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Ju HJ, Bae JM. Bridging Molecular Mechanism and Clinical Practice in Vitiligo Treatment: An Updated Review. Dermatology 2024; 240:474-486. [PMID: 38417409 DOI: 10.1159/000537810] [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: 08/02/2022] [Accepted: 02/11/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Treatment of vitiligo seeks to achieve three goals: cessation of disease progression, regeneration of pigmentation, and prevention of recurrence. SUMMARY Number of nonsurgical interventions are available that suppress the autoimmune response and regenerate the melanocytes from the reservoir: phototherapy including psoralen and ultraviolet A, narrowband ultraviolet B, and 308-nm excimer and 311-nm Titanium:Sapphire lasers; topical agents including topical calcineurin inhibitors, topical corticosteroids, and topical 5-fluorouracil; and systemic agents including corticosteorids, mycophenolate mofetil, cyclosporine, methotrexate, minocycline, afamelanotide, and antioxidants. In recent years, a great advance has been made in the understanding of pathogenesis of vitiligo, and JAK inhibitors are being investigated as a new treatment. Minimally invasive procedures such as fractional lasers or microneedling can help achieve the optimal treatment outcome when used properly. KEY MESSAGES Our review describes various treatment modalities for vitiligo based on their molecular mechanism of action. Bridging the gap between molecular mechanisms and therapeutic options would be a valuable reference for physicians in clinical practice.
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Affiliation(s)
- Hyun Jeong Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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2
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Vitiligo Treatments: Review of Current Therapeutic Modalities and JAK Inhibitors. Am J Clin Dermatol 2023; 24:165-186. [PMID: 36715849 DOI: 10.1007/s40257-022-00752-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/31/2023]
Abstract
Vitiligo is a chronic autoimmune disease characterized by loss of pigment of the skin, affecting 0.5-2% of the population worldwide. It can have a significant impact on patients' quality of life. In recent years, there has been significant progress in our understanding of the pathogenesis of vitiligo. It is believed that vitiligo develops due to a complex combination of genetics, oxidative stress, inflammation, and environmental triggers. Conventional treatments include camouflage, topical corticosteroids, topical calcineurin inhibitors, oral corticosteroids, phototherapy, and surgical procedures, with the treatment regimen dependent on the patient's preferences and characteristics. With increased understanding of the importance of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway in the pathogenesis of vitiligo, treatment has expanded to include the first US FDA-approved cream to repigment patients with vitiligo. This review summarizes our understanding of the major mechanisms involved in the pathogenesis of vitiligo and its most common available treatments.
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Ubaydee AHN, Issa R, Hajleh MNA, Ghanim BY, Al-Akayleh F, Qinna NA. The effect of Medicago sativa extract and light on skin hypopigmentation disorders in C57/BL6 mice. J Cosmet Dermatol 2022; 21:6270-6280. [PMID: 35815838 DOI: 10.1111/jocd.15233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vitiligo is a common depigmentation skin disease that affects the quality of life in many patients. AIMS This study aims to investigate the effect of Medicago sativa methanol extract on the treatment of skin hypopigmentation disorders. METHODS Antioxidant activity and phytochemical constituents of the extract were determined using DDPH assay, Folin-Ciocalteu, AlCl3, and HPLC-MS/MS analysis. Oil in water (o/w) creams were prepared to contain the methanolic extract, and applied to hydroquinone-induced depigmentation in vivo model and further challenged in combination with UVA light exposure. Skin and hair colors were visually scored and evaluated at different time intervals, and histopathological examinations of skin layers and hair follicles were performed. RESULTS A total phenolic content of 187.70 mg/g, equivalent to gallic acid, and total flavonoid content of 21.97 mg/g, equivalent to quercetin, were recorded. Extract showed 71% antioxidant activity. Moreover, the HPLC-MS/MS detection revealed the presence of 18 compounds including P-coumaric acid and antioxidants flavonoids, of those are seven compounds not previously detected in this species. The in vivo study showed a remarkable skin and hair pigmentation effect on plant extract-treated groups, compared to the reference, placebo, and control groups. Histopathological examinations showed the growth of colored hair follicles in the dermis and epidermis layers of the extract-treated mice. CONCLUSION The study suggests the use of M. sativa extract in enhancing the pigmentation process in hypopigmented skin and hair if combined with UVA light. Therefore, M. sativa extract can be considered a potential treatment for vitiligo.
