger accumulation of MPt. The level of caveolin-1 (Cav-1) determines entry rate and switch of entry pathways of LMPt, indicating a novel role of Cav-1 in nanoparticle entry. After endosome-lysosome processing, in unchanged metabolite, MPt is released and targets mitochondria to enhance binding of mitochondria protease LONP1 with POLG and TFAM, to degrade POLG and TFAM. Then, via PINK1-Parkin axis, mitophagy is induced by POLG and TFAM degradation-initiated mitochondrial DNA (mtDNA) replication blocking. Additionally, POLG and TFAM are identified as novel prognostic markers of pancreatic cancer, and mtDNA replication-induced mitophagy blocking mediates their pro-cancer activity. Our findings reveal that the target of this liposomal platinum agent is mitochondria but not DNA (target of most platinum agents), and totally distinct mechanism of MPt and other formulations of MPt. Self-assembly offers LMPt special efficacy and mechanisms. Prominent action and characteristic mechanism make LMPt a promising cancer candidate.
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Affiliation(s)
- Xiaowei Wang
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
- Pharmaceutics Department, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Mengyan Wang
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Meilian Cai
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Rongguang Shao
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Guimin Xia
- Pharmaceutics Department, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Wuli Zhao
- State Key Laboratory of Respiratory Health and Multimorbidity, Key Laboratory of Antibiotic Bioengineering, Ministry of Health, Laboratory of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
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Kaushik H, Kumar V, Parsad D. Mitochondria-Melanocyte cellular interactions: An emerging mechanism of vitiligo pathogenesis. J Eur Acad Dermatol Venereol 2023; 37:2196-2207. [PMID: 36897230 DOI: 10.1111/jdv.19019] [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: 10/15/2022] [Accepted: 02/07/2023] [Indexed: 03/11/2023]
Abstract
Mitochondria has emerged as a potential modulator of melanocyte function other than just meeting its cellular ATP demands. Mitochondrial DNA defects are now an established cause of maternal inheritance diseases. Recent cellular studies have highlighted the mitochondrial interaction with other cellular organelles that lead to disease conditions such as in Duchenne muscular dystrophy, where defective mitochondria was found in melanocytes of these patients. Vitiligo, a depigmentory ailment of the skin, is another such disorder whose pathogenesis is now found to be associated with mitochondria. The complete absence of melanocytes at the lesioned site in vitiligo is a fact; however, the precise mechanism of this destruction is still undefined. In this review we have tried to discuss and link the emerging facts of mitochondrial function or its inter- and intra-organellar communications in vitiligo pathogenesis. Mitochondrial close association with melanosomes, molecular involvement in melanocyte-keratinocyte communication and melanocyte survival are new paradigm of melanogenesis that could ultimately account for vitiligo. This definitely adds the new dimensions to our understanding of vitiligo, its management and designing of future mitochondrial targeted therapy for vitiligo.
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Affiliation(s)
- Hitaishi Kaushik
- Department of Dermatology, Venereology & Leprology, PGIMER, Chandigarh, 160012, India
| | - Vinod Kumar
- Department of Dermatology, Venereology & Leprology, PGIMER, Chandigarh, 160012, India
| | - Davinder Parsad
- Department of Dermatology, Venereology & Leprology, PGIMER, Chandigarh, 160012, India
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Luo L, Zhu J, Guo Y, Li C. Mitophagy and immune infiltration in vitiligo: evidence from bioinformatics analysis. Front Immunol 2023; 14:1164124. [PMID: 37287971 PMCID: PMC10242039 DOI: 10.3389/fimmu.2023.1164124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/11/2023] [Indexed: 06/09/2023] Open
Abstract
