ABSTRACT
The nucleotide-binding oligomerization domain-like receptor 3 (NLRP3) inflammasome is a high molecular weight protein complex that has been linked to a variety of allergic and inflammatory disorders in humans, including atopic dermatitis (AD). Polymorphisms in NLRP3 genes could lead to immune dysregulation. This case-control study aimed to assess the association between NLRP3 inflammasome (rs10754558) gene polymorphism in AD and the incidence and severity of the disease. We included 62 subjects in each of the AD and control groups. Serum total IgE levels and NLRP3 inflammasome (rs10754558) gene polymorphism were assessed and compared between the two study groups and among the AD group as arranged by disease severity. The AD group showed significantly higher levels of serum total IgE compared to controls (pË0.001). Serum IgE levels were also significantly associated with AD severity. The (rs10754558) G allele was significantly predominant among AD participants (OR: 2.33; 95% CI: 1.1 -4.92) and 51.6% of the AD group was carriers of the GG genotype. Moreover, there was a substantial correlation between NLRP3 (rs10754558) G allele and AD score index for disease severity (OR: 7.17; 95% CI: 1.47 - 35.7). In conclusion, NLRP3 inflammasome (rs10754558) gene polymorphism G allele could be an important factor in the predisposition and exacerbation of AD.
Subject(s)
Dermatitis, Atopic , Inflammasomes , Humans , Inflammasomes/genetics , Genetic Predisposition to Disease , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , Dermatitis, Atopic/genetics , Case-Control Studies , Polymorphism, Single Nucleotide , Genotype , Immunoglobulin EABSTRACT
BACKGROUND: NB-UVB has long been the vitiligo management pillar with capability of achieving the main treatment outcomes; repigmentation and stabilization. Its stabilizing effect in dark skin has been debatable. However, randomized controlled trials regarding NB-UVB ability to control disease activity are lacking. PURPOSE: To assess stabilizing effect of NB-UVB in comparison to systemic corticosteroids, the mainstay in vitiligo stabilization, in skin photo-types (III-V). METHODS: This is a multicenter, placebo-controlled, randomized, prospective study. Eighty patients with active nonsegmental vitiligo (NSV) (Vitiligo disease activity (VIDA) ≥2) were randomized to either NB-UVB and placebo (NB-placebo) or NB-UVB and dexamethasone oral mini-pulse (OMP) therapy (NB-OMP) for 6 months. Sixty four patients completed the study, 34 in the NB-OMP group and 30 in the NB-placebo group. Patients were evaluated fortnightly according to presence or absence of symptoms/signs of activity. RESULTS: In spite of earlier control of disease activity observed in the NB-OMP group, it was comparable in both groups by the end of the study period. Disease activity prior to therapy, but not extent, was found to influence control of activity in both groups. Thus, NB-UVB is a safe sole therapeutic tool in vitiligo management. Not only does it efficiently achieve repigmentation, but also it is a comparable stabilizing tool for systemic corticosteroids in spite of slightly delayed control. CONCLUSION: NB-UVB is the only well-established vitiligo therapy that can be used solely whenever corticosteroids are contraindicated or immune-suppression is unjustified. Nonetheless, its combination with corticosteroids expedites response and improves compliance.
Subject(s)
Ultraviolet Therapy , Vitiligo , Combined Modality Therapy , Humans , Prospective Studies , Skin Pigmentation , Treatment Outcome , Vitiligo/drug therapy , Vitiligo/radiotherapyABSTRACT
This cross-sectional multicenter study aimed to evaluate serum CXCL-10, as an activity marker for vitiligo, and compare it with other putative serum and tissue markers. Serum CXCL-10 was compared to interferon gamma (IFN-γ), interleukin 6 (IL-6), and IL-17 using ELISA in 55 non-segmental vitiligo patients (30 active and 25 stable) and 30 healthy controls. Marginal skin biopsy was taken for immunohistochemical evaluation of CD8+T cells and CXCL-10+ve cells. Serum levels of CXCL-10, IL-17, and IL-6 were elevated in all vitiligo patients compared to controls (p < .05). All investigated serum markers were higher in active versus stable vitiligo. Tissue expression of CXCL-10+ve cells and CD8+ve T cells was stronger in vitiligo patients compared to controls, and tissue CXCL-10+ve cell expression was stronger in active versus stable cases. Positive correlations were noted between the different serum and tissue markers. CXCL-10 was the most specific, whereas IL-6 was the most sensitive serum marker to distinguish active from stable disease.