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1.
Photodermatol Photoimmunol Photomed ; 40(3): e12974, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38728444

RESUMO

BACKGROUND/PURPOSE: Existing phototherapies are ineffective for treating patients with vitiligo with complete leukotrichia. We compared the efficacy of reverse perilesional irradiation, during which only the lesional areas are covered, with conventional narrowband ultraviolet B (NB-UVB) home phototherapy for repigmentation of non-segmental vitiligo in patients with complete leukotrichia. METHODS: This was a 12-week, open-label, double-arm, multicenter clinical trial, with a total of 121 patients with non-segmental vitiligo who were randomly divided into two groups (both received topical tacrolimus): the conventional NB-UVB irradiation (CI) and reverse perilesional NB-UVB irradiation (RI) groups. RESULTS: A statistically significant difference in improvement from baseline was observed in the RI group compared with the findings in the CI group (-30.8% ± 11.8% vs. -25.5% ± 11.05%, respectively [p = .010]; pair-wise comparison p = .900 at week 4, p = .104 at week 8, and p = .010 at week 12). At week 12, the average percentage change from baseline of leukotrichia in the irradiation area significantly decreased from 100% to 82.2% ± 13.65% in the RI group, and from 100% to 88.7% ± 9.64% in the CI group (p = .027). Adverse events were minor, including desquamation, dryness, erythema, and blisters. No severe or lasting side effects were observed during the study. CONCLUSION: RI mediated better repigmentation of vitiligo with complete leukotrichia than CI.


Assuntos
Terapia Ultravioleta , Vitiligo , Humanos , Vitiligo/terapia , Vitiligo/radioterapia , Feminino , Masculino , Adulto , Terapia Ultravioleta/métodos , Pigmentação da Pele , Pessoa de Meia-Idade , Adolescente , Tacrolimo/uso terapêutico , Tacrolimo/administração & dosagem
2.
Mol Biol Rep ; 51(1): 650, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38734811

RESUMO

BACKGROUND: Vitiligo is a common autoimmune skin disease. Capsaicin has been found to exert a positive effect on vitiligo treatment, and mesenchymal stem cells (MSCs) are also confirmed to be an ideal cell type. This study aimed to explore the influence of capsaicin combined with stem cells on the treatment of vitiligo and to confirm the molecular mechanism of capsaicin combined with stem cells in treating vitiligo. METHODS AND RESULTS: PIG3V cell proliferation and apoptosis were detected using CCK-8 and TUNEL assays, MitoSOX Red fluorescence staining was used to measure the mitochondrial ROS level, and JC-1 staining was used to detect the mitochondrial membrane potential. The expression of related genes and proteins was detected using RT‒qPCR and Western blotting. Coimmunoprecipitation was used to analyze the protein interactions between HSP70 and TLR4 or between TLR4 and mTOR. The results showed higher expression of HSP70 in PIG3V cells than in PIG1 cells. The overexpression of HSP70 reduced the proliferation of PIG3V cells, promoted apoptosis, and aggravated mitochondrial dysfunction and autophagy abnormalities. The expression of HSP70 could be inhibited by capsaicin combined with MSCs, which increased the levels of Tyr, Tyrp1 and DCT, promoted the proliferation of PIG3V cells, inhibited apoptosis, activated autophagy, and improved mitochondrial dysfunction. In addition, capsaicin combined with MSCs regulated the expression of TLR4 through HSP70 and subsequently affected the mTOR/FAK signaling pathway CONCLUSIONS: Capsaicin combined with MSCs inhibits TLR4 through HSP70, and the mTOR/FAK signaling pathway is inhibited to alleviate mitochondrial dysfunction and autophagy abnormalities in PIG3V cells.


Assuntos
Apoptose , Capsaicina , Proliferação de Células , Proteínas de Choque Térmico HSP70 , Melanócitos , Mitocôndrias , Transdução de Sinais , Serina-Treonina Quinases TOR , Receptor 4 Toll-Like , Vitiligo , Receptor 4 Toll-Like/metabolismo , Humanos , Mitocôndrias/metabolismo , Mitocôndrias/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Proteínas de Choque Térmico HSP70/metabolismo , Proteínas de Choque Térmico HSP70/genética , Serina-Treonina Quinases TOR/metabolismo , Vitiligo/metabolismo , Vitiligo/tratamento farmacológico , Capsaicina/farmacologia , Proliferação de Células/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Melanócitos/metabolismo , Melanócitos/efeitos dos fármacos , Linhagem Celular , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/efeitos dos fármacos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Autofagia/efeitos dos fármacos
3.
Int Immunopharmacol ; 133: 112132, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38691918