Background Vitiligo is an acquired, autoimmune, depigmented skin disease with unclear pathogenesis. Mitochondrial dysfunction contributes significantly to vitiligo, and mitophagy is vital for removing damaged mitochondria. Herein, using bioinformatic analysis, we sought to determine the possible role of mitophagy-associated genes in vitiligo and immune infiltration. Methods Microarrays GSE53146 and GSE75819 were used to identify differentially expressed genes (DEGs) in vitiligo. By crossing vitiligo DEGs with mitophagy-related genes, the mitophagy-related DEGs were identified. Functional enrichment and protein-protein intersection (PPI) analyses were conducted. Then, the hub genes were identified using two machine algorithms, and receiver operating characteristic (ROC) curves were generated. Next, the immune infiltration and its connection with hub genes in vitiligo were investigated. Finally, the Regnetwork database and NetworkAnalyst were used to predict the upstream transcriptional factors (TFs), microRNAs (miRNAs), and the protein-compound network. Results A total of 24 mitophagy-related genes were screened. Then, five mitophagy hub genes (GABARAPL2, SP1, USP8, RELA, and TBC1D17) were identified using two machine learning algorithms, and these genes showed high diagnostic specificity for vitiligo. The PPI network showed that hub genes interacted with each other. The mRNA expression levels of five hub genes were validated in vitiligo lesions by qRT-PCR and were compatible with the bioinformatic results. Compared with controls, the abundance of activated CD4+ T cells, CD8+ T cells, immature dendritic cells and B cells, myeloid-derived suppressor cells (MDSCs), gamma delta T cells, mast cells, regulatory T cells (Tregs), and T helper 2 (Th2) cells was higher. However, the abundance of CD56 bright natural killer (NK) cells, monocytes, and NK cells was lower. Correlation analysis revealed a link between hub genes and immune infiltration. Meanwhile, we predicted the upstream TFs and miRNAs and the target compounds of hub genes. Conclusion Five hub mitophagy-related genes were identified and correlated with immune infiltration in vitiligo. These findings suggested that mitophagy may promote the development of vitiligo by activating immune infiltration. Our study might enhance our comprehension of the pathogenic mechanism of vitiligo and offer a treatment option for vitiligo.
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Affiliation(s)
- Lingling Luo
- Department of Dermatology, Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
| | - Jing Zhu
- Department of Dermatology, Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
| | - Youming Guo
- Department of Dermatology, Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
| | - Chengrang Li
- Department of Dermatology, Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
- Department of Dermatology, Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and Sexually Transmitted Infections, Nanjing, Jiangsu, China
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Shehata WA, Hammam MA, Abdo A, Tayel N, Abdelsattar S. Mitochondrial DNA copy number as a diagnostic marker and indicator of degree of severity in alopecia areata. J Immunoassay Immunochem 2023; 44:256-268. [PMID: 36681933 DOI: 10.1080/15321819.2023.2168557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Alopecia areata (AA) is a disorder with several etiologies. The evidence suggests that the absolute copy number of mitochondrial deoxyribonucleic acid (mtDNA), as well as proportion of mutated mtDNA copies, determines disease onset. This study aims to quantify the relative index of the mtDNA copy number in patients with AA and healthy controls and correlate the results with the existing clinical information. This case-control study included 50 patients with AA and 50 age- and sex-coordinated healthy persons as controls. The severity of AA was weighed using the Severity of Alopecia Tool and Kavak's classification. The relative index of the mtDNA copy number was measured by real-time qPCR. Significant statistical difference was observed between cases and controls regarding mean mtDNA copy number, p < .001. There was significant positive correlation with SALT score (p = 0.001). A cutoff value of >1.619 N/µL could significantly diagnose AA cases (p < .001), and a cutoff value of > 1.36 N/µL could discriminate mild AA cases from those with moderate AA (p = 0.007). The relative index of mtDNA copy number is significantly elevated in AA cases and could be helpful in diagnosing and evaluating AA severity.
