Narayan V S, van den Bol L L C, van Geel N, Bekkenk M W, Luiten R M, Wolkerstorfer A
Department of Dermatology, Amsterdam University Medical Center, Netherlands Institute for Pigment Disorders, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands.
Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
J Eur Acad Dermatol Venereol. 2021 May;35(5):1077-1086. doi: 10.1111/jdv.17108. Epub 2021 Feb 12.
Stabilized vitiligo resistant to conventional therapy (e.g. segmental vitiligo) and piebaldism lesions can be treated with autologous cellular grafting techniques, such as non-cultured cell suspension transplantation (NCST) and cultured melanocyte transplantation (CMT). These methods are preferred when treating larger surface areas due to the small amount of donor skin needed. However, the donor to recipient expansion ratios and outcomes reported in studies with cellular grafting vary widely, and to date, no overview or guideline exists on the optimal ratio. The aim of our study was to obtain an overview of the various expansion ratios used in cellular grafting and to identify whether expansion ratios affect repigmentation and colour match. We performed a systematic literature search in MEDLINE and EMBASE to review clinical studies that reported the expansion ratio and repigmentation after cellular grafting. We included 31 eligible clinical studies with 1591 patients in total. Our study provides an overview of various expansion ratios used in cellular grafting for vitiligo and piebaldism, which varied from 1:1 up to 1:100. We found expansion ratios between 1:1 and 1:10 for studies investigating NCST and from 1:20 to 1:100 in studies evaluating CMT. Pooled analyses of studies with the same expansion ratio and repigmentation thresholds showed that when using the lowest (1:3) expansion ratio, the proportion of lesions achieving >50% or >75% repigmentation after NCST was significantly better than when using the highest (1:10) expansion ratio (χ P = 0.000 and χ P = 0.006, respectively). Less than half of our included studies stated the colour match between different expansion ratios, and results were variable. In conclusion, the results of our study indicate that higher expansion ratios lead to lower repigmentation percentages after NCST treatment. This should be taken into consideration while determining which expansion ratio to use for treating a patient.
对传统疗法耐药的稳定期白癜风（如节段性白癜风）和斑驳病皮损可采用自体细胞移植技术进行治疗，如非培养细胞悬液移植（NCST）和培养黑素细胞移植（CMT）。由于所需供皮量少，这些方法在治疗较大面积皮损时更受青睐。然而，细胞移植研究中报道的供体与受体扩增比例及结果差异很大，迄今为止，尚无关于最佳比例的综述或指南。我们研究的目的是概述细胞移植中使用的各种扩增比例，并确定扩增比例是否会影响色素再生和颜色匹配。我们在MEDLINE和EMBASE中进行了系统的文献检索，以回顾报道细胞移植后扩增比例和色素再生情况的临床研究。我们纳入了31项符合条件的临床研究，共1591例患者。我们的研究概述了用于白癜风和斑驳病细胞移植的各种扩增比例，范围从1:1到1:100。我们发现，研究NCST的研究中扩增比例在1:1至1:10之间，评估CMT的研究中扩增比例在1:20至1:100之间。对具有相同扩增比例和色素再生阈值的研究进行汇总分析表明，使用最低（1:3）扩增比例时，NCST后皮损色素再生>50%或>75%的比例明显优于使用最高（1:10）扩增比例时（χ²P = 0.000和χ²P = 0.006，分别）。我们纳入的研究中不到一半说明了不同扩增比例之间的颜色匹配情况，结果各不相同。总之，我们的研究结果表明，较高的扩增比例会导致NCST治疗后色素再生百分比降低。在确定为患者使用哪种扩增比例时应考虑到这一点。