RESUMO

OBJECTIVE: This study employed Mendelian Randomization (MR) to investigate the causal relationship between genetic susceptibility to vitiligo and the risk of various autoimmune diseases, along with the mediating role of blood metabolites. METHODS: We performed two-sample MR analyses using aggregated genome-wide association studies (GWAS) data on 486 blood metabolites, vitiligo, and nine autoimmune diseases to investigate blood metabolites' causal effects on the susceptibility of vitiligo and the associations of vitiligo with nine autoimmune comorbidities. We also applied multivariable MR to unravel metabolites by which vitiligo influences the pathogenesis of autoimmune diseases. RESULTS: Our findings indicate that vitiligo amplified the risk of several autoimmune diseases, including rheumatoid arthritis (OR 1.17; 95 % CI 1.08-1.27), psoriasis (OR 1.10; 95 % CI 1.04-1.17), type 1 diabetes (OR 1.41; 95 % CI 1.23-1.63), pernicious anemia (OR 1.23; 95 % CI 1.12-1.36), autoimmune hypothyroidism (OR 1.19; 95 % CI 1.11-1.26), alopecia areata (OR 1.22; 95 % CI 1.10-1.35), and autoimmune Addison's disease (OR 1.22; 95 % CI 1.12-1.33). Additionally, our analysis identified correlations with vitiligo for 14 known (nine risk, five protective) and seven uncharacterized serum metabolites. After adjusting for genetically predicted levels of histidine and pyruvate, the associations between vitiligo and these diseases were attenuated. CONCLUSIONS: We substantiated vitiligo's influence on susceptibility to seven autoimmune diseases and conducted a thorough investigation of serum metabolites correlated with vitiligo. Histidine and pyruvate are potential mediators of vitiligo associated with autoimmune diseases.By combining metabolomics with genomics, we provide new perspectives on the etiology of vitiligo and its immune comorbidities.


Assuntos
Doenças Autoimunes , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Vitiligo , Vitiligo/genética , Vitiligo/sangue , Humanos , Doenças Autoimunes/sangue , Doenças Autoimunes/genética , Polimorfismo de Nucleotídeo Único
4.
Front Immunol ; 15: 1387011, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38715599

RESUMO

An unbiased screening of which proteins are deregulated in vitiligo using proteomics can offer an enormous value. It could not only reveal robust biomarkers for detecting disease activity but can also identify which patients are most likely to respond to treatments. We performed a scoping review searching for all articles using proteomics in vitiligo. Eight manuscripts could be identified. Unfortunately, very limited overlap was found in the differentially expressed proteins between studies (15 out of 272; 5,51%) with variable degrees of the type of proteins and a substantial variety in the prevalence of acute phase proteins (range: 6-65%). Proteomics research has therefore brought little corroborating evidence on which proteins are differentially regulated between vitiligo patients and healthy controls or between active and stable vitiligo patients. While a limited patient size is an obvious weakness for several studies, an incomplete description of patient characteristics is an unfortunate and avoidable shortcoming. Additionally, the variations in the used methodology and analyses may further contribute to the overall observed variability. Nonetheless, more recent studies investigating the response to treatment seem to be more robust, as more differentially expressed proteins that have previously been confirmed to be involved in vitiligo were found. The further inclusion of proteomics analyses in clinical trials is recommended to increase insights into the pathogenic mechanisms in vitiligo and identify reliable biomarkers or promising drug targets. A harmonization in the study design, reporting and proteomics methodology could vastly improve the value of vitiligo proteomics research.


Assuntos
Biomarcadores , Proteômica , Vitiligo , Vitiligo/metabolismo , Humanos , Proteômica/métodos , Proteoma
5.
J Coll Physicians Surg Pak ; 34(5): 514-517, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38720208

RESUMO

OBJECTIVE: To assess the efficacy of microneedling in combination with topical tacrolimus ointment 0.1% versus topical tacrolimus ointment 0.1% for treatment of refractory stable vitiligo. STUDY DESIGN: Comparative cross-sectional study. Place and Duration of the Study: Department of Dermatology, PNS Shifa, Karachi, Pakistan, from December 2022 to May 2023. METHODOLOGY: The study included 30 clinically diagnosed individuals of either gender who had refractory symptoms and aged between 20 and 60 years. For every patient, two comparable lesions on two comparable limb regions were selected. Group A (right side) received treatment with both topical tacrolimus ointment 0.1% twice daily in addition to microneedling every two weeks, whereas, Group B (left side) was treated with topical tacrolimus ointment 0.1% only. Every lesion was investigated as a separate entity. Both groups were subsequently observed for a further six months. RESULTS: When topical tacrolimus ointment 0.1% was combined with microneedling, the total re-pigmentation rate was substantially higher than the usage of tacrolimus ointment 0.1% alone. Fifty-three percent of lesions treated with topical tacrolimus ointment 0.1% alone and 76.7% of lesions treated with microneedling in conjunction with it showed a good-to-excellent response. No adverse negative effects were noted. During the follow-up period, no problems or recurrences were noted. CONCLUSION: Tacrolimus ointment combined with microneedling is a successful treatment for refractory stable vitiligo. KEY WORDS: Dermapen, Depigmentation, Microneedling, Tacrolimus ointment, Vitiligo.