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Affiliation(s)
- Wafaa Ahmed Shehata
- Dermatology, Andrology & STDs Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Mostafa Ahmed Hammam
- Dermatology, Andrology & STDs Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Aya Abdo
- General Practitioner in Health Sector, Shebin El-Kom, Menoufia, Egypt
| | - Nermin Tayel
- Department of Molecular Diagnostics & Therapeutics, Genetic Engineering and Biotechnology Research Institute, Sadat City University, Sadat, Egypt
| | - Shimaa Abdelsattar
- Clinical Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufia University, Menoufia, Egypt
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7
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OZCAN Y, KARAGÜN E, ALPAY M. Interplay Between Vitiligo And Oxidative Stress: Evaluation Of The Mechanisms Of Autoımmune Diseases. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.880577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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The Promising Role of Chemokines in Vitiligo: From Oxidative Stress to the Autoimmune Response. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8796735. [PMID: 35096274 PMCID: PMC8791757 DOI: 10.1155/2022/8796735] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/09/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022]
Abstract
Vitiligo is a common chronic autoimmune skin disorder featured with depigmented patches and underlying destruction of melanocytes in the lesional skin. Multiple factors and mechanisms have been proposed for the etiopathogenesis of vitiligo, among which oxidative stress has been widely accepted as a key factor in initiating melanocyte loss. The altered redox status caused by oxidative stress, including the overproduction of reactive oxygen species (ROS) and the decreased activity of the antioxidant system in the skin, surrenders the resistance of melanocytes to exogenous or endogenous stimuli and eventually impairs the normal defense mechanism, leading to the absence of melanocytes. Considering the important role of innate and adaptive immunity in vitiligo, there is mounting evidence revealing an association between oxidative stress and autoimmunity. Since the significant changes of chemokines have been documented in vitiligo in many recent studies, it has been suggested that ROS-mediated chemotactic signals are not only the biomarkers of disease progression and prognosis but also are involved in the pathogenesis of vitiligo by facilitating the innate and adaptive immune cells, especially melanocyte-specific T cells, trafficking to the lesional areas of vitiligo. In this review, we discuss the interaction between oxidative stress and autoimmune response orchestrated by chemokines, including CXCL16-CXCR6 axis, CXCL9/CXCL10-CXCR3 axis, and other altered chemokines in vitiligo, and we also try to provide insight into potential therapeutic options through targeting these pathways.
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Li S, Dai W, Wang S, Kang P, Ye Z, Han P, Zeng K, Li C. Clinical Significance of Serum Oxidative Stress Markers to Assess Disease Activity and Severity in Patients With Non-Segmental Vitiligo. Front Cell Dev Biol 2021; 9:739413. [PMID: 34977005 PMCID: PMC8716723 DOI: 10.3389/fcell.2021.739413] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Non-segmental vitiligo (NSV) is a chronic autoimmune disease characterized by progressive depigmentation of the skin. Oxidative stress (OS) has been proposed as one among the main principal causes in the development and establishment of a sustained autoimmune state in patients with NSV. However, the disease-associated OS biomarkers in clinical practice are not well studied. In this study, we found significantly reduced antioxidant enzymes [catalase (CAT) and superoxide dismutase (SOD)], total antioxidant capacity (TAC), and increased levels of lipid oxidation product malondialdehyde (MDA) and oxidative DNA damage byproduct [8-hydroxy-2-deoxyguanosine (8-OHdG)] in serum of NSV patients compared with healthy controls (HC). Serum TAC, MDA, and 8-OHdG levels were correlated with disease activity in all patients with NSV and much lower in patients receiving conventional treatment in the past 1 year compared to that without treatment. In addition, both serum MDA and 8-OHdG levels were significantly correlated with CXCL10 expression in patients with NSV. And the serum TAC, MDA, and 8-OHdG levels were also correlated with affected body surface area and Vitiligo Area Scoring Index score in patients with NSV. This study demonstrates dysregulated OS status in patients with NSV and provides the evidence that the serum TAC, MDA, and 8-OHdG have a capacity to indicate the activity and severity in patients with NSV.
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Affiliation(s)
- Shuli Li
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Wei Dai
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Sijia Wang
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Pan Kang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Zhubiao Ye
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Peng Han
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
- Department of Otolaryngology, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Kang Zeng
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- *Correspondence: Chunying Li,
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Esfahanian F, Hazaveh MM, Garehbagh LH, Falahati K, Ataei M, Sanati MH, Jadali Z. Increased Mitochondrial DNA Copy Number and Oxidative Damage in Patients with Hashimoto's Thyroiditis. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1697-1704. [PMID: 34917541 PMCID: PMC8643530 DOI: 10.18502/ijph.v50i8.6817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022]
Abstract
Background: The purpose of present study was to investigate mitochondrial DNA copy number (mtDNAcn) and mtDNA damage in peripheral blood of patients with Hashimoto’s thyroiditis (HT) and healthy controls (HC). Methods: The relative mtDNAcn and oxidative DNA damage in this case-control study were measured in peripheral blood of 50 patients with Hashimoto’s thyroiditis and 50 healthy controls using quantitative real-time PCR. The study was conducted in Tehran University of Medical Sciences hospital, Tehran, Iran in 2018. Results: HT patients had significantly higher mitochondrial DNA copy number and mitochondrial oxidative damage than the comparison group. Conclusion: These data suggest the possible involvement of mitochondria and oxidative stress in the pathophysiology of HT.