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Affiliation(s)
- Azal Hussein Najm Ubaydee
- Department of Pharmaceutical Sciences, Pharmacological and Diagnostic Research Center (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Reem Issa
- Department of Pharmaceutical Sciences, Pharmacological and Diagnostic Research Center (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Maha N Abu Hajleh
- Department of Cosmetic Science, Pharmacological and Diagnostic Research Centre, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Bayan Y Ghanim
- University of Petra Pharmaceutical Center (UPPC), University of Petra, Amman, Jordan
| | - Faisal Al-Akayleh
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Nidal A Qinna
- University of Petra Pharmaceutical Center (UPPC), University of Petra, Amman, Jordan.,Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
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Liang Y, Xie L, Liu K, Cao Y, Dai X, Wang X, Lu J, Zhang X, Li X. Bergapten: A review of its pharmacology, pharmacokinetics, and toxicity. Phytother Res 2021; 35:6131-6147. [PMID: 34347307 DOI: 10.1002/ptr.7221] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/23/2021] [Accepted: 07/03/2021] [Indexed: 12/15/2022]
Abstract
Bergapten is a natural furocoumarin, also known as 5-methoxypsoralen, and its medicinal value has been paid more and more attention. By sorting out the pharmacological literature of bergapten, we found that bergapten has a wide range of pharmacological effects, including neuroprotection, organ protection, anticancer, antiinflammatory, antimicrobial, and antidiabetes effects. However,bergapten has complex impacts on the hepatic metabolic enzyme. Moreover, pharmacokinetic studies showed that bergapten has higher absolute bioavailability and can cross the blood-brain barrier and has a great potential for treating brain disease, but the mechanism needs further clarification to make greater use of its ability to treat brain diseases. Furthermore, the phototoxicity of bergapten combined with ultraviolet light has always been mentioned. In view of its wide range of pharmacological activities, bergapten is expected to be a potential drug candidate for the treatment of diabetes and diabetes-induced osteoporosis, epilepsy, Alzheimer's disease, depression, and cancer. However, further studies are needed to elucidate its molecular mechanisms and targets. The phototoxicity of bergapten as a side effect should be further avoided. On the other hand, the photoactivation of bergapten in the anticancer aspect can be better utilized.
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Affiliation(s)
- Youdan Liang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Long Xie
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Kai Liu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yi Cao
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaolin Dai
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xian Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Lu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xumin Zhang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaofang Li
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Awad SS, Moftah NH, Rashed LA, Touni AA, Telep RAA. Evaluation of the effect of narrow band-ultraviolet B on the expression of tyrosinase, TYRP-1, and TYRP-2 mRNA in vitiligo skin and their correlations with clinical improvement: A retrospective study. Dermatol Ther 2020; 34:e14649. [PMID: 33314655 DOI: 10.1111/dth.14649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/19/2020] [Accepted: 12/03/2020] [Indexed: 12/01/2022]
Abstract
Narrowband-ultraviolet B (NB-UVB) is considered one of the main therapeutic tools in vitiligo, which is able to induce repigmentation and halt depigmentation. However, little remains known about the effect of NB-UVB on TYR gene family, the main pigmentary genes, in vitiligo patients. To assess the effect of NB-UVB on expression of some genes related to the pigmentary problem of vitiligo; tyrosinase (TYR), tyrosinase related protein 1 (TYRP1) and tyrosinase related protein 2 (TYRP2), mRNA levels of those genes were quantitatively evaluated by Real-Time quantitative Polymerase Chain Reaction (RT-qPCR) in skin biopsies obtained from 30 patients with nonsegmental vitiligo and five healthy controls. Vitiligo patients were classified into two groups; group 1, involving 12 untreated vitiligo patients and group 2, including 18 vitiligo patients treated by NB-UVB. The levels of TYR, TYRP-1, and TYRP-2 mRNAs in untreated group were significantly lower than in control subjects (P < .001). In NB-UVB treated group, the three genes were significantly higher than in group 1 (P < .001), however, they were still significantly lower than in the control subjects (P < .001). A significant positive correlation was detected between TYR and TYRP-2 genes in group 2 (P = .03). This study demonstrated that mRNA level of TYR, TYRP-1, and TYRP-2, which decreased in vitiligo, was significantly increased upon treatment with NB-UVB. Accordingly, the mechanism of depigmentation in vitiligo disease and repigmentation by NB-UVB treatment may be related to the changes in the expression of these genes.