Assuntos
Imunossupressores , Pomadas , Tacrolimo , Vitiligo , Humanos , Vitiligo/terapia , Vitiligo/tratamento farmacológico , Tacrolimo/administração & dosagem , Tacrolimo/uso terapêutico , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Resultado do Tratamento , Terapia Combinada , Agulhas , Adulto Jovem , Administração Cutânea , Administração Tópica , Agulhamento Seco/métodos , Indução Percutânea de Colágeno
6.
Exp Dermatol ; 33(5): e15091, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38711220

RESUMO

KIT ligand and its associated receptor KIT serve as a master regulatory system for both melanocytes and mast cells controlling survival, migration, proliferation and activation. Blockade of this pathway results in cell depletion, while overactivation leads to mastocytosis or melanoma. Expression defects are associated with pigmentary and mast cell disorders. KIT ligand regulation is complex but efficient targeting of this system would be of significant benefit to those suffering from melanocytic or mast cell disorders. Herein, we review the known associations of this pathway with cutaneous diseases and the regulators of this system both in skin and in the more well-studied germ cell system. Exogenous agents modulating this pathway will also be presented. Ultimately, we will review potential therapeutic opportunities to help our patients with melanocytic and mast cell disease processes potentially including vitiligo, hair greying, melasma, urticaria, mastocytosis and melanoma.


Assuntos
Mastócitos , Mastocitose , Melanócitos , Proteínas Proto-Oncogênicas c-kit , Fator de Células-Tronco , Humanos , Fator de Células-Tronco/metabolismo , Melanócitos/metabolismo , Mastócitos/metabolismo , Mastocitose/tratamento farmacológico , Mastocitose/metabolismo , Proteínas Proto-Oncogênicas c-kit/metabolismo , Melanoma/metabolismo , Melanoma/tratamento farmacológico , Vitiligo/metabolismo , Vitiligo/tratamento farmacológico , Vitiligo/terapia , Transtornos da Pigmentação/tratamento farmacológico , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/tratamento farmacológico , Animais
7.
Front Immunol ; 15: 1386727, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38720888

RESUMO

Introduction: Vitiligo is an acquired de-pigmentation disorder characterized by the post-natal loss of epidermal melanocytes (pigment-producing cells) resulting in the appearance of white patches in the skin. The Smyth chicken is the only model for vitiligo that shares all the characteristics of the human condition including: spontaneous post-natal loss of epidermal melanocytes, interactions between genetic, environmental and immunological factors, and associations with other autoimmune diseases. In addition, an avian model for vitiligo has the added benefit of an easily accessible target tissue (a growing feather) that allows for the repeated sampling of an individual and thus the continuous monitoring of local immune responses over time. Methods: Using a combination of flow cytometry and gene expression analyses, we sought to gain a comprehensive understanding of the initiating events leading to expression of vitiligo in growing feathers by monitoring the infiltration of leukocytes and concurrent immunological activities in the target tissue beginning prior to visual onset and continuing throughout disease development. Results: Here, we document a sequence of immunologically significant events, including characteristic rises in infiltrating B and αß T cells as well as evidence of active leukocyte recruitment and cell-mediated immune activities (CCL19, IFNG, GZMA) leading up to visual vitiligo onset. Examination of growing feathers from vitiligo-susceptible Brown line chickens revealed anti-inflammatory immune activities which may be responsible for preventing vitiligo (IL10, CTLA4, FOXP3). Furthermore, we detected positive correlations between infiltrating T cells and changes in their T cell receptor diversity supporting a T cell-specific immune response. Conclusion: Collectively, these results further support the notion of cell-mediated immune destruction of epidermal melanocytes in the pulp of growing feathers and open new avenues of study in the vitiligo-prone Smyth and vitiligo-susceptible Brown line chickens.


Assuntos
Galinhas , Modelos Animais de Doenças , Plumas , Melanócitos , Vitiligo , Animais , Vitiligo/imunologia , Galinhas/imunologia , Plumas/imunologia , Melanócitos/imunologia , Melanócitos/metabolismo , Linfócitos T/imunologia
8.
J Med Invest ; 71(1.2): 177-178, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38735717

RESUMO

Vitiligo is an acquired chronic depigmenting disorder of the skin and is characterized by the destruction of melanocytes. One of the clinical features of vitiligo is that damage to normal skin frequently results in the formation of depigmented macules, which is known as Köebner's phenomenon (KP). Here, we presented a case of vitiligo, in which depigmented macules followed the course of a dilated varicose vein. Dilatation of blood vessels was considered to contribute to the development of the vitiliginous lesions as a trigger for KP. Any kind of skin injury can trigger KP, but this is only the second case in which a dilated blood vessel caused KP in vitiligo. J. Med. Invest. 71 : 177-178, February, 2024.