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Affiliation(s)
- Fatemeh Esfahanian
- Department of Endocrinology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Laya Hooshmand Garehbagh
- Department of Endocrinology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Kowsar Falahati
- Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Mitra Ataei
- Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Mohammad Hossein Sanati
- Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Zohreh Jadali
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Passeron T, Malmqvst VEA, Bzioueche H, Marchetti S, Rocchi S, Tulic MK. Increased Activation of Innate Immunity and Pro-Apoptotic CXCR3B in Normal-Appearing Skin on the Lesional Site of Patients with Segmental Vitiligo. J Invest Dermatol 2021; 142:480-483.e2. [PMID: 34343558 DOI: 10.1016/j.jid.2021.07.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Thierry Passeron
- Mediterranean Centre for Molecular Medicine (C3M), Team 12, INSERM U1065, Université Côte d'Azur, Nice, France; Department of Dermatology, University Hospital of Nice, Côte d'Azur University, Nice, France.
| | - Valentina E A Malmqvst
- Department is Dermatology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Hanene Bzioueche
- Mediterranean Centre for Molecular Medicine (C3M), Team 12, INSERM U1065, Université Côte d'Azur, Nice, France
| | - Sandrine Marchetti
- Mediterranean Centre for Molecular Medicine (C3M), Team 3, INSERM U1065, Université Côte d'Azur, Nice, France
| | - Stephane Rocchi
- Mediterranean Centre for Molecular Medicine (C3M), Team 12, INSERM U1065, Université Côte d'Azur, Nice, France
| | - Meri K Tulic
- Mediterranean Centre for Molecular Medicine (C3M), Team 12, INSERM U1065, Université Côte d'Azur, Nice, France
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12
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Zaidieh T, Smith JR, Ball KE, An Q. Mitochondrial DNA abnormalities provide mechanistic insight and predict reactive oxygen species-stimulating drug efficacy. BMC Cancer 2021; 21:427. [PMID: 33865346 PMCID: PMC8053302 DOI: 10.1186/s12885-021-08155-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background Associations between mitochondrial genetic abnormalities (variations and copy number, i.e. mtDNAcn, change) and elevated ROS have been reported in cancer compared to normal cells. Since excessive levels of ROS can trigger apoptosis, treating cancer cells with ROS-stimulating agents may enhance their death. This study aimed to investigate the link between baseline ROS levels and mitochondrial genetic abnormalities, and how mtDNA abnormalities might be used to predict cancer cells’ response to ROS-stimulating therapy. Methods Intracellular and mitochondrial specific-ROS levels were measured using the DCFDA and MitoSOX probes, respectively, in four cancer and one non-cancerous cell lines. Cells were treated with ROS-stimulating agents (cisplatin and dequalinium) and the IC50s were determined using the MTS assay. Sanger sequencing and qPCR were conducted to screen the complete mitochondrial genome for variations and to relatively quantify mtDNAcn, respectively. Non-synonymous variations were subjected to 3-dimensional (3D) protein structural mapping and analysis. Results Our data revealed novel significant associations between the total number of variations in the mitochondrial respiratory chain (MRC) complex I and III genes, mtDNAcn, ROS levels, and ROS-associated drug response. Furthermore, functional variations in complexes I/III correlated significantly and positively with mtDNAcn, ROS levels and drug resistance, indicating they might mechanistically influence these parameters in cancer cells. Conclusions Our findings suggest that mtDNAcn and complexes I/III functional variations have the potential to be efficient biomarkers to predict ROS-stimulating therapy efficacy in the future. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08155-2.
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Affiliation(s)
- Tarek Zaidieh
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, St Michael's Building, White Swan Road, Portsmouth, PO1 2DT, UK. .,Institute of Life Science, Swansea University Medical School, Swansea, SA2 8PP, UK.
| | - James R Smith
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, St Michael's Building, White Swan Road, Portsmouth, PO1 2DT, UK
| | - Karen E Ball
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, St Michael's Building, White Swan Road, Portsmouth, PO1 2DT, UK
| | - Qian An
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, St Michael's Building, White Swan Road, Portsmouth, PO1 2DT, UK.
