Could α MSH-MIFT Axis and IDH2 be Considered Promising Predictors of Non-segmental Vitiligo Response to NB-UVB Phototherapy?

Background: The search for objective factors that help in predicting the response of vitiligo treatment is very important. Objective: We sought to evaluate the effect of NB-UVB phototherapy on both the alpha melanocyte stimulating hormone-microphthalmia-associated transcription factor (α-MSH-MIFT) axis, and isocitrate dehydrogenase 2 (IDH2) in non-segmental vitiligo (NSV). Methods: This prospective clinical trial included 50 NSV patients and 50 healthy control subjects. α-MSH tissue levels as well as MITF and IDH2 immunostaining were assessed in normal and vitiliginous skin biopsies before treatment and then in the repigmented areas following 24 NB-UVB phototherapy treatment sessions using ELISA technique and immunohistochemical study, respectively. Results: There was a significant negative correlation between baseline VASI scores and the tissue levels of α-MSH (p=0.006) and the expression of both MITF (p<0.00001) and IDH-2 (p= 0.001). The mean α-MSH tissue levels increased significantly after treatment (p<0.001). Tissue expression of both MTIF and IDH-2 was significantly upregulated following treatment (P-value <0.001). The percentage of improvement showed a significant positive correlation with the studied markers (p<0.00001). Conclusion: α-MSH- MIFT axis and the antioxidant protein IDH2 are promising objective markers of non-segmental vitiligo severity, and are suggested as predictors of vitiligo response to treatment.

Inflammatory markers in acne vulgaris: Saliva as a novel diagnostic fluid.

BACKGROUND: Despite the wide use of saliva-based measurements in inflammatory, autoimmune and neoplastic conditions, its use in dermatology is still limited. AIMS: The aims of this study were to assess the serum and salivary levels of interleukin-1 beta (IL-1ß) and C-reactive protein (CRP) in patients with acne vulgaris. PATIENTS/METHODS: The study included 84 moderate-to-severe acne vulgaris patients, in addition to 105 healthy control subjects. Serum and salivary levels of CRP and IL-1ß were estimated using enzyme-linked immunosorbent assay (ELISA) technique. RESULTS: Using T-test, the serum and salivary levels of both CRP and IL-1ß in the patients were significantly higher than the measured levels in the control subjects (p < 0.001). Using Pearson correlation coefficient, serum and salivary CRP and serum IL-1ß levels showed significantly positive correlation with GAGS scores (p < 0.001). The levels of IL-1ß in saliva did not show significant correlation with GAGS scores or with serum and salivary CRP. CONCLUSIONS: The current study supports the emerging role of saliva as a valid noninvasive tool for monitoring inflammation and as a reliable and stress-free tool to evaluate cytokines and other inflammatory marker levels in acne vulgaris.

Factors affecting vitiligo response to treatment: do MiRNA 196a2C/T gene polymorphism and serum tyrosinase levels have any role?

BACKGROUND: Factors contributing to the pathogenesis of vitiligo and factors affecting its response to treatment are still a major area of debate. AIM OF THE WORK: The study aimed to assess the serum levels of tyrosinase and Micro-RNAs (miRNAs) gene polymorphism in a sample of Egyptian vitiligo patients, and to determine factors affecting the response of vitiligo to treatment. SUBJECTS AND METHODS: This prospective case-control interventional study included 212 non-segmental vitiligo patients and 96 control subjects. Before treatment, vitiligo was evaluated using Vitiligo Area Severity Index. Detection of miRNA 196a-2 polymorphism was done using PCR-REELP and serum tyrosinase was measured using ELISA. After treatment, patients were reevaluated clinically and serum tyrosinase levels were re-measured. RESULTS: The tyrosinase levels were significantly elevated in patients. The TT genotype was the most prevalent one in the patients. The percentage of improvement showed a significant positive correlation with patients' ages and age of the disease onset and a negative correlation with disease duration, baseline VASI scores and serum tyrosinase levels. CONCLUSION: MiRNA 196a-2 C/T (11614913) gene polymorphism and the elevated serum tyrosinase levels might be related to the pathogenesis of vitiligo and may affect its therapeutic response.

Nd:YAG laser vs IPL in inflammatory and noninflammatory acne lesion treatment.

BACKGROUND: Several topical and systemic therapies are available for the treatment of acne vulgaris but are associated with several limitations, and recently, intense pulse light (IPL) and long-pulsed 1064 nm Nd: YAG laser have shown efficacy. AIMS: The current study aimed to compare the efficacy of Nd:YAG laser and IPL in inflammatory and noninflammatory acne lesions. PATIENTS AND METHODS: Thirty patients with inflammatory and noninflammatory facial acne were assigned randomly and equally into two groups, the Nd:YAG and IPL groups. The patients received three sessions of laser 2 weeks apart, and the clinical improvement was assessed by the reduction in the number of lesions. RESULTS: At baseline, the two groups showed a nonsignificant difference as regards total number (P = .476), inflammatory (P = .457), and noninflammatory lesions (P = .420). The improvement in total lesions was significant in the Nd:YAG Group but nonsignificant in the IPL Group (P < .001, P = .13, respectively). Three patients (20%) in the IPL Group showed exacerbation after the first and second sessions. One month after the last session, the difference in improvement between noninflammatory and inflammatory lesions showed a significant difference in the Nd:YAG Group (P = .017) and a nonsignificant difference in the IPL Group (P = .823). Nd:YAG, compared to the IPL Group, showed a significant difference as regards the improvement score in noninflammatory lesions (P = .0099) and a nonsignificant difference in inflammatory lesions (P = .4295). CONCLUSION: The significant improvement in noninflammatory lesions and the absence of a significant flare-up of acne as seen among patients treated with IPL make Nd:YAG a better therapeutic modality for acne.