ABSTRACT
Objective To investigate the relationship between the efficacy of autologous epidermal grafting and the levels of epidermal cytokines in vitiligo. Methods A total of 57 patients with stable vitiligo receiving autologous epidermal grafting were included in this study. Before grafting, 17 patients were irradiated with narrow-band UVB on vitiliginous sites. Suction blister fluid was collected from the recipient site (vitiligous lesions) and donor site (normal skin) in these patients (including the 17 patients irradiated with NB-UVB). ELISA was used to detect the levels of endothelin-1 (ET-1 ) and stem cell factors (SCF) in suction blister fluid. Clinical efficacy was evaluated through a 3-month follow-up. Resttlts Among these 57 patients, 45 successfully responded to autologous epidermal grafting. In these 45 patients, the levels of ET-1 and SCF in vitiligous lesions were 728.97±286.12 ng/L and 329.97±114.13 ng/L respectively, significantly higher than those in nomal skin (503.16±251.44 ng/L, 224.73±107.91 ng/L, t = 5.443, 5.897, respectively, both P < 0.05 ). In those who responded poorly, significant difference was also observed in the level of SCF between the normal skin and vitiligous lesions (309.00±163.89 ng/L vs 204.22±83.25 ng/L, t = 3.03, P < 0.05), but not in the level of ET-1. Increased level of ET-1 was observed in both vitiligous lesions and normal skin of patients who responded well compared to those who responded poorly, while no difference was noticed in the level of SCF between these two groups of patients. The level of ET-1 was statistically higher in vitiligous lesions in patients exposed to NB-UVB than in those without exposure (t = 1.44, P > 0.05). In those patients who responded successfully, the level of ET-1 was lower in the 15 patients exposed to NB-UVB compared to the other 30 patients without exposure (548.48±230.22 ng/L vs 794.60±278.72 ng/L, P<0.05); no significant difference in the level of SCF was noted. Conclusions ET-1 and SCF may both play important roles in the repigmentation of vitiligo, with ET-1 exerting a more important role.
ABSTRACT
Objective To observe the curative effect of narrow-band ultraviolet(NB-UVB)on stable vitiligo with autologous epidermis grafting.Methods A total of 82 patients with stable vitiligo were recruited and randomly divided into a control group and a treatment group.The patients in the treatment group were pretreated with NB-UVB before autologous epidermis grafting,while those in the control group were not.The pretreatment with NB-UVB was implemented twice a week for at least 4 weeks before the autologous epidermis grafting. A 3-month follow-up observation was conducted with regard to the effectiveness. Results Pretreatment with NB-UVB could significantly increase the survival rate of skin grafts and rate of repigment of leukoplakia,when compared with autologous epidermises transplantation alone.The rate of complete repigment raised significantly(P＜0.05),and so did the curative effect for vulgaris generalized vitiligo(P＜0.029).It was found that the curative effect on vitiligo was closely related to the frequency of NB-UVB radiation,location of leukoplakia,color of skin,and the time of repigment appearance. ConclusiOn Pretreatment with NB-UVB can significantly improve curative effect of autologous epidermis grafting on vitiligo.