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Affiliation(s)
- Sherif Shoukry Awad
- Department of Dermatology and Venereology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Noha Hassan Moftah
- Department of Dermatology and Venereology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Laila Ahmed Rashed
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Ahmed Touni
- Department of Dermatology and Venereology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Rowida Ahmed Amer Telep
- Department of Dermatology and Venereology, Faculty of Medicine, Minia University, Minia, Egypt
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6
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Kundu R, Kaur G, Punia R, Thami G. Evaluation of active and stable stages of vitiligo using S-100 and human melanoma black-45 immunostains. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2020. [DOI: 10.4103/ijdpdd.ijdpdd_44_19] [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] Open
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7
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Microemulsions incorporating Brosimum gaudichaudii extracts as a topical treatment for vitiligo: In vitro stimulation of melanocyte migration and pigmentation. J Mol Liq 2019. [DOI: 10.1016/j.molliq.2019.111685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Eldelee SA, Gheida SF, Sarhan NI, Ibrahim ZA, Elfar NN. Evaluation of the effect of combined intralesional injection of prostaglandin F2α with narrow band UVB phototherapy in treatment of resistant cases of vitiligo. J DERMATOL TREAT 2019; 32:383-390. [DOI: 10.1080/09546634.2019.1658860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Samah A. Eldelee
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shereen F. Gheida
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Zeinab A. Ibrahim
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nashwa N. Elfar
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Datz E, Zeman F, Koller M, Szeimies RM, Berneburg M, Landthaler M, Bosserhoff AK, Karrer S. Phototherapy-induced elevation of serum level of melanoma inhibitory activity. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:255-260. [PMID: 30815924 DOI: 10.1111/phpp.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/27/2019] [Accepted: 02/25/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Phototherapy is a frequently used treatment modality for a variety of dermatologic diseases. UV radiation has different effects on the skin, for example increased production and release of cytokines and other proteins, and is involved in the initiation and progression of skin cancer. Objective of this clinical trial was to investigate potential systemic effects of UV phototherapy on cytokine profiles in blood. METHODS In a prospective, mono-centric, one-armed study, the serum levels of the melanoma tumour marker "melanoma inhibitory activity" (MIA), Il-1α, Il-4, Il-6, Il-10, TNF-α and IFN-γ of 115 patients with different skin diseases were compared before and 24-48 hours as well as 2-4 weeks after the first phototherapy with PUVA (psoralen and ultraviolet A), UVA or UVB, or both. Data were analysed using linear mixed models. RESULTS Estimated marginal means of MIA levels were 6.05 ng/mL (95%-CI: 5.37-6.72, range: 2.83-14.49) before the first treatment, which had significantly increased to 6.79 ng/mL 2-4 weeks after the first phototherapy (CI 95%: 6.12-7.47, range: 3.09-15.45; P = 0.0042). MIA levels 2-4 weeks after the first phototherapy were significantly higher than 24-48 hours after the first phototherapy (P = 0.0083). 2-4 weeks after the first treatment, TNF-α levels had decreased significantly (P = 0.033) more in patients with psoriasis who had responded well to phototherapy than in patients unresponsive to treatment. Serum levels of the other cytokines had not changed significantly. CONCLUSIONS Short-term phototherapy significantly increased the serum levels of the melanoma tumour marker MIA. The potential clinical relevance of these findings (ie an increased risk of melanoma) is unclear and should be further investigated.
