The Role of Cytokines in Vitiligo
Background: Vitiligo is an acquired disorder of melanin pigmentation that affects approximately 0.5-2% of the population. It is characterized by macular depigmentation of varying sizes or shapes with a tendency to progress. Depending on the extent of the lesions, vitiligo can be classified into two main categories: generalized and localized. Although several theories have been proposed to explain the loss of melanocytes in vitiligo the pathogenesis of the disease is still unclear. The clinical association with autoimmune disorders and organ specific antibodies indirectly support the idea of an autoimmune pathogenesis of the disease. Furthermore, many patients with vitiligo have serum auto antibodies and circulating auto reactive T cells directed against melanocytes and there are findings of activated T-cells in the periphery of actively progressing lesions in some vitiligo patients. Several studies have shown that within the cascade of pathogenesis of vitiligo, cytokines play an important role. An imbalance of several melanogenic cytokines that can affect melanocyte activity and survival has been shown in vitiligo lesional skin and serum of vitiligo patients.
Objectives: Cytokines are the key mediators for cellular communication and networking. Although it is well known that multiple cytokines simultaneous play role in vitiligo, the aim of our study was to evaluate serum concentrations of interleukin- IL-2 (IL-2) and interleukin-2 soluble receptor (IL-2 sR) in patients with vitiligo and healthy subjects and also to asses a possible association between these cytokines and duration of the disease.
Study Design: Case control study.
Place of the Study: The study was carried out in University Clinical Center Sarajevo, Department of Dermatology and Venereology.
Patients and Methods: Twenty one patients (11 female and 10 male; age range 15-53 years) with vitiligo and 20 healthy controls (10 female and 10 male; age range 17-52) were enrolled in the study. c The duration of vitiligo ranged from 2 to 252 months. Ten patients (47.62%) had generalized, and eleven patients (52.38%) had localized vitiligo Serum concentrations of cytokines were measured using enzyme-linked immunoassay techniques.
Results: Both IL-2 (median 22.600 pg/ml, range 20.900-76.100) and IL-2sR (median 76.100 pg/ml, range 15.700-183.800) in the patient group were significantly higher when compared with that of the normal controls. When the serum cytokine level in vitiligo group were compared to total disease duration (Spearman correlation ρ), serum IL-2 was negatively (ρ= -0.000573, P= 0.9980) and IL-2 sR was positively (ρ=0.241, P= 0.2797) correlated with total disease duration, but it is of borderline significance.
Conclusions: Although the initiating event in vitiligo has not yet been defined, a growing body of evidence indicates that cytokines may help the development and the perpetuation of the chronic inflammatory state. The results presented in our study demonstrate that the median levels of IL-2 and IL-2 sR were significantly elevated in vitiligo patients in comparison with healthy subjects. Vitiligo is an acquired depigmentary skin inflammatory disorders. Although the initiating event in vitiligo has not yet been defined, a growing body of evidence indicates that cytokines may help the development and the perpetuation of the chronic inflammatory state. An increase in the production of pro-inflammatory cytokines in vitiligo patients, may play an important role in melanocytic cytotoxicity. The imbalance observed in the cytokines examined in the current study suggest their involvement in the pathogenesis of vitiligo. This research could contribute to the interpretation of the role and significance of cytokines in the pathogenesis of vitiligo, and these findings may provide important clues to assist in the development of new therapeutic strategies for patients with vitiligo. The specific blockade of cytokines or their receptors is an alternative approach for the treatment of vitiligo.
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