Assuntos
Perna (Membro) , Varizes , Vitiligo , Humanos , Vitiligo/patologia , Varizes/etiologia , Varizes/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Masculino , Feminino , Adulto
9.
Eur J Pharmacol ; 973: 176537, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38604546

RESUMO

Previous studies have shown that all kinin system is constitutively expressed in the normal and inflamed skin, with a potential role in both physiological and pathological processes. However, the understanding regarding the involvement of the kinin system in skin pigmentation and pigmentation disorders remains incomplete. In this context, the present study was designed to determine the role of kinins in the Monobenzone (MBZ)-induced vitiligo-like model. Our findings showed that MBZ induces higher local skin depigmentation in kinin receptors knockout mice (KOB1R, KOB2R and KOB1B2R) than in wild type (WT). Remarkably, lower levels of melanin content and reduced ROS generation were detected in KOB1R and KOB2R mice treated with MBZ. In addition, both KOB1R and KOB2R show increased dermal cell infiltrate in vitiligo-like skin, when compared to WT-MBZ. Additionally, lack of B1R was associated with greater skin accumulation of IL-4, IL-6, and IL-17 by MBZ, while KOB1B2R presented lower levels of TNF and IL-1. Of note, the absence of both kinin B1 and B2 receptors demonstrates a protective effect by preventing the increase in polymorphonuclear and mononuclear cell infiltrations, as well as inflammatory cytokine levels induced by MBZ. In addition, in vitro assays confirm that B1R and B2R agonists increase intracellular melanin synthesis, while bradykinin significantly enhanced extracellular melanin levels and proliferation of B16F10 cells. Our findings highlight that the lack of kinin receptors caused more severe depigmentation in the skin, as well as genetic deletion of both B1/B2 receptors seems to be linked with changes in levels of constitutive melanin levels, suggesting the involvement of kinin system in crucial skin pigmentation pathways.


Assuntos
Melaninas , Pigmentação da Pele , Animais , Pigmentação da Pele/efeitos dos fármacos , Camundongos , Melaninas/metabolismo , Melaninas/biossíntese , Camundongos Knockout , Receptor B1 da Bradicinina/metabolismo , Receptor B1 da Bradicinina/genética , Citocinas/metabolismo , Vitiligo/metabolismo , Vitiligo/patologia , Receptor B2 da Bradicinina/metabolismo , Pele/metabolismo , Pele/efeitos dos fármacos , Pele/patologia , Espécies Reativas de Oxigênio/metabolismo , Camundongos Endogâmicos C57BL , Humanos , Masculino
10.
Syst Rev ; 13(1): 110, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38641831

RESUMO

BACKGROUND: Vitiligo is a disease that affects people of all skin shades and can impact their quality of life. Reliable evidence on the effectiveness and adverse events associated with the recent use of Janus kinase (JAK) inhibitors to treat vitiligo is needed. This protocol for a systematic review and meta-analysis seeks to collect evidence from both randomized controlled trials (RCTs) and observational studies to determine the effectiveness and patient-centered outcomes concerning treatment with JAK inhibitors. METHODS: We will conduct a systematic review of the literature for RCTs and observational studies that used upadacitinib, ritlecitinib, brepocitinib, ifidancitinib, cerdulatinib, deglocitinib, baricitinib, tofacitinib, and ruxolitinib JAK inhibitors as treatments for vitiligo compared to placebo, no treatment, or combination therapies. We will systematically search from inception in Epistemonikos, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, PsycINFO, Allied and Complementary Medicine Database, Latin American and Caribbean Health Sciences Literature, Web of Science Core Collection, relevant preprint servers, and the gray literature. Ethics approval was not sought as the protocol and systematic review will not involve human participants, but rather summarized and anonymous data from studies. Primary outcomes include quality of life, percentage repigmentation, decreased vitiligo within 1 year or more, lasting repigmentation after a 2-year follow-up, cosmetic acceptability of repigmentation and tolerability or burden of treatment, and adverse events. Secondary outcomes are patient and study characteristics. We will include full-text articles, preprints, and clinical trial data in any language and all geographic regions. For data sources unavailable in English, we will obtain translations from global collaborators via the Cochrane Engage network. We will exclude articles for which sufficient information cannot be obtained from the authors of articles and systematic reviews. At least two investigators will independently assess articles for inclusion and extract data; reliability will be assessed before subsequent selection and data extraction of remaining studies. The risk of bias and certainty of evidence with Grading of Recommendations Assessment, Development, and Evaluation guidelines will be assessed independently by at least two investigators. We will estimate treatment effects by random-effects meta-analyses and assess heterogeneity using I2. Data that cannot be included in the meta-analysis will be reported narratively using themes. DISCUSSION: The proposed systematic review and meta-analysis describe the methods for summarizing and synthesizing the evidence on the effectiveness and patient-centered outcomes concerning the treatment of vitiligo with JAK inhibitors that were recently approved for this indication. To disseminate further the results of our systematic review, we plan to present them at international conferences and meetings. Our findings will provide robust evidence to facilitate decision-making at the policy or practitioner level. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023383920.