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Affiliation(s)
- Elisabeth Datz
- Department of Dermatology, University Medical Centre Regensburg, Regensburg, Germany
| | - Florian Zeman
- Centre for Clinical Studies, University Medical Centre Regensburg, Regensburg, Germany
| | - Michael Koller
- Centre for Clinical Studies, University Medical Centre Regensburg, Regensburg, Germany
| | - Rolf-Markus Szeimies
- Department of Dermatology and Allergology, Klinikum Vest GmbH, Recklinghausen, Germany
| | - Mark Berneburg
- Department of Dermatology, University Medical Centre Regensburg, Regensburg, Germany
| | - Michael Landthaler
- Department of Dermatology, University Medical Centre Regensburg, Regensburg, Germany
| | - Anja K Bosserhoff
- Institute of Biochemistry, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Sigrid Karrer
- Department of Dermatology, University Medical Centre Regensburg, Regensburg, Germany
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10
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Abdel‐Raouf Mohamed H, Ali Nasif G, Saad Abdel‐Azim E, Abd El‐Fatah Ahmed M. Comparative study of fractional Erbium: YAG laser vs combined therapy with topical steroid as an adjuvant treatment in melasma. J Cosmet Dermatol 2018; 18:517-523. [DOI: 10.1111/jocd.12751] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 01/17/2018] [Accepted: 06/19/2018] [Indexed: 11/25/2022]
Affiliation(s)
| | - Ghada Ali Nasif
- Department of Dermatology, Faculty of Medicine Minia University Al‐Minya Egypt
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11
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Rojo de la Vega M, Zhang DD, Wondrak GT. Topical Bixin Confers NRF2-Dependent Protection Against Photodamage and Hair Graying in Mouse Skin. Front Pharmacol 2018; 9:287. [PMID: 29636694 PMCID: PMC5880955 DOI: 10.3389/fphar.2018.00287] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/13/2018] [Indexed: 01/10/2023] Open
Abstract
Environmental exposure to solar ultraviolet (UV) radiation causes acute photodamage, premature aging, and skin cancer, attributable to UV-induced genotoxic, oxidative, and inflammatory stress. The transcription factor NRF2 [nuclear factor erythroid 2 (E2)-related factor 2] is the master regulator of the cellular antioxidant response protecting skin against various environmental stressors including UV radiation and electrophilic pollutants. NRF2 in epidermal keratinocytes can be activated using natural chemopreventive compounds such as the apocarotenoid bixin, an FDA-approved food additive and cosmetic ingredient from the seeds of the achiote tree (Bixa orellana). Here, we tested the feasibility of topical use of bixin for NRF2-dependent skin photoprotection in two genetically modified mouse models [SKH1 and C57BL/6J (Nrf2+/+ versus Nrf2-/- )]. First, we observed that a bixin formulation optimized for topical NRF2 activation suppresses acute UV-induced photodamage in Nrf2+/+ but not Nrf2-/- SKH1 mice, a photoprotective effect indicated by reduced epidermal hyperproliferation and oxidative DNA damage. Secondly, it was demonstrated that topical bixin suppresses PUVA (psoralen + UVA)-induced hair graying in Nrf2+/+ but not Nrf2-/- C57BL/6J mice. Collectively, this research provides the first in vivo evidence that topical application of bixin can protect against UV-induced photodamage and PUVA-induced loss of hair pigmentation through NRF2 activation. Topical NRF2 activation using bixin may represent a novel strategy for human skin photoprotection, potentially complementing conventional sunscreen-based approaches.
