Uttmani Bhargavi M, Adya Keshavmurthy A, Inamadar Arun C
Department of Dermatology, Venereology and Leprosy, Shri B M Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, India.
J Cutan Aesthet Surg. 2024 Jul-Sep;17(3):266-271. doi: 10.4103/JCAS.JCAS_12_23. Epub 2023 Aug 4.
Vitiligo is an acquired depigmenting disorder due to the destructive loss of melanocytes, clinically presenting as hypopigmented or depigmented macules and/or patches. Many theories have been proposed to explain its etiopathogenesis among which cell-mediated immunity is one of the crucial links. Estimation of vitiligo activity and extent in a patient is important in tailoring an optimal treatment regimen. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (HsCRP) are sensitive indicators for systemic inflammation and are found to be relevant in determining vitiligo disease activity. This study was conducted to estimate serum levels of IL-6 and HsCRP in vitiligo patients and to correlate them with the disease activity and extent in order to assess if these serum markers serve as objective indicators of vitiligo disease activity. This was a hospital-based cross-sectional study of 58 vitiligo patients diagnosed clinically irrespective of age, gender, and any ongoing or past treatment. Disease activity and extent were calculated using the vitiligo disease activity (VIDA) score and vitiligo area severity index (VASI), respectively. Serum levels of IL-6 and HsCRP were obtained and their correlation with VIDA and VASI values were statistically analyzed. A weak negative statistically insignificant correlation was found between IL-6 and VIDA (P = 0.092). No correlation was found between VIDA and HsCRP (P = 0.998). A weak positive, statistically insignificant correlation was found between VASI and IL-6 as well as between VASI and HsCRP (P = 0.175 and P = 0.238, respectively). Although statistically insignificant, the patients who were not on immunosuppressive therapy showed higher mean values of IL-6 and HsCRP compared to those who were on immunosuppressive therapy. In contrast to the findings of previous studies, our study found a weak negative correlation between VIDA and IL-6 levels possibly attributable to the difference between the mean levels of IL-6 among the subgroups of patients who were, and were not on immunosuppressive therapy. The VIDA score and HsCRP levels did not show any statistical correlation. However, patients who were not on immunosuppressive therapy showed a higher albeit statistically insignificant mean value of HsCRP. Our observations suggest that any ongoing and/or treatment in the recent past, especially immunosuppressive therapy, and any co-morbidities should be essentially considered while investigating for sensitive serum markers of inflammation as determinants of vitiligo disease activity.
白癜风是一种由于黑素细胞遭受破坏而导致的后天性色素脱失性疾病，临床上表现为色素减退或色素脱失斑和/或斑片。人们提出了许多理论来解释其发病机制，其中细胞介导的免疫是关键环节之一。评估患者白癜风的活动度和范围对于制定最佳治疗方案很重要。白细胞介素-6（IL-6）和高敏C反应蛋白（HsCRP）是全身炎症的敏感指标，并且发现它们与白癜风疾病活动度相关。本研究旨在评估白癜风患者血清IL-6和HsCRP水平，并将它们与疾病活动度和范围相关联，以评估这些血清标志物是否可作为白癜风疾病活动度的客观指标。这是一项基于医院的横断面研究，纳入了58例临床诊断为白癜风的患者，不考虑年龄、性别以及任何正在进行或过去接受过的治疗。分别使用白癜风疾病活动度（VIDA）评分和白癜风面积严重程度指数（VASI）计算疾病活动度和范围。获取血清IL-6和HsCRP水平，并对它们与VIDA和VASI值的相关性进行统计学分析。发现IL-6与VIDA之间存在微弱的负相关，但无统计学意义（P = 0.092）。未发现VIDA与HsCRP之间存在相关性（P = 0.998）。发现VASI与IL-6以及VASI与HsCRP之间存在微弱的正相关，但无统计学意义（分别为P = 0.175和P = 0.238）。尽管无统计学意义，但未接受免疫抑制治疗的患者与接受免疫抑制治疗的患者相比，IL-6和HsCRP的平均值更高。与先前研究的结果相反，我们的研究发现VIDA与IL-6水平之间存在微弱的负相关，这可能归因于接受和未接受免疫抑制治疗的患者亚组中IL-6平均水平的差异。VIDA评分与HsCRP水平未显示出任何统计学相关性。然而，未接受免疫抑制治疗的患者HsCRP的平均值虽无统计学意义但更高。我们的观察结果表明，在研究作为白癜风疾病活动度决定因素的敏感血清炎症标志物时，应充分考虑任何正在进行的和/或近期的治疗，尤其是免疫抑制治疗，以及任何合并症。