Assuntos
Inibidores de Janus Quinases , Vitiligo , Humanos , Inibidores de Janus Quinases/uso terapêutico , Vitiligo/tratamento farmacológico , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Terapia Combinada , Estudos Observacionais como Assunto , Literatura de Revisão como Assunto
11.
Sci Rep ; 14(1): 9127, 2024 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-38644396

RESUMO

Vitiligo is a hypopigmented skin disease characterized by the loss of melanin. The progressive nature and widespread incidence of vitiligo necessitate timely and accurate detection. Usually, a single diagnostic test often falls short of providing definitive confirmation of the condition, necessitating the assessment by dermatologists who specialize in vitiligo. However, the current scarcity of such specialized medical professionals presents a significant challenge. To mitigate this issue and enhance diagnostic accuracy, it is essential to build deep learning models that can support and expedite the detection process. This study endeavors to establish a deep learning framework to enhance the diagnostic accuracy of vitiligo. To this end, a comparative analysis of five models including ResNet (ResNet34, ResNet50, and ResNet101 models) and Swin Transformer series (Swin Transformer Base, and Swin Transformer Large models), were conducted under the uniform condition to identify the model with superior classification capabilities. Moreover, the study sought to augment the interpretability of these models by selecting one that not only provides accurate diagnostic outcomes but also offers visual cues highlighting the regions pertinent to vitiligo. The empirical findings reveal that the Swin Transformer Large model achieved the best performance in classification, whose AUC, accuracy, sensitivity, and specificity are 0.94, 93.82%, 94.02%, and 93.5%, respectively. In terms of interpretability, the highlighted regions in the class activation map correspond to the lesion regions of the vitiligo images, which shows that it effectively indicates the specific category regions associated with the decision-making of dermatological diagnosis. Additionally, the visualization of feature maps generated in the middle layer of the deep learning model provides insights into the internal mechanisms of the model, which is valuable for improving the interpretability of the model, tuning performance, and enhancing clinical applicability. The outcomes of this study underscore the significant potential of deep learning models to revolutionize medical diagnosis by improving diagnostic accuracy and operational efficiency. The research highlights the necessity for ongoing exploration in this domain to fully leverage the capabilities of deep learning technologies in medical diagnostics.


Assuntos
Aprendizado Profundo , Vitiligo , Vitiligo/diagnóstico , Humanos
12.
Turk J Ophthalmol ; 54(2): 112-115, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38646109

RESUMO

In recent years, adalimumab has been increasingly used in the chronic treatment of non-infectious uveitis. This case report aimed to describe a drug-induced adverse event in a 34-year-old man who presented with blurred vision and floaters in the right eye and was being treated for intermediate uveitis. The patient had started topical treatment with a diagnosis of uveitis at another center. Best corrected visual acuity at presentation was 0.8 (decimal) in the right eye and 1.0 in the left eye. On examination, the anterior chamber in the right eye was clear, with anterior vitreous cells and mild haze, and snow banking and vitreous opacities in the inferior periphery. Fluorescein angiography (FA) showed hyperfluorescence in the right disc and leakage in the inferior periphery. As the inflammation did not resolve with local treatment, systemic cyclosporine was administered, after which the patient exhibited vomiting and weakness. Cyclosporine was discontinued and adalimumab treatment was started. On examination 5 months later, bilateral vitreous cells and mild vitreous opacity were noted, and FA showed mild leakage in the inferior periphery bilaterally. In addition, a depigmented patchy vitiligo lesion was observed on the chin. Due to the persistence of intraocular inflammation and on the recommendation of the dermatology clinic, adalimumab treatment was continued and topical tacrolimus was started for the lesion. On examination 3 months later, the inflammatory findings had resolved and there was no progression of the vitiligo lesion. The patient's treatment was continued. Taken together with the previous literature findings, no pathology was found in the patient's systemic examination, suggesting that this lesion was a side effect of the treatment. Ophthalmologists should be alert for this side effect in patients receiving adalimumab.


