Hussein Sherief M, Sorour Mohammed Abd El Hakim, Samir Mahitab, Abd El Azim Shaimaa Ahmed, Hossain Ahmed
Department of Dermatology and Venereology, Medical Division, National Research Centre, Dokki, Giza, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Indian J Dermatol. 2022 Jul-Aug;67(4):319-323. doi: 10.4103/ijd.ijd_11_22.
Vitiligo is a common depigmenting skin disorder characterized by white macules and patches accompanied by local melanocyte loss, caused by autoimmune destruction. Vitiligo is classified into two major forms: segmental vitiligo (SV) and non-segmental vitiligo (NSV). It was also found that the IFN-ȣ/CXCL10 axis is functionally required for both progression and maintenance of the disease. Chemokine 10 (CXCL10) is a pro-inflammatory chemokine which was found to be elevated in the serum of vitiligo patients. UVB has been found to be a useful therapy that results in rapid repigmentation in NSV patients.
To evaluate CXCL10 in vitiligo patients before and after narrow band UVB (NB-UVB) phototherapy, which if targeted could provide new insights for therapeutic intervention for vitiligo.
The study included 25 active NSV patients who were able to comply with the study protocol in the Center of Excellence, Dermatology Outpatient Clinic, National Research Center, Egypt (February 2020-2021). All recruited patients were subjected to documentation of complete history. Dermatological assessment of vitiligo lesions, including vitiligo area score index (VASI) score, CXCL10 and extent of the disease were performed. A 3 mm punch biopsy from active vitiligo lesion (site of biopsy) was taken before and after treatment by NB-UVB, and then immunohistochemical staining was performed to evaluate expression of CXCL10.
After treatment by NB-UVB there was a significant decrease in VASI score, extent of the disease and CXCL10 expression.
The decrease in CXCL10 levels could be attributed to the effect of NB-UVB which leads to decrease in IFN-γ level, necessary to release CXCL10 through its pathway resulting in repigmentation and decrease in the extent of the disease and VASI scores.
白癜风是一种常见的色素脱失性皮肤病,其特征为白色斑片并伴有局部黑素细胞缺失,由自身免疫破坏引起。白癜风主要分为两种类型:节段型白癜风(SV)和非节段型白癜风(NSV)。研究还发现,IFN-γ/CXCL10轴在疾病的进展和维持过程中发挥功能性作用。趋化因子10(CXCL10)是一种促炎趋化因子,在白癜风患者血清中水平升高。紫外线B(UVB)已被证实是一种有效的治疗方法,可使NSV患者迅速复色。
评估窄谱中波紫外线(NB-UVB)光疗前后白癜风患者体内CXCL10的水平,若将其作为治疗靶点,可为白癜风的治疗干预提供新的思路。
该研究纳入了25例活动期NSV患者,这些患者均来自埃及国家研究中心卓越皮肤科门诊(2020年2月至2021年),且能够遵守研究方案。所有纳入的患者均记录了完整病史。对白癜风皮损进行了皮肤科评估,包括白癜风面积评分指数(VASI)评分、CXCL10水平及疾病范围。在NB-UVB治疗前后,从活动期白癜风皮损处(活检部位)取3mm钻孔活检组织,随后进行免疫组化染色以评估CXCL10的表达。
NB-UVB治疗后,VASI评分、疾病范围及CXCL10表达均显著降低。
CXCL10水平的降低可能归因于NB-UVB的作用,NB-UVB导致IFN-γ水平下降,而IFN-γ是通过其信号通路释放CXCL10所必需的,进而导致复色、疾病范围缩小及VASI评分降低。