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13
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Lee AY. Skin Pigmentation Abnormalities and Their Possible Relationship with Skin Aging. Int J Mol Sci 2021; 22:ijms22073727. [PMID: 33918445 PMCID: PMC8038212 DOI: 10.3390/ijms22073727] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 12/13/2022] Open
Abstract
Skin disorders showing abnormal pigmentation are often difficult to manage because of their uncertain etiology or pathogenesis. Abnormal pigmentation is a common symptom accompanying aging skin. The association between skin aging and skin pigmentation abnormalities can be attributed to certain inherited disorders characterized by premature aging and abnormal pigmentation in the skin and some therapeutic modalities effective for both. Several molecular mechanisms, including oxidative stress, mitochondrial DNA mutations, DNA damage, telomere shortening, hormonal changes, and autophagy impairment, have been identified as involved in skin aging. Although each of these skin aging-related mechanisms are interconnected, this review examined the role of each mechanism in skin hyperpigmentation or hypopigmentation to propose the possible association between skin aging and pigmentation abnormalities.
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Affiliation(s)
- Ai-Young Lee
- Department of Dermatology, College of Medicine, Dongguk University Ilsan Hospital, 814 Siksa-dong, Ilsandong-gu, Goyang-si 410-773, Gyeonggi-do, Korea
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14
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Xiao S, Wang X, Xu L, Miao D, Li T, Su G, Zhao Y. Novel ginsenoside derivatives have shown their effects on PC-3 cells by inducing G1-phase arrest and reactive oxygen species-mediate cell apoptosis. Bioorg Chem 2021; 112:104864. [PMID: 33819738 DOI: 10.1016/j.bioorg.2021.104864] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 02/09/2023]
Abstract
In this study, piperazine groups were introduced into ginsenoside to enhance its ability to induce Reactive Oxygen Species (ROS) production and apoptosis in cancer cells. In total, 27 ginsenoside piperazine derivatives were synthesized and tested for their anti-proliferative activity in cancer cell lines by MTT assay. The results showed that compounds 4a, 4g, 4f, 4i, 5g, 5i, 6a, 6g, 6f and 6i had significant inhibitory effects on cancer cell growth. Compound 6g showed the strongest anti-proliferative effect on PC-3 cells with an IC50 of 1.98 ± 0.34 μM. Compound 6g could also induce G1-phase arrest and apoptosis in PC-3 cells, with apoptosis rates of 8.1%, 41% and 56.1% observed at 5, 10 and 20 μM, respectively. Compound 6g also significantly enhanced the intracellular fluorescence of ROS sensitive substrates, with a fluorescence intensity ratio of 23.1% observed in treated cells, indicative of ROS production. Following N-acetylcysteine treatment, apoptotic rates of the cancer cell lines decreased from 38.9% to 7.3%, and the expression of Cl-PARP, Cl-Caspase-3 and Cl-Caspase-9 also decreased, confirming that compound 6g induced apoptosis through ROS induction. Compound 6g also stimulated the translocation of Bax from the cytoplasm to the mitochondria, which enhanced Cytochrome C (Cyt C) release, and increased the expression of the apoptotic markers Cl-PARP, Cl-Caspase-3, and Cl-Caspase-9 in PC-3 cells. Taken together, these data reveal the anti-cancer effects of compound 6g that enhance ROS production, and then induce apoptosis through mitochondrial pathway.
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Affiliation(s)
- Shengnan Xiao
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Xude Wang
- Dalian University, Dalian 116622, China
| | - Lei Xu
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Dongyu Miao
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Tao Li
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Guangyue Su
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, China.
| | - Yuqing Zhao
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Structure-based Drug Design & Discovery, Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China.