Assuntos
Adalimumab , Anti-Inflamatórios , Angiofluoresceinografia , Vitiligo , Humanos , Adalimumab/efeitos adversos , Adalimumab/uso terapêutico , Masculino , Adulto , Angiofluoresceinografia/métodos , Vitiligo/diagnóstico , Vitiligo/induzido quimicamente , Anti-Inflamatórios/efeitos adversos , Anti-Inflamatórios/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Acuidade Visual , Fundo de Olho
13.
Arch Dermatol Res ; 316(5): 126, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38652183

RESUMO

Vitiligo is characterized by skin depigmentation, which can lead to profound psychological effects and decreased quality of life, especially for those with skin of color. Individuals with vitiligo may utilize complementary and alternative medicine (CAM) due to limited treatment options with varying efficacy.An anonymous, multiple-choice, cross-sectional questionnaire was distributed to participants with vitiligo in the United States through online forums. Data on disease characteristics, use of prescription medications, use of topical therapies, supplements, and diets, and perceptions of CAM were collected.In total, 625 respondents completed the survey. Overall, 32.5% of participants (203/625) have tried CAM. Commonly reported CAM include supplements of vitamin D (57.7%, 116/203), vitamin B12 (46.3%, 93/203), vitamin C (27.4%, 55/203), topical Nigella sativa oil (26.4%, 53/203), oral omega-3 fatty acids (24.9%, 50/203), folic acid (22.9%, 46/203), and vitamin E (22.9%, 46/203). Frequently cited reasons for CAM use include desire to try "new" (40.4%, 82/203) or "more natural" (26.6%, 54/203) therapies, "frustration with conventional medicine" (24.6%, 50/203), and fear of "adverse side effects of conventional medicine" (23.6%, 48/203). Non-White participants were more likely than their White counterparts to report CAM use and have more positive perceptions of CAM therapies. Less than half (43.3%, 88/203) of CAM users reported that they disclosed their use of CAM with their physician.Dermatologists should be mindful of CAM and ask patients about their use. Further investigation of the role of CAM as adjuvant therapy for vitiligo is warranted to better advise patients.


Assuntos
Terapias Complementares , Suplementos Nutricionais , Vitiligo , Humanos , Vitiligo/terapia , Vitiligo/psicologia , Estudos Transversais , Terapias Complementares/estatística & dados numéricos , Terapias Complementares/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Suplementos Nutricionais/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem , Estados Unidos , Idoso , Qualidade de Vida , Adolescente , Pigmentação da Pele
14.
Arch Dermatol Res ; 316(5): 134, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38662224

RESUMO

Exploration of gene expression variations is a potential source to unravel biological pathways involved in pathological changes in body and understand the mechanism underneath. Vitiligo patients were explored for gene expression changes transcriptionally at perilesional site in comparison to normal site of same patients for melanogenesis pathway (TYR, DCT & TYRP1) cell adhesion (MMPs & TIMP1), cell survival (BCL2 & BAX1) as well as proliferation, migration & development (SOX9, SOX10 & MITF) regulatory system, using skin biopsy samples. Results were also compared with changes in gene expression for melanocytes under stress after hydrogen peroxide treatment in-vitro. Gene amplification was carried out via real time PCR. We found increased expression of proliferation, migration & development regulatory genes as well as melanogenesis pathway genes at perilesional site of patients. In-vitro study also supports induced MITF expression and disturbed melanogenesis in melanocytes under stress. Expression level ratio of cell survival regulatory genes' (BCL2/BAX1) as well as cell adhesion regulatory genes (MMPs/TIMP1) was observed upregulated at patient's perilesional site however downregulated in hydrogen peroxide treated melanocytes in-vitro. Observed upregulated gene expression at perilesional site of patients may be via positive feedback loop in response to stress to increase cell tolerance power to survive against adverse conditions. Gene expression analysis suggests better cell survival and proliferation potential at perilesional site in vitiligo patients. It seems in-vivo conditions/growth factors supports cells to fight for survival to accommodate stressed conditions.


Assuntos
Sobrevivência Celular , Peróxido de Hidrogênio , Melanócitos , Vitiligo , Humanos , Vitiligo/genética , Vitiligo/patologia , Melanócitos/metabolismo , Melanócitos/patologia , Sobrevivência Celular/efeitos dos fármacos , Peróxido de Hidrogênio/metabolismo , Masculino , Adulto , Feminino , Proliferação de Células/genética , Pele/patologia , Pele/metabolismo , Fator de Transcrição Associado à Microftalmia/genética , Fator de Transcrição Associado à Microftalmia/metabolismo , Pessoa de Meia-Idade , Adulto Jovem , Fatores de Transcrição SOXE/genética , Fatores de Transcrição SOXE/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Fatores de Transcrição SOX9/genética , Fatores de Transcrição SOX9/metabolismo , Biópsia , Adolescente , Adesão Celular/genética
15.
Photodermatol Photoimmunol Photomed ; 40(3): e12968, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38632705

