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.

Diagnostic implications of MicroRNAs; 155, 146 a, and 203 lesional expression in alopecia areata: A preliminary case-controlled study.

BACKGROUND: Alopecia areata (AA) is an immune mediated disorder that attacks hair follicles with unknown pathophysiology. MicroRNAs (miRNAs) are small noncoding RNA molecules, and their aberrant expression or function has been involved in different autoimmune conditions. OBJECTIVES: We aimed at exploring the association between some miRNAs lesional expression and AA pathogenesis by measurement of miRNAs-155, 146a, and 203 expression levels in the lesional skin from patchy AA patients and to evaluate their relation with the studied parameters. SUBJECTS AND METHODS: Skin expression levels of miRNAs-155, 146a, and 203 were evaluated in 50 patients with patchy AA and 25 healthy controls using reverse transcriptase-quantitative PCR (RT-qPCR). The activity and severity of alopecia were assessed according to AA Investigational Assessment Guidelines criteria. RESULTS: Studied patients showed significant up-regulation of miRNAs-203, 146a, and 155 lesional tissue expression levels when compared to control group (p < 0.05 each). Only miRNA-146a skin expression level was significantly higher in patients with multiple lesions (p < 0.001). However, patients with active AA had significantly higher tissue expression levels of the investigated miRNAs than those with inactive disease (P 0.001, 0.009, and 0.001, respectively). CONCLUSIONS: Investigated miRNAs seem to be role players in AA pathogenesis and may be considered potential indicators of disease activity. However, more research is needed to clarify their accurate role and clinical importance.

Nuclear Factor Erythroid-2-related Factor 2 Gene Polymorphisms in Vitiligo.

BACKGROUND: Oxidative stress is now one of the accepted theories of vitiligo development. Nuclear factor erythroid-2-related factor 2 (Nrf2) regulates the expression of antioxidant proteins. OBJECTIVE: This work aimed to evaluate the association of Nrf2 gene polymorphisms with the susceptibility to vitiligo among a sample of Egyptian patients with vitiligo. METHODS: This case-control study included 100 patients with vitiligo and 50 healthy matched volunteers serving as a control group. Genotyping was carried out by real-time polymerase chain reaction. RESULTS: The frequencies of TT, CT, and combined (TT+CT) genotypes and the T allele of Nrf2 (rs35652124) were significantly increased in the studied patients with vitiligo relative to the healthy controls (p<0.001, p=0.012, p<0.001 and p<0.001, respectively). There was a nonsignificant difference between patients and controls regarding Nrf2 (rs6721961) genotypes. However, the T allele of Nrf2 (rs6721961) was significantly predominant in the studied patients compared to in the controls (p=0.029). Among the studied criteria, the T allele of Nrf2 (rs6721961) was predominant in patients with a marginal type of repigmentation (p=0.022), while the G allele of the same single-nucleotide polymorphism was associated with a higher body mass index value (p=0.034). One hundred percent of patients with vitiligo with the Nrf2 (rs6721961) GT genotype had a progressive disease course (p=0.015). CONCLUSION: Nrf2 (-617 T/G) and (-653 T/C) polymorphism might play a role in patient susceptibility to vitiligo and modify the clinical presentation of the disease.

Assessment of macrophage migration inhibitory factor in patients with verruca vulgaris.

BACKGROUND: Common warts are caused by human papillomaviruses (HPVs), they are among the most common cutaneous viral infections. Macrophage migration inhibitory factor (MIF) is an essential contributor in many inflammatory and immune skin diseases. Yet, its role in the pathology of common warts is unclear. OBJECTIVE: To assess MIF levels in lesional and perilesional skin in patients with common warts in comparison to apparently healthy control group with matching age and sex. SUBJECTS AND METHODS: A case-control study performed on 60 patients with common warts (group A) and 30 age and sex matching healthy controls (group B). Two biopsies were taken from each patient in group A; one from the lesion (lesional) and the other one from the skin around the wart (perilesional), while biopsies of controls were taken from matched sites to patients. Measurement of MIF in all groups was done by quantitative ELISA kits. RESULTS: Significant high MIF levels were detected in lesional and perilesional skin biopsies compared to controls (P<0.001). Yet, the difference in MIF levels between lesional and perilesional skin biopsy was non-significant. No significant relations were found between lesional and perilesional MIF levels and clinical characteristics of the studied patients while both lesional and perilesional MIF levels were significantly correlated (rh=0.269, P=0.021). CONCLUSION: The significantly elevated MIF levels in lesional and perilesional skin biopsies compared to controls point to its role in wart progression from HPV infected cells.