Guerra L, Capurro S, Melchi F, Primavera G, Bondanza S, Cancedda R, Luci A, De Luca M, Pellegrini G
Laboratory of Tissue Engineering, Istituto Dermopatico dell'Immacolata, Via dei Castelli Romani, 83/85, 00040 Pomezia (Roma), Italy.
Arch Dermatol. 2000 Nov;136(11):1380-9. doi: 10.1001/archderm.136.11.1380.
To optimize melanocyte/keratinocyte co-cultivation and to evaluate the effectiveness of autologous cultured epidermal grafts in the surgical treatment of stable vitiligo.
After optimization of melanocyte/keratinocyte cultures, achromic lesions were disepithelialized by means of programmed diathermosurgery (Timedsurgery) and covered with autologous epidermal grafts prepared from secondary cultures. Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system.
A biosafety level 3 cell culture facility and a dermatological department in a hospital.
Thirty-two patients carrying different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were (1) failure of at least 2 standard medical approaches; (2) no therapy for at least 12 months; (3) absence of progression of old lesions, absence of appearance of new lesions, and absence of Koebner phenomenon within the past 18 months; and (4) absence of autoimmune disorders.
One hundred five achromic lesions (a total of 6078.2 cm(2)) were treated. The average percentage of repigmentation, evaluated after 12 to 36 months of follow-up, was 77%. Independent of the type of vitiligo, average percentages of repigmentation of extremities and periorificial sites were 8% (31.8 cm(2) repigmented/420.5 cm(2) transplanted) and 35% (17.6 cm(2) repigmented/50.0 cm(2) transplanted), respectively. Percentages of repigmentation of all other body sites ranged from 88% to 96% (4329.7 cm(2) repigmented/4675.2 cm(2) transplanted). Color matching was good and scar formation was not observed.
Cultured epidermal grafts can be considered a real therapeutic surgical alternative for "stable" but not lip-tip vitiligo.
优化黑素细胞/角质形成细胞共培养，并评估自体培养表皮移植在稳定期白癜风手术治疗中的有效性。
在优化黑素细胞/角质形成细胞培养后，通过程控透热手术（定时手术）去除色素脱失性皮损的上皮，并覆盖由传代培养制备的自体表皮移植片。通过多巴反应评估黑素细胞含量。使用半自动图像分析系统计算色素再生百分比。
医院的生物安全3级细胞培养设施和皮肤科。
32例患有不同类型白癜风的患者纳入本研究，接受自体培养表皮移植治疗。纳入标准为：（1）至少2种标准医学方法治疗失败；（2）至少12个月未接受治疗；（3）在过去18个月内旧皮损无进展，无新皮损出现，无同形反应；（4）无自身免疫性疾病。
共治疗105处色素脱失性皮损（总面积6078.2 cm²）。随访12至36个月后评估的平均色素再生百分比为77%。无论白癜风类型如何，四肢和口周部位的平均色素再生百分比分别为8%（色素再生31.8 cm²/移植420.5 cm²）和35%（色素再生17.6 cm²/移植50.0 cm²）。所有其他身体部位的色素再生百分比在88%至96%之间（色素再生4329.7 cm²/移植4675.2 cm²）。颜色匹配良好，未观察到瘢痕形成。
对于“稳定期”但非唇缘白癜风，培养的表皮移植可被视为一种真正的治疗性手术选择。