RESUMO

BACKGROUND: Vitiligo is characterized by depigmented patches resulting from loss of melanocytes. Phototherapy has emerged as a prominent treatment option for vitiligo, utilizing various light modalities to induce disease stability and repigmentation. AIMS AND METHODS: This narrative review aims to explore the clinical applications and molecular mechanisms of phototherapy in vitiligo. RESULTS AND DISCUSSION: The review evaluates existing literature on phototherapy for vitiligo, analyzing studies on hospital-based and home-based phototherapy, as well as outcomes related to stabilization and repigmentation. Narrowband ultra-violet B, that is, NBUVB remains the most commonly employed, studied and effective phototherapy modality for vitiligo. Special attention is given to assessing different types of lamps, dosimetry, published guidelines, and the utilization of targeted phototherapy modalities. Additionally, the integration of phototherapy with other treatment modalities, including its use as a depigmenting therapy in generalized/universal vitiligo, is discussed. Screening for anti-nuclear antibodies and tailoring approaches for non-photo-adapters are also examined. CONCLUSION: In conclusion, this review provides a comprehensive overview of phototherapy for vitiligo treatment. It underscores the evolving landscape of phototherapy and offers insights into optimizing therapeutic outcomes and addressing the challenges ahead. By integrating clinical evidence with molecular understanding, phototherapy emerges as a valuable therapeutic option for managing vitiligo, with potential for further advancements in the field.


Assuntos
Terapia Ultravioleta , Vitiligo , Humanos , Vitiligo/terapia , Terapia Ultravioleta/métodos , Fototerapia , Melanócitos , Resultado do Tratamento
16.
Acta Dermatovenerol Alp Pannonica Adriat ; 33(2): actaapa.2024.10, 2024 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-38606648

RESUMO

Multiple autoimmune syndrome is a manifestation of polyautoimmunity with the co-occurrence of three or more autoimmune diseases in a single patient. We report a unique case of a 55-year-old female patient that presented with four autoimmune diseases: autoimmune thyroid disease, vitiligo, morphea, and lichen sclerosus. She was evaluated for progression of morphea and lichen sclerosus, and we confirmed histopathological overlapping of these two diseases in the same lesion. We discuss the increasing prevalence of autoimmune diseases and similar case reports on dermatological polyautoimmunity.


Assuntos
Doenças Autoimunes , Líquen Escleroso e Atrófico , Esclerodermia Localizada , Doenças da Glândula Tireoide , Vitiligo , Feminino , Humanos , Pessoa de Meia-Idade , Esclerodermia Localizada/complicações , Esclerodermia Localizada/patologia , Líquen Escleroso e Atrófico/patologia , Vitiligo/complicações , Doenças Autoimunes/complicações , Doenças da Glândula Tireoide/complicações
17.
Eur J Dermatol ; 34(1): 13-17, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38557453

RESUMO

Vitiligo is a human pigmentary disorder characterized by autoimmune destruction of mature melanocytes in the skin. In addition to studies on the inflammatory component of the disease, current treatments tend to involve stimulation of local melanocyte stem cells or transplantation of functional melanocytes from uninjured areas, however, in some cases of extensive depigmentation, only a few healthy cells can be obtained. This review discusses examples in the literature of the use of different sources of autologous stem and somatic cells in order to obtain melanocyte progenitors or mature melanocytes, and compares the strategy of stem cell differentiation with that of somatic cell reprogramming. More specifically, this review illustrates the capability of stem cells to differentiate from dental pulp, bone marrow, and adipose tissue; the reprogramming of pluripotent cells and the transdifferentiation of fibroblasts and keratinocytes. Each of these approaches is capable of producing fully functional melanocytes, but all have advantages and disadvantages. Finally, the relevance for potential clinical application is discussed, along with the risks associated with each strategy and the major current barriers to their use.


Assuntos
Vitiligo , Humanos , Vitiligo/terapia , Melanócitos , Pele , Queratinócitos , Diferenciação Celular
18.
Noise Health ; 26(120): 37-43, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38570309

