Increased level of cathelicidin (LL-37) in vitiligo: Possible pathway independent from vitamin D receptor gene polymorphism.

Vitiligo is a multifactorial skin disease with established role of genetics and autoimmunity in its pathogenesis. Vitamin D receptor (VDR) polymorphisms have been suggested to correlate with risk of vitiligo in some ethnic populations. On the other hand, cathelicidin, one of the innate immune system components, has a role in development of some chronic skin diseases and VDR regulates the expression of cathelicidin. We aimed to determine the plasma level of cathelicidin and its association with the VDR gene polymorphisms as well as plasma vitamin D level in patients with vitiligo. Ninety vitiligo patients and 90 non-vitiligo controls participated in this study. Blood levels of 25(OH) vitamin D and cathelicidin were determined with ELISA. Genotyping for VDR polymorphisms (ApaI, TaqI, FokI and BsmI) was done with RFLP-PCR method. Mean blood level of cathelicidin was significantly higher in vitiligo patients as compared to controls (P < .0001). Mean blood level of vitamin D was significantly lower in patients than controls (P = .01). Statistically significant differences were not observed for both genotype and allele frequencies of BsmI, ApaI and TaqI polymorphisms. There was a borderline increased risk of vitiligo in over-dominant model of FokI polymorphism with OR = 1.8 and P = .051. Our findings was suggestive of the potential role of cathelicidin in the pathogenesis of vitiligo; however, future evaluations are needed to determine its precise mechanism. Genetic study of VDR gene polymorphism was suggestive of increased risk of vitiligo in association with a FokI polymorphism in Iranian population.

Medical Students' Occupational Burnout and its Relationship with Professionalism.

INTRODUCTION: Occupational burnout is a prevalent syndrome among medical students as well as other health professionals. It may be an important factor contributing to professional conducts. The aim of this study was to determine the prevalence of burnout among medical students of Shiraz University of Medical Sciences at clinical level and its relationship with professionalism. METHODS: In this cross-sectional study, all medical clinical students who had spent a minimum of six months of the first year of clinical level and who were in their final year, in 2015-16 were examined (using the census method). Data were gathered using demographics, educational background, and the dimensions of professionalism questionnaires and Maslach Job Burnout Inventory. Data analysis was performed using descriptive statistics, ANOVA and Pearson correlation test by SPSS, version 14. A p-value of <0.05 was considered statistically significant. RESULTS: The total mean score of burnout was 61.37+20.44 (moderate). In this study, 54.3% of the students had low, 35.2% moderate and 10.4% high job burnout. There was a negative correlation between job burnout and professional ethics with Pearson correlation test (p <0/000, r=0.23). There was no significant relationship between the increase in academic years and burnout. CONCLUSION: Regarding the high prevalence of burnout and its adverse effects among medical students, developing a workplace assistance program and adequate facilities to help them is necessary. Also, due to the negative correlation between professionalism and burnout, continuous training of professional ethics should be taken into consideration by educational authorities.