Postgraduate Program In Translational Medicine, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil; Department of Dermatology, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil; Sleep Institute, São Paulo, Brazil.
Cytokine. 2024 Apr;176:156493. doi: 10.1016/j.cyto.2023.156493. Epub 2024 Jan 20.
Vitiligo is an autoimmune dermatosis that affects quality of life, which englobes sleep quality. Sleep regulates the immune system, including inflammatory cytokines, and other pathways, which may influence vitiligo pathogenesis.
To analyze levels of immune serum components (cytokines) in a vitiligo group, and assess whether there was any association with sleep.
This study comprised 30 vitiligo patients and 26 control individuals. Quality of life and sleep questionnaires were completed [Dermatology Life Quality Index (DLQI), Short-Form Health Survey (SF-36), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI)]. Seven cytokines have been measured: IFN-γ, interleukin (IL)-4, IL-6, IL-10, IL-17A, IL-12 p40 and TNF-α.
The mean age of the vitiligo group was 47.7 years-old, with prevalence of females (66.7 %). Mucosal (70 %), acral (60 %) and focal subtype (53.3 %) predominated. Signs of vitiligo activity were identified in 63.3 % of the disease sample. Total PSQI scores and scores for domain 4 (sleep efficiency) were statistically worse in vitiligo group. The SF-36 and ISI total scores were worse in the vitiligo group, although not statistically significant compared with controls. Four SF-36 domains were statistically worse in vitiligo sample, and the DLQI mean score was mild to moderate (5.57). Cytokine levels were not different between groups, or when associated with PSQI. Higher ISI scores (more severe insomnia) were related to increased IL-17A. Higher IL-4, IL-6 and IL-10 levels were associated with previous phototherapy.
Poor sleep and impaired aspects of quality of life predominated in the vitiligo sample. Insomnia was related to IL-17A increase in vitiligo. Increased levels of IL-4, IL-6 and IL-10 were related to previous ultraviolet B narrow band (UVB-NB) phototherapy, suggesting an interaction of this treatment on immune system. Sleep disruption and the course of vitiligo may have common pathways in respect of circadian cytokines, which may represent an important subject in vitiligo management.
白癜风是一种影响生活质量的自身免疫性皮肤病，其中包括睡眠质量。睡眠调节免疫系统，包括炎症细胞因子和其他途径，这可能影响白癜风的发病机制。
分析白癜风患者的免疫血清成分（细胞因子）水平，并评估其与睡眠的关系。
本研究包括 30 名白癜风患者和 26 名对照个体。完成生活质量和睡眠问卷[皮肤病生活质量指数（DLQI）、健康调查简表（SF-36）、匹兹堡睡眠质量指数（PSQI）和失眠严重程度指数（ISI）]。测量了七种细胞因子：干扰素-γ、白细胞介素（IL）-4、IL-6、IL-10、IL-17A、IL-12 p40 和 TNF-α。
白癜风组的平均年龄为 47.7 岁，女性患病率（66.7%）较高。黏膜（70%）、肢端（60%）和局限性（53.3%）为主。疾病样本中有 63.3%存在白癜风活动迹象。白癜风组的总 PSQI 评分和第 4 域（睡眠效率）评分均明显较差。与对照组相比，SF-36 和 ISI 总分在白癜风组较差，但无统计学意义。白癜风样本中有四个 SF-36 域统计学较差，DLQI 平均评分轻度至中度（5.57）。细胞因子水平在组间或与 PSQI 相关时无差异。较高的 ISI 评分（更严重的失眠）与 IL-17A 增加有关。较高的 IL-4、IL-6 和 IL-10 水平与之前的紫外线 B 窄带（UVB-NB）光疗有关，这表明这种治疗对免疫系统有相互作用。白癜风样本中睡眠障碍和疾病病程可能与昼夜节律细胞因子有共同途径，这可能是白癜风管理中的一个重要课题。