RESUMO

OBJECTIVE: Noise is a kind of perceived public nuisance that is closely related to people's subjective feelings and lives. This study explores the clinical application effect of comprehensive noise reduction technology in outpatients with vitiligo. METHODS: A total of 76 patients with vitiligo were selected in the Department of Dermatology at Baoding No. 2 Central Hospital from January 2020 to January 2021, as the control group (CG), receiving 5S management mode, and 80 patients with vitiligo from February 2021 to October 2022 were selected as the study group (SG), receiving comprehensive noise reduction technology combined with the 5S management mode for this retrospective study. The effects of different management modes on these patients were observed. RESULTS: SG had higher nursing quality scores in service attitude, service initiative, communication skills, environmental management and item management and overtly a lower noise level than CG (all P < 0.001). The Hamilton Anxiety Scale (HAMA) scores of the two groups at the end of treatment were significantly lower than those on admission (P < 0.05), with SG showing a lower score than CG (P < 0.001). Correlation analysis showed that noise levels and HAMA scores had a positive correlation (r = 0.423, P < 0.001). Patients with negative feelings about medical treatment caused by various noise sources in SG were obviously less than those in CG (P < 0.05). Both the groups had a statistical difference in overall satisfaction (P < 0.05). CONCLUSION: The investigation and data analysis demonstrated that comprehensive noise reduction in outpatients with vitiligo had a considerable effect. This technology can standardise the behaviour of medical staff, enhance nursing quality, reduce noise levels and alleviate patients' anxiety and improve their satisfaction. It has great benefits for the outpatient environment and patients.


Assuntos
Vitiligo , Humanos , Estudos Retrospectivos , Vitiligo/terapia , Pacientes Ambulatoriais , Inquéritos e Questionários , Satisfação do Paciente
19.
Eur Rev Med Pharmacol Sci ; 28(6): 2464-2482, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38567607

RESUMO

OBJECTIVE: Vitiligo is a common systemic, idiopathic autoimmune disease. The aim of this study was to analyze the frequency of variants of the superoxide dismutase 1 (SOD1) gene (50 bp Ins/Del, rs4817415, rs2070424, rs1041740, rs17880135) and circulating plasma protein levels through in-silico analysis. PATIENTS AND METHODS: Blood samples were collected from adult patients of both sexes with a clinical diagnosis of vitiligo. ELISA tests for SOD and analysis of gene variants by qPCR were compared to a disease-free reference group. RESULTS: The population analyzed was young people between 29 and 37 years old, with a higher percentage of women. The population was found in the Hardy-Weinberg equilibrium (HWE). The 50 bp Ins/Del, rs4817415, and rs2070424 variants showed no significant difference between groups (p > 0.05). Although, in the dominant model, the CT and CTTT genotypes of the rs1041740 and rs17880135 variants showed an association with susceptibility to vitiligo compared to the control. Plasma SOD levels showed significant differences between the groups, and when stratified according to the genotypes of each variant, there was a significant difference, except with the rs17880135 variant. The haplotypes InsCGTC and InsAGCC are shown to be risk factors for susceptibility to vitiligo. The in-silico analysis demonstrated that the rs4817415, rs2070424, rs1041740, and rs17880135 variants of the SOD1 gene participate in the modification of selected regulatory elements for differentiating the protein, transcription factors, and long non-coding RNA. CONCLUSIONS: Information regarding the pathogenesis of vitiligo helps recognize risk factors and identify the relationship of diagnostic markers of cell damage inherent to the disease. This will help improve aspects of prevention and the choice of treatment alternatives appropriate to each case.


Assuntos
Vitiligo , Masculino , Adulto , Humanos , Feminino , Adolescente , Superóxido Dismutase-1/genética , Vitiligo/genética , Genótipo , Fatores de Risco , Proteínas Sanguíneas/genética , Estudos de Casos e Controles , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único
20.
Cell Mol Biol (Noisy-le-grand) ; 70(4): 147-151, 2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38678613

RESUMO

Vitiligo belongs to a frequent chronic autoimmune skin disease with the features of pigmented plaques on the diseased skin along with potential damage of melanocytes. There are many factors underlying the pathogenesis of vitiligo, among which oxidative stress is extensively regarded to be the critical factor leading to the loss of melanocytes. The changed redox state resulting from oxidative stress, containing ROS overproduction along with the reduced activity of the skin's antioxidant system, makes melanocytes less resistant to exogenous or endogenous stimuli, and ultimately pushes normal defense mechanisms, resulting in the loss of melanocytes. Given the crucial potential of innate together with adaptive immunity in vitiligo, there is growing evidence of a relation between oxidative stress and autoimmunity. Our review offers estimable insights into the possible properties of oxidative stress and autoimmunity in pathogenesis of vitiligo, as well as the potential role of antioxidant-based supportive therapy in vitiligo repigmentation, providing a hopeful value for further research and development of effective treatments.


Assuntos
Autoimunidade , Melanócitos , Estresse Oxidativo , Vitiligo , Vitiligo/imunologia , Vitiligo/metabolismo , Humanos , Melanócitos/metabolismo , Melanócitos/imunologia , Antioxidantes/metabolismo , Antioxidantes/uso terapêutico , Espécies Reativas de Oxigênio/metabolismo , Pigmentação da Pele , Animais
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