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Affiliation(s)
- Montserrat Rojo de la Vega
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ, United States
| | - Donna D Zhang
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ, United States.,The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Georg T Wondrak
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ, United States.,The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
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Salah Eldin MM, Sami NA, Aly DG, Hanafy NS. Comparison Between (311-312 nm) Narrow Band Ultraviolet-B Phototherapy and (308 nm) Monochromatic Excimer Light Phototherapy in Treatment of Vitiligo: A Histopathological Study. J Lasers Med Sci 2017; 8:123-127. [PMID: 29123631 DOI: 10.15171/jlms.2017.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Recently, the monochromatic excimer light (MEL) of 308 nm wavelength has shown some advantages in comparison to narrow band ultraviolet B (NB-UVB) for the treatment of vitiligo. To histopathologically compare the early effects of NB-UVB and 308-nm MEL phototherapy on vitiliginous patches using H&E and HMB-45. Methods: Thirty subjects with non-segmental vitiligo lesions were treated twice a week for 6 weeks with 308-nm MEL, while NB-UVB was used to treat lesions contra laterally. Skin biopsies were taken from lesional areas before and after 6 weeks of treatment by either modality. It was prepared for light microscopy and immunohistochemical study (HMB-45). This study was performed as a clinical trial (Trial registration: http://www.pactr.org; Identifier: PACTR201705002279419) Results: All lesions before treatment had labeling index (number of pigmented cells/non-pigmented cells) of 0.0 (0%). After treatment the LI for MEL was 4.2 ± 2.6, while for NB-UVB LI it was 0.3 ± 0.7. MEL showed higher statistical significance regarding increase of basal pigmented cells, and significant decrease in vacuolated keratinocytes and basal membrane thickness than NB-UVB. Conclusion: Although NB-UVB is considered as treatment of choice for vitiligo, MEL is acknowledged as an effective treatment modality for vitiliginous lesions that induces more repigmentation than NB-UVB, and more rapidly, as confirmed by our study.
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Affiliation(s)
- Manal Mohamed Salah Eldin
- Department of Medical Application of Laser, National Institute of Laser Enhanced Sciences, Giza, Egypt
| | - Nevein Ahmed Sami
- Department of Medical Application of Laser, National Institute of Laser Enhanced Sciences, Giza, Egypt
| | - Dalia Gamal Aly
- Department of Dermatology and Venereology, National Research Centre, Giza, Egypt
| | - Noha Sami Hanafy
- Department of Dermatology and Venereology, National Research Centre, Giza, Egypt
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Abstract
Vitiligo, an acquired depigmentation disorder, manifests as white macules on the skin and can cause significant psychological stress and stigmatization. Recent advances have shed light on key components that drive disease onset and progression as well as therapeutic approaches. Vitiligo can be triggered by stress to the melanin pigment-producing cells of the skin, the melanocytes. The triggers, which range from sunburn to mechanical trauma and chemical exposures, ultimately cause an autoimmune response that targets melanocytes, driving progressive skin depigmentation. The most significant progress in our understanding of disease etiology has been made on three fronts: (1) identifying cellular responses to stress, including antioxidant pathways and the unfolded protein response (UPR), as key players in disease onset, (2) characterizing immune responses that target melanocytes and drive disease progression, and (3) identifying major susceptibility genes. The current model for vitiligo pathogenesis postulates that oxidative stress causes cellular disruptions, including interruption of protein maturation in the endoplasmic reticulum (ER), leading to the activation of the UPR and expression of UPR-regulated chemokines such as interleukin 6 (IL-6) and IL-8. These chemokines recruit immune components to the skin, causing melanocytes to be targeted for destruction. Oxidative stress can further increase melanocyte targeting by promoting antigen presentation. Two key components of the autoimmune response that promote disease progression are the interferon (IFN)-γ/CXCL10 axis and IL-17-mediated responses. Several genome-wide association studies support a role for these pathways, with the antioxidant gene
NRF2, UPR gene
XBP1, and numerous immune-related genes including class I and class II major histocompatibility genes associated with a risk for developing vitiligo. Novel approaches to promote repigmentation in vitiligo are being investigated and may yield effective, long-lasting therapies.
