ABSTRACT
Objective To assess the efficacy of 308 nm excimer laser irradiation for the treatment of guinea pig model of vitiligo and its immunoregulatory effect on Treg cell and Th17 cell.Methods Vitiligo was induced in guinea pigs by hydroquinone bleaching,and they were randomly divided into an experimental group and a control group.There was also a normal control group.The experimental group was treated with a 308 nm excimer laser at the nidus of vitiligo; the two control groups were given no intervention.After 8 weeks of treatment,leukasmus of the different groups were compared.The mRNA expression of Foxp3 and IL-17 were measured by real-time fluorescence quantitative (RTFQ-PCR) and the expression of Foxp3 and IL-17 in the lesions were measured by immunohistochemistry staining.Results The effectiveness rate was 100％ in the experiment group.The results of RTFQ-PCR showed that the mRNA expression of Foxp3 in the experimental group and the vitiligo control group was significantly higher than the healthy control group (all P ＜ 0.05),being 0.33 ± 0.03 and 0.02 ±0.07 respectively,as was the mRNA expression of IL-17,being 0.21 ± 0.05 and 0.94 ± 0.06 accordingly; and the mRNA expression of IL-17 in the experimental group was significantly lower than the vitiligo control group(P ＜ 0.05).The immunohistochemical staining showed that Foxp3 and IL-17 protein was scattered in the lesions of the experimental group,while they were crowded in those of the vitiligo control group.Conclusion Laser irradiation might contribute to a therapeutic effect on vitiligo through modulating the balance of Treg and Th17 cells,at least in guinea pigs.
ABSTRACT
Objective To evaluate the efficacy and safety of fractionated CO2 laser combined with 308-nm excimer laser for the treatment of stable vitiligo.Methods Forty-nine patients with 109 lesions of stable vitiligo were enrolled in this clinical trial.Each of these lesions was equally divided into 2 parts along the longest diameter,which were then assigned into the treatment group and control group respectively.The treatment group were treated with fractionated CO2 laser radiation for 15-20 minutes once every two weeks combined with 308-nm excimer laser radiation twice weekly.The control group were only treated with 308-nm excimer laser radiation twice weekly.Efficacy was evaluated on day 3 after 12 consecutive weeks of treatment.Results After the treatment,the total response rate in the treatment group and control group was 92.7％ (101/109) and 77.1％ (84/109) respectively.The marked response rate in the treatment group and control group was 85.4％ (35/41) and 65.8％ (27/41) respectively for lesions on the face and neck (x2 =4.23,P ＜ 0.05),70.6％ (24/34) and 41.2％ (14/34) respectively for lesions on the trunk (x2 =7.27,P＜ 0.01),64.0％ (16/25) and 36.0％ (9/25) respectively for lesions on the extremities (x2 =3.92,P ＜ 0.05),5/9 and 1/9 respectively for lesions on the dorsal hands (X2 =4.00,P ＜ 0.05).The number of sessions of 308-nm excimer laser therapy required for the marked response of vitiligo in the treatment group and control group was 7.24 ± 1.23 and 10.81 ± 2.01 respectively for lesions on the face and neck (t =9.70,P ＜ 0.05),15.10 ± 2.47 and 18.95 ± 3.45 respectively for lesions on the trunk (t =5.29,P＜ 0.05),17.37 ± 3.84 and 21.06 ± 4.23 respectively for lesions on the extremities (t =3.23,P ＜ 0.05).No severe adverse reactions were observed in any of the patients during the treatment.Conclusion Fractionated CO2 laser combined with 308-nm excimer laser is effective and safe in treating stable vitiligo.