Altered circulating memory T cells in vitiligo cases followed NB-UVB therapy

Single-cell multiomic analysis unveils the immune landscape dynamics of graves' ophthalmopathy

Graves' ophthalmopathy (GO) is an autoimmune disease that occurs concurrently with Graves' disease, potentially leading to facial disfigurement and irreversible vision loss. However, the molecular characteristics of cellular changes in the peripheral immune environment of GO patients remain unclear. This study presents a multi-omics single-cell analysis of peripheral blood from GO patients and healthy controls, revealing key molecular alterations in immune cell subpopulations. We identify increased chromatin accessibility and regulatory activity of pro-inflammatory factors, such as FOS and NF-κB family. Immune repertoire analysis shows enhanced diversity in GO patients. Notably, GO-specific clonal expansions are enriched in CD8 effector T (CD8 Te) cells, which exhibit signs of enhanced T cell chemotaxis and exhaustion. Multi-omics integration analysis reveals that changes in SLC35G1 and IDNK expression in CD8 Te are linked to disease phenotypes, with trends aligning with experimental results. We find that this cell cluster could infiltrate into orbital tissues and upregulate fibrosis-related pathways associated with fibroblasts in GO. These findings indicate its potential role in driving disease progression. Our study reveals the epigenetic and transcriptomic landscape in the peripheral blood of GO patients, enhancing the understanding of the pathogenic molecular mechanisms and offering potential directions for prevention and treatment.

Beyond Repigmentation-A Prospective Study of Patients With Stable Vitiligo Treated With Suction Blister Epidermal Grafting Plus Phototherapy

BACKGROUND

Vitiligo is a common skin disorder that greatly impacts patients' appearance. The effects of grafting surgery combined with phototherapy on repigmentation and quality of life in patients with vitiligo remain underexplored.

OBJECTIVE

To evaluate the effect of suction blister epidermal grafting (SBEG) combined with phototherapy on repigmentation and quality of life in patients with stable vitiligo.

MATERIALS AND METHODS

This prospective study included 42 skin lesions from 23 patients with stable vitiligo who underwent SBEG followed by postoperative phototherapy. Repigmentation rate, Dermatology Life Quality Index (DLQI), and Vitiligo-specific Quality-of-life Instrument (VitiQoL) scores were assessed at 3 and 6 months postoperation.

RESULTS

The mean repigmentation rates at 3 and 6 months were 63.35% (±4.90) and 70.23% (±4.27), respectively. Lesions covered with terminal hair exhibited lower repigmentation rates compared to those without. Quality of life improved significantly, with DLQI scores decreasing from 7.37 to 4.06 at 6 months postsurgery (p = .0213). No significant correlation was found between DLQI or VitiQoL improvement rates and repigmentation rates.

CONCLUSION

SBEG combined with postoperative phototherapy effectively promotes repigmentation in stable vitiligo, particularly in areas without terminal hair. The procedure also enhances patient quality of life, although the relationship between repigmentation and quality of life requires further investigation.

Phototherapy for vitiligo: A narrative review on the clinical and molecular aspects, and recent literature

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.

Comparison of NB-UVB combination therapy regimens for vitiligo: A systematic review and network meta-analysis

BACKGROUND

Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation.

OBJECTIVES

To compare the effectiveness of current NB-UVB combination regimen at the improvement in repigmentation through a systematic review and network meta-analysis.

METHODS

We searched the electronic databases for randomized controlled trials related to NB-UVB combination therapy for vitiligo till October 2022. STATA15.0 software was applied to carrying out data analysis.

RESULTS

A total of 28 eligible studies involving 1194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy [OR = 32.35, 95% CI (1.79, 586.05)], Er: YAG laser+ topical 5% 5-FU [OR = 10.74, 95% CI (4.05, 28.49)], needling/micro-needling [OR = 3.42, 95% CI (1.18, 9.88)], betamethasone intramuscular injection [OR = 3.08, 95% CI (1.17, 8.13)], topical tacrolimus [OR = 2.54, 95% CI (1.30, 4.94)], and oral Chinese herbal medicine compound [OR = 2.51, 95% CI (1.40, 4.50)] integrated with NB-UVB were more efficacious in excellent to complete repigmentation response rate (≥75%). Besides, NB-UVB+ Er: YAG laser+ topical 5% 5-FU [OR = 0.17, 95% CI (0.04, 0.67)] and NB-UVB+ needling/micro-needling [OR = 0.24, 95% CI (0.06, 0.88)] were less likely evaluated as ineffective repigmentation response (≤25%).

CONCLUSIONS

All combination therapies ranked higher than NB-UVB monotherapy in inducing successful repigmentation and avoiding failed treatment in patients with vitiligo. Comprehensive consideration, NB-UVB+ Er: YAG laser+ topical 5% 5-FU and NB-UVB+ needling/microneedling would be the preferred therapeutic approaches.