Serum brain-derived neurotrophic factor and vitamin D: Two concordant players controlling depression among alopecia areata and vitiligo patients: A case-control study.

BACKGROUND: Depression is a common psychiatric comorbidity among chronic dermatology patients. There is extreme lacking in the research studying biomarkers responsible for it. Both brain-derived neurotrophic factor (BDNF) and vitamin D have a significant role in the development of depression. AIM: To assess BDNF and vitamin D serum levels in different clinical verities of alopecia areata (AA) and vitiligo patients, correlating them with depression prevalence and quality of life. METHODS: In all, 30 AA patients, 30 vitiligo patients, and 30 healthy volunteers were included. Both alopecia and vitiligo severity and activity were evaluated using the suitable clinical scores. Depression was assessed using Beck depression inventory (BDI) scale and quality of life was recorded using Dermatology Life Quality Index (DLQI). Both serum BDNF and vitamin D levels were investigated using ELISA. RESULTS: In both alopecia and vitiligo patients, serum BDNF and serum vitamin D were significantly lower compared to controls (p = 0.001 for both). Both were associated and negatively correlated with BDI and DLQI. Regarding alopecia, they showed a significant decline in more sever disease and with longer disease duration. However, in vitiligo, BDNF (p = 0.001) and vitamin D (p = 0.03) correlated negatively with disease activity, but not with disease severity. Serum BDNF and vitamin D correlated positively with each other (p = 0.001) in both AA and vitiligo cases. CONCLUSION: The inverse association of both serum BDNF and vitamin D with depression, and the positive correlation noted between their serum levels, may indicate a potential combined effect of these two players on development of depression and its negative health-related outcomes.

Serum nuclear factor E-2-related factor 2 in female pattern hair loss.

BACKGROUND: Female pattern hair loss (FPHL) is a common dermatological complaint with multifactorial etiology. Nuclear factor erythroid-2-related factor 2 (NRF2) is a transcription factor that has a major role in protection from ROS-induced apoptosis. AIM: To investigate the relationship between Nrf2 and systemic oxidative stress in FPHL patients. PATIENTS AND METHODS: This case-control study included 30 patients with FPHL and 30 age- and sex-matched healthy volunteers as a control group. Serum NRF2, total antioxidant capacity (TAC), and total oxidant capacity (TOC) were measured by ELISA, and oxidative stress index (OSI) was calculated. RESULTS: The serum level of TOC and OSI was found to be significantly higher (p ≤ 0.001 for both) while serum level of NRF2 and TAC was found to be significantly lower in cases than controls (p < 0.001 for both). There were a significant negative correlation between TAC and BMI (p = 0.03, r = -0.391) and a significant positive correlation between OSI and BMI (p = 0.04, r = 0.365). There were a significant positive correlation between serum level of NRF2 and TAC (p = 0.003, r = 0.532) and a significant negative correlation between serum the level of NRF2 and TOC (p = 0.02, r = -0.418) and OSI (p = 0.003, r = -0.395). CONCLUSION: Systemic oxidative stress in FPHL may be, at least in part, due to NRF2 deficiency. NRF2 activators may help in treatment of this disease. NRF2 deficiency has no role in disease severity. Healthy diet and body weight reduction may help in improving oxidative stress and subsequently improving FPHL.

Immunohistochemical evaluation of vitiliginous hair follicle melanocyte reservoir: is it retained?

BACKGROUND: Vitiligo is an acquired depigmentaion of skin and hair. The presence of white hair within vitiligo lesions is considered a bad prognostic sign since these lesions are difficult to repigment. Melanocyte reservoir was not extensively studied in vitiliginous white hair. OBJECTIVE: To evaluate pigment cell reservoir in vitiliginous black and white hair. METHOD: Using immunohistochemical technique, skin biopsies from 30 vitiligo patients (including either black or white hair) and 10 age- and gender-matched healthy subjects were examined. Human Melanoma Black-45 (HMB-45) was used for detecting active melanocytes and Tyrosinase Related Protein 2 (TRP2) for detecting the whole melanocyte lineage including melanocyte stem cells (MelSC). RESULTS: About 61.1% of black hair was positive for HMB-45 and 83.3% was positive for TRP2. About 25% of white hair was positive for HMB-45 and 75% retained TRP2 positivity. Follicular HMB-45 expression and TRP2 expression percentage were significantly lower in white than black hair (P = 0.05, 0.04 respectively). Epidermal HMB-45 and TRP2 expression percentages were significantly higher in lesions containing black rather than white hair (P < 0.001, P = 0.05 respectively). Black hair was significantly associated with histologically pigmented hair follicles (P = 0.049), and with residual interfollicular melanin pigment (P = 0.007). CONCLUSION: Melanocytes, either active (melanotic) or inactive (amelanotic which may include MelSC), are not totally absent from vitiliginous white hair. However, intact melanocyte reservoir was observed more in black than white hair. This may add avenues for future research about the possibility of white vitiliginous hair to repigment.