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Affiliation(s)
- Prashiela Manga
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, 10016, USA
| | - Nada Elbuluk
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, 10016, USA
| | - Seth J Orlow
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, 10016, USA
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Fawzy MM, El Maadawi ZM, Hegazy RA, El Fatah NSA. Vitiligo - The story from within: A transmission electron microscopic study before and after narrow-band ultraviolet B. Ultrastruct Pathol 2016; 40:265-75. [PMID: 27594347 DOI: 10.1080/01913123.2016.1218987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Melanocyte loss is the main feature of vitiligo, but evidence refers to pathological multiplayers. Transmission electron microscopy was utilized to further explore vitiligo before and after narrow-band ultraviolet B (NB-UVB) therapy. Skin biopsies were retrieved from lesional and perilesional skin and compared to normal control skin. Sections were examined for melanocytes and keratinocytes and the number of melanosomes and thickness of basal lamina were measured. In lesional skin, keratinocytes revealed two types of degeneration with a significant increase in the mean thickness of basal lamina and decrease in the number of melanosomes. After treatment, lesional and perilesional skin showed variable ultrastructural features.
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Affiliation(s)
- Marwa M Fawzy
- a Department of Dermatology , Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Zeinab M El Maadawi
- b Department of Histology & Cell Biology , Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Rehab A Hegazy
- a Department of Dermatology , Faculty of Medicine, Cairo University , Cairo , Egypt
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15
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Wang JH, Pei YY, Xu HD, Li LJ, Wang YQ, Liu GL, Qu Y, Zhang N. Effects of bavachin and its regulation of melanin synthesis in A375 cells. Biomed Rep 2016; 5:87-92. [PMID: 27347410 DOI: 10.3892/br.2016.688] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/09/2016] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the effect of bavachin treatment on A375 cells and the regulation of melanin synthesis. The cultured A375 cells in vitro were treated with bavachin; and the effect of bavachin on cell activity, tyrosinase (TYR) activity and melanin synthesis were respectively tested by the MTT assay, L-dopa oxidation assay and the NaOH lysis assay. The expression levels of TYR and c-Jun N-terminal kinases (JNK) proteins were tested by western blot analysis. The expression levels of TYR, tyrosinase-related protein-1 (TRP-1), TRP-2, extracellular signal-regulated kinase 1 (ERK1), ERK2 and JNK2 mRNA were tested by the reverse transcription-polymerase chain reaction assay. Simultaneously, the effect of estrogen receptor inhibitor (ICI182780) and ERK pathway inhibitor (U0126) was also tested on A375 cells following bavachin. The safe dose of bavachin significantly inhibited melanin synthesis and TYR activity. Bavachin (10 µmol/l) inhibited the expression of TYR and JNK proteins, and the expression of TYR, TRP-1, TRP-2, ERK1, ERK2 and JNK2 mRNA in A375 cells. ICI182780 and U0126 could significantly reverse the bavachin treatment on the protein expression levels and the mRNA expression of TYR, TRP-1, TRP-2, ERK1, ERK2 and JNK2. In conclusion, bavachin inhibited the synthesis of melanin on A375 cells by inhibiting the protein and mRNA expression of TYR, TRP-1, TRP-2, ERK1, ERK2 and JNK2.