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15
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Huang Z, Chen Y, Zhang Y. Mitochondrial reactive oxygen species cause major oxidative mitochondrial DNA damages and repair pathways. J Biosci 2020. [DOI: 10.1007/s12038-020-00055-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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16
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Movassaghi S, Jafari S, Falahati K, Ataei M, Sanati MH, Jadali Z. Quantification of mitochondrial DNA damage and copy number in circulating blood of patients with systemic sclerosis by a qPCR-based assay. An Bras Dermatol 2020; 95:314-319. [PMID: 32307203 PMCID: PMC7253925 DOI: 10.1016/j.abd.2019.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 11/12/2019] [Indexed: 11/24/2022] Open
Abstract
Background Although not fully understood, oxidative stress has been implicated in the pathogenesis of different autoimmune diseases such as systemic sclerosis. Accumulating evidence indicates that oxidative stress can induce mitochondrial DNA (mtDNA) damage and variations in mtDNA copy number (mtDNAcn). Objective The aim of this study was to explore mtDNAcn and oxidative DNA damage byproducts in peripheral blood of patients with systemic sclerosis and healthy controls. Methods Forty six patients with systemic sclerosis and forty nine healthy subjects were studied. Quantitative real-time PCR used to measure the relative mtDNAcn and the oxidative damage (oxidized purines) of each sample. Results The mean mtDNAcn was lower in patients with systemic sclerosis than in healthy controls whereas the degree of mtDNA damage was significantly higher in cases as compared to controls. Moreover, there was a negative correlation between mtDNAcn and oxidative DNA damage. Study limitations The lack of simultaneous analysis and quantification of DNA oxidative damage markers in serum or urine of patients with systemic sclerosis and healthy controls. Conclusion These data suggest that alteration in mtDNAcn and increased oxidative DNA damage may be involved in the pathogenesis of systemic sclerosis.
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Affiliation(s)
- Shafieh Movassaghi
- Department of Rheumatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Jafari
- Department of Rheumatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kowsar Falahati
- Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Mitra Ataei
- Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Mohammad Hossein Sanati
- Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Zohreh Jadali
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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17
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Zaidieh T, Smith JR, Ball KE, An Q. ROS as a novel indicator to predict anticancer drug efficacy. BMC Cancer 2019; 19:1224. [PMID: 31842863 PMCID: PMC6916036 DOI: 10.1186/s12885-019-6438-y] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/05/2019] [Indexed: 12/17/2022] Open
Abstract
Background Mitochondria are considered a primary intracellular site of reactive oxygen species (ROS) generation. Generally, cancer cells with mitochondrial genetic abnormalities (copy number change and mutations) have escalated ROS levels compared to normal cells. Since high levels of ROS can trigger apoptosis, treating cancer cells with low doses of mitochondria-targeting / ROS-stimulating agents may offer cancer-specific therapy. This study aimed to investigate how baseline ROS levels might influence cancer cells’ response to ROS-stimulating therapy. Methods Four cancer and one normal cell lines were treated with a conventional drug (cisplatin) and a mitochondria-targeting agent (dequalinium chloride hydrate) separately and jointly. Cell viability was assessed and drug combination synergisms were indicated by the combination index (CI). Mitochondrial DNA copy number (mtDNAcn), ROS and mitochondrial membrane potential (MMP) were measured, and the relative expression levels of the genes and proteins involved in ROS-mediated apoptosis pathways were also investigated. Results Our data showed a correlation between the baseline ROS level, mtDNAcn and drug sensitivity in the tested cells. Synergistic effect of both drugs was also observed with ROS being the key contributor in cell death. Conclusions Our findings suggest that mitochondria-targeting therapy could be more effective compared to conventional treatments. In addition, cancer cells with low levels of ROS may be more sensitive to the treatment, while cells with high levels of ROS may be more resistant. Doubtlessly, further studies employing a wider range of cell lines and in vivo experiments are needed to validate our results. However, this study provides an insight into understanding the influence of intracellular ROS on drug sensitivity, and may lead to the development of new therapeutic strategies to improve efficacy of anticancer therapy.
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Affiliation(s)
- Tarek Zaidieh
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK.
| | - James R Smith
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK
| | - Karen E Ball
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK
| | - Qian An
- School of Pharmacy and Biomedical Sciences, Institute of Biological and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK.
