Vinay K, Dogra S, Parsad D, Kanwar A J, Kumar R, Minz R W, Saikia U N
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Eur Acad Dermatol Venereol. 2015 Jan;29(1):31-7. doi: 10.1111/jdv.12426. Epub 2014 Mar 14.
Autologous non-cultured outer root sheath hair follicle cell suspension (NCORSHFS) is a recently described novel cellular graft technique for the treatment of stable vitiligo. There is lack of data about various factors determining the repigmentation rate in vitiligo patients undergoing this novel surgical therapy.
To study the clinical characteristics and treatment variables determining therapeutic outcome in patients of stable vitiligo undergoing NCORSHFS.
Non-cultured outer root sheath hair follicle cell suspension was prepared from anagen hairs extracted from the occipital area. The number of melanocytes and hair follicle stem cells (HFSC) in the suspension was quantified by staining with anti-HMB45 and anti-CD200 antibody, respectively. In all patients, a 2 mm punch skin biopsy was taken from one of the vitiligo patch to be treated prior to surgery for assessment of histomorphological features. Post surgery patients were followed up at regular intervals for 24 weeks.
Thirty patients (21 females, 9 males) with a clinical diagnosis of stable vitiligo, with a total of 60 target lesions were included in this study. The mean age of the study population was 21.10 ± 5.64 years. The number of melanocytes (P = 0.04) and HFSC (P = 0.01) transplanted were significantly higher among patients achieving optimum repigmentation (>75% repigmentation). There was a strong correlation between repigmentation at 24 week and number of melanocytes and HFSC transplanted. Number of HFSC transplanted and absence of dermal inflammation were significant predictors of achieving optimum repigmentation.
The number of melanocytes and HFSC transplanted and absence of dermal inflammation were important determents of optimal repigmentation in patients undergoing NCORSHFS for treatment of stable vitiligo. Hence, refining the technique of NCORSHFS on the basis of these factors would help in achieving better surgical outcomes.
自体非培养外根鞘毛囊细胞悬液（NCORSHFS）是一种最近描述的用于治疗稳定期白癜风的新型细胞移植技术。目前缺乏关于影响接受这种新型手术治疗的白癜风患者色素恢复率的各种因素的数据。
研究接受NCORSHFS治疗的稳定期白癜风患者的临床特征和决定治疗效果的变量。
从枕部提取的生长期毛发中制备非培养外根鞘毛囊细胞悬液。分别用抗HMB45和抗CD200抗体染色，对悬液中的黑素细胞和毛囊干细胞（HFSC）数量进行定量。所有患者在手术前从待治疗的白癜风斑块中取2mm的皮肤活检样本，以评估组织形态学特征。术后定期对患者进行24周的随访。
本研究纳入了30例临床诊断为稳定期白癜风的患者（21例女性，9例男性），共有60个目标皮损。研究人群的平均年龄为21.10±5.64岁。色素恢复最佳（色素恢复>75%）的患者移植的黑素细胞数量（P = 0.04）和HFSC数量（P = 0.01）明显更高。24周时的色素恢复与移植的黑素细胞和HFSC数量之间存在很强的相关性。移植的HFSC数量和无真皮炎症是实现最佳色素恢复的重要预测因素。
移植的黑素细胞和HFSC数量以及无真皮炎症是接受NCORSHFS治疗稳定期白癜风患者实现最佳色素恢复的重要决定因素。因此，基于这些因素改进NCORSHFS技术将有助于获得更好的手术效果。