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Affiliation(s)
- Jing-Hua Wang
- College of Pharmacy, Mudanjiang Medical University, Mudanjiang, Heilongjiang 157011, P.R. China
| | - Yuan-Yuan Pei
- College of Pharmacy, Jiamusi University, Jiamusi, Heilongjiang 154007, P.R. China
| | - Hong-Dan Xu
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Jiamusi, Heilongjiang 154007, P.R. China
| | - Li-Jing Li
- College of Pharmacy, Changchun University of Chinese Medicine, Changchun, Jilin 130117, P.R. China
| | - Ye-Qiu Wang
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Jiamusi, Heilongjiang 154007, P.R. China
| | - Guo-Liang Liu
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Jiamusi, Heilongjiang 154007, P.R. China
| | - Yan Qu
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Jiamusi, Heilongjiang 154007, P.R. China
| | - Ning Zhang
- College of Jiamusi, Heilongjiang University of Chinese Medicine, Jiamusi, Heilongjiang 154007, P.R. China
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The changes in melanocyte number and melanin density occurring in vitiligo patches during 180 days of narrow band-ultraviolet B therapy. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2015. [DOI: 10.1097/01.ewx.0000453689.94338.3b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Llamas-Velasco M, Fraga J, Kutzner H, Steegmann JL, García-Diez A, Requena L. Hypopigmented macules secondary to imatinib for the treatment of chronic myeloid leukemia: a histopathologic and immunohistochemical study. J Cutan Pathol 2014; 41:417-26. [PMID: 24467724 DOI: 10.1111/cup.12298] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/24/2013] [Accepted: 12/16/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND A few series addressing the cutaneous side effects related to imatinib in the skin have been published, but only one described scarce histopathologic information in seven patients. OBJECTIVE To characterize these lesions and compare the number of melanocytes between hypopigmented lesions and normal appearing skin. METHODS We retrieved clinical data of the patients and performed 24 skin biopsies (13 from hypopigmented skin and 11 from normal-appearing skin) within a cohort of 41 patients with chronic myeloid leukemia treated with imatinib. We classified the biopsies into three patterns. RESULTS About 45% of patients presented with periocular hypopigmentation. Perifollicular fibrosis was observed in hypopigmented skin biopsies (76.9%) and in normal-appearing skin (45.5%). Epidermal melanin, as determined with Masson-Fontana staining, and melanocyte number, as evaluated with MiTF, Melan A and c-kit immunostains, were lower in hypopigmented skin. CONCLUSIONS Histopathologic study of hypopigmented macules demonstrates the presence of melanin with a statistically significant decrease in the number of melanocytes. Therefore, these findings differ from vitiligo, as melanocytes are present. Three histopathological patterns may be found, namely (a) perifollicular fibrosis, (b) lichen planopilaris-like and (c) apparently normal skin. One of the most striking histopathologic finding consisted of the presence of perifollicular fibrosis in both hypopigmented lesions and apparently normal skin.
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Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology, Instituto de Investigación Sanitaria de La Princesa (IP), Hospital Universitario de la Princesa, Madrid, Spain
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18
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Lee BW, Schwartz RA, Hercogová J, Valle Y, Lotti TM. Vitiligo road map. Dermatol Ther 2013; 25 Suppl 1:S44-56. [PMID: 23237038 DOI: 10.1111/dth.12006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vitiligo is a depigmenting disorder stemming from melanocyte loss or dysfunction. It has a complex, multifaceted etiology. We constructed a "vitiligo road map," consisting of basic science, clinical, and treatment components, in order to better portray our current understanding of vitiligo pathogenesis and reflect upon novel biomarkers and therapeutic targets for future research. The melanocyte map elaborates on the molecular processes and intracellular signaling pathways initiated by various external autocrine/paracrine factors in representing normal melanocyte homeostatic functions modulating its viability, proliferation, differentiation, dendricity, migration, and melanogenic processes. This vitiligo map identifies known inducers/triggers of vitiligo onset and progression that cultivate a microenvironment for melanocyte disappearance, real or functional. This map describes the molecular mechanisms of currently utilized clinical and experimental treatments of vitiligo that facilitate repigmentation.
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Affiliation(s)
- Brian W Lee
- Dermatology and Pathology, New Jersey Medical School, Newark, New Jersey 07103-2714, USA
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