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18
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Cui T, Zhang W, Li S, Chen X, Chang Y, Yi X, Kang P, Yang Y, Chen J, Liu L, Jian Z, Li K, Wang G, Gao T, Song P, Li C. Oxidative Stress-Induced HMGB1 Release from Melanocytes: A Paracrine Mechanism Underlying the Cutaneous Inflammation in Vitiligo. J Invest Dermatol 2019; 139:2174-2184.e4. [PMID: 30998983 DOI: 10.1016/j.jid.2019.03.1148] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 02/07/2023]
Abstract
Vitiligo is a cutaneous depigmentation disorder caused by the destruction of epidermal melanocytes. The generation and the skin infiltration of autoreactive CD8+ cytotoxic T cells triggered by oxidative stress play a critical role in vitiligo. High-mobility group protein B1 (HMGB1) is a classic damage-associated molecular pattern molecule with strong proinflammatory effects in inflammatory reactions. A previous study reported an enhanced expression of HMGB1 in vitiligo lesions, but the role of HMGB1 in cutaneous inflammation of vitiligo is still unknown. In the present study, we initially found that HMGB1 was released from the nucleus of melanocytes in vitiligo perilesional skin. Furthermore, cultured normal human melanocytes could release HMGB1 under treatment with hydrogen peroxide. Moreover, HMGB1 facilitated the secretion of CXCL16 and IL-8 from keratinocytes by binding to the receptor for advanced glycation end products and activating NF-κB and extracellular signal-regulated kinase signaling pathways. Subsequently, HMGB1 led to the formation of chemotaxis for the migration of CD8+ T cells from patients with vitiligo by increasing the release of CXCL16 from keratinocytes. Additionally, HMGB1 promoted the maturation of dendritic cells from patients with vitiligo. Altogether, our study demonstrates that HMGB1 released from melanocytes contributes to the formation of oxidative stress-induced autoimmunity in vitiligo.
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Affiliation(s)
- Tingting Cui
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Weigang Zhang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shuli Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Xuguang Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuqian Chang
- 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
| | - Pan Kang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuqi Yang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jiaxi Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Ling Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Zhe Jian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Kai Li
- 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
| | - Pu Song
- 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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19
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Wang Y, Li S, Li C. Perspectives of New Advances in the Pathogenesis of Vitiligo: From Oxidative Stress to Autoimmunity. Med Sci Monit 2019; 25:1017-1023. [PMID: 30723188 PMCID: PMC6373225 DOI: 10.12659/msm.914898] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vitiligo is an autoimmune cutaneous disease in which melanocytes are destroyed by CD8+ T cells resulting in disfiguring white spots. From the very beginning of the disease, oxidative stress plays a significant role in promoting the onset of vitiligo, as noted by many studies. Multiple factors lead to the overproduction of reactive oxygen species (ROS), and collaboratively cause ROS accumulation in vulnerable melanocytes. However, ROS are responsible for melanocyte damage manifested by the level of molecules, organelles, and cells, and the generation of autoantigens, through different pathways related to the dysregulation of melanocytes. Recent studies have shown that presentation of autoantigens is mediated by innate immunity, which bridges the gap between oxidative stress and adaptive immunity. The recruitment of CD8+ T cells induced by cytokines and chemokines guarantees the final destruction of epidermal melanocytes. Moreover, emerging concerns regarding regulatory T cells and resident memory T cells help explain the reinstatement and relapse of vitiligo. Here, we provide new perspectives in the advances in understanding of this disease pathogenesis and we attempt to find more interrelationships between oxidative stress and autoimmunity.
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Affiliation(s)
- Yinghan Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).,Department of Dermatology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Shuli Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
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20
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Di Nardo V, Barygina V, França K, Tirant M, Valle Y, Lotti T. Functional nutrition as integrated approach in vitiligo management. Dermatol Ther 2018; 32:e12625. [DOI: 10.1111/dth.12625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/16/2018] [Indexed: 01/29/2023]
Affiliation(s)
| | - Victoria Barygina
- Department of Biomedical Experimental and Clinical Sciences; University of Florence; Florence Italy
| | - Katlein França
- Department of Dermatology & Cutaneous Surgery, Institute for Bioethics & Health Policy; University of Miami Miller School of Medicine; Miami Florida
- Department of Psychiatry & Behavioral Sciences, Institute for Bioethics & Health Policy; University of Miami Miller School of Medicine; Miami Florida
| | | | - Yan Valle
- University of Rome “G. Marconi”; Rome Italy
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