Özgün Geçer Melin, Kaya Gökhan
Department of Pathology, Bezmialem Vakıf University, İstanbul, Türkiye.
Department of Dermatology, Ministry of Health Nizip State Hospital, Gaziantep, Türkiye.
Sci Rep. 2025 Jul 28;15(1):27425. doi: 10.1038/s41598-025-11448-2.
Non-segmental vitiligo (NSV) is a chronic autoimmune skin disease marked by melanocyte loss and depigmented macules. While clinical features are well recognized, immunohistological correlates such as Melan-A expression and CD8⁺ T-cell infiltration remain undercharacterized. To examine the clinical, histological, and immunohistochemical features of NSV, with a focus on their relationship to disease severity. In this prospective case-control study, 25 NSV patients and 25 matched healthy controls were evaluated using standardized scoring systems (VASI, VIDA, VETF, VETI). Biopsies from lesional, marginal, and normal skin underwent immunohistochemical staining for Melan-A and CD8⁺ T cells. Histopathological changes were graded using a structured scoring system. Lesional skin exhibited significant melanocyte loss (Melan-A⁺ median: 5 [IQR: 3-8]) and elevated CD8⁺ T-cell infiltration (median: 15 [10-18]) compared to controls (p < 0.001). Marginal zones showed intermediate values, indicating subclinical immune activation. CD8⁺ infiltration positively correlated with VASI (r = 0.53), while Melan-A expression showed a negative correlation (r = - 0.55). Both markers were independent predictors of disease severity. NSV exhibits a spatial immunohistological gradient, where melanocyte loss and CD8⁺ T-cell infiltration parallel clinical severity. The integration of immunophenotyping with clinical scoring provides a novel biomarker strategy for personalized therapy.
非节段性白癜风（NSV）是一种慢性自身免疫性皮肤病，其特征为黑素细胞丢失和色素脱失斑。虽然临床特征已得到充分认识，但诸如Melan-A表达和CD8⁺ T细胞浸润等免疫组织学相关性仍未得到充分描述。为了研究NSV的临床、组织学和免疫组化特征，重点关注它们与疾病严重程度的关系。在这项前瞻性病例对照研究中，使用标准化评分系统（VASI、VIDA、VETF、VETI）对25例NSV患者和25例匹配的健康对照进行了评估。对病变皮肤、边缘皮肤和正常皮肤进行活检，进行Melan-A和CD8⁺ T细胞的免疫组化染色。使用结构化评分系统对组织病理学变化进行分级。与对照组相比，病变皮肤显示出显著的黑素细胞丢失（Melan-A⁺中位数：5 [四分位间距：3-8]）和CD8⁺ T细胞浸润增加（中位数：15 [10-18]）（p < 0.001）。边缘区域显示出中间值，表明存在亚临床免疫激活。CD8⁺浸润与VASI呈正相关（r = 0.53），而Melan-A表达呈负相关（r = -0.55）。这两种标志物都是疾病严重程度的独立预测因子。NSV表现出空间免疫组织学梯度，其中黑素细胞丢失和CD8⁺ T细胞浸润与临床严重程度平行。免疫表型分析与临床评分的整合为个性化治疗提供了一种新的生物标志物策略。
