People with Vitiligo - Vitiligo Cure - Vitiligo Treatment

According to two articles in the October issue of The Archives of Dermatology, one of the JAMA/Archives journals; people who have stable vitiligo can achieve good re-pigmentation by transplanting their own skin from normally pigmented areas of the body.

These articles state that vitiligo is primarily the most common skin pigment disorders and about 1% of the world population is suffering from this skin disorder. Vitiligo’s psychosocial impact is often underestimated. There are several treatment methods for vitiligo but the standard treatment for vitiligo is UV light therapy and this therapy can last for several months. Transplantation of skin cells is another alternative option for the treatment of vitiligo.

Nanny van Geel, M.D., of Ghent University Hospital, Belgium, and colleagues researched about the effectiveness of using transplanted pigment cells to treat 28 patients with vitiligo. They divided patient into two groups: patients with stable vitiligo (no new de-pigmented patches in the past 12 months, n = 19) and patients with progressive vitiligo (n = 9). The researchers selected 33 pairs of de-pigmented skin patches on the patients, they randomly selected a patch and assigned it to be treated with grafted pigment cells and the other was given a sham transplant. They took this skin from normally pigmented area of the skin. After three weeks of the surgery, all patches were given UV light therapy twice a week for almost two months.

When the researchers analyzed the skin they found that there was a major difference between pigment cells graft sites and placebo graft sites after three, six and twelve months.

The results of this research were like this, one of the group of patients with stable vitiligo re-pigmentation of at least 70 percent of the treated area was achieved in 55 percent, 57 percent and 77 percent of the actively treated lesions at three, six and twelve months after treatment. Whereas in the other group re-pigmentation of at least 70 percent was not achieved at any time point, re-pigmentation was diffuse on 94 percent of responding patients.

The authors wrote that, “After a strict preoperative selection for disease stability, transplantation resulted in re-pigmentation of at least 70 percent of the treated area in most actively treated vitiligo lesions.”

In another research study conducted at the the Noble Clinic, Pune, India, Sanjeev V. Mulekar (M.D.) investigated the long-term effectiveness of skin cell transplantation in sixty seven vitiligo patients. He used a mixture of melanocytes (melanin producing cells) and keratinocytes (structural skin cells) taken from normally-pigmented area on the patients’ own bodies. Patients were followed up for five years.

Dr. Mulekar found that 41 patients (which were 84 percent of the total) with segmental vitiligo had 95 percent to 100 percent re-pigmentation in the treated areas. In patients with focal vitiligo, 73 percent showed an excellent response at the end of their respective follow-up period. “Melanocyte-keratinocyte cell transplantation is a simple, safe, and effective surgical therapy,” Dr. Mulekar writes. “Patients with segmental and focal vitiligo can experience a prolonged disease-free period, which may extend through the rest of their lives.”

Source: http://www.archdermatol.com

The researchers from St George’s, University of London, the University of Colorado at Denver and Health Sciences Center (UCDHSC) and the Barbara Davis Center for Childhood Diabetes have revealed a link between gene and vitiligo plus other autoimmune diseases.

They analyzed two independent groups of families enrolled from 1996 – 2005 and obtained samples from a total of 656 Caucasian individuals from 114 extended families with vitiligo and other autoimmune diseases from America and the UK.

When the researchers started studying vitiligo they found that vitiligo patients had a risk of developing other autoimmune diseases, as do their relative, even those without vitiligo.

Researchers while searching the genome found that a key gene (NALP1) was involved in predisposing to vitiligo and other autoimmune diseases that ran in these families. NALP1 is a gene that controls the part of the immune system which is responsible for alerting the body about the viral and bacterial attacks.

During this research they got the answer of why the immune system attacks body’s own tissues. The answer was over-reactivity of the sensor NALP1. The over-reactivity of NALP1 could trigger a response to the wrong stimulus. All the samples and information collected from patients were sent to University of Colorado for analysis.

Richard Spritz lead investigator for this study said that NALP1 for the first time has been specifically implicated in autoimmune diseases. “Since NALP1 appears to be part of our body’s early-warning system for viral or bacterial attack, this gives us ideas about how to try to discover the environmental triggers of these diseases. This finding may also open up new approaches to treatment, possibly for many different autoimmune diseases.” he added.

Dr. Spritz and his team are planning soon begin arranging a clinical trial of a new treatment for vitiligo based on the discovery of NALP1. Dr. Spriztz anticipates labs using the information from the UCDHSC study to replicate or test the results in patients with other autoimmune diseases to see how broad potential applications might be.

“All diseases are complex, the result of different genes and environmental risk factors acting together in concert. But if NALP1 turns out to be one of the major genes involved in numerous autoimmune diseases, and if we can interrupt its negative effects, we may have the chance to treat many different chronic autoimmune disorders like vitiligo, lupus and psoriasis and perhaps eventually eliminate them altogether,” said Dr. Spritz.

Source: http://www.sgul.ac.uk

Patients with vitiligo, a skin disease characterized by patches of un-pigmented skin, had better re-pigmentation of these patches when they were treated with a combination of laser therapy and tacrolimus ointment than the patients who were treated only with laser therapy, according to an article in the September issue of The Archives of Dermatology, one of the JAMA/Archives journals.

According to this article one to two percent people around the world are affected by vitiligo. Recently, the 308 nanometer excimer laser has shown good results in treating vitiligo patients. Furthermore, a new topical ointment (tacrolimus) has also given good results.

Thierry Passeron, M.D., of Hopital de l’Archet, Nice, France, and colleagues examined the results of the 308-nm excimer laser therapy in combination with tacrolimus ointment on 14 vitiligo patients aged between twelve and sixty three years.

In this comparative prospective randomized intra individual study, patients were divided into two groups (A & B). Four to ten lesions were chosen from each patient. Group A was treated twice a week with the 308-nm excimer laser for a total of 24 sessions and topical 0.1 percent tacrolimus ointment was also applied twice a day to target lesions for patients in group A whereas Group B was only given laser treatment. A total of forty-three lesions were treated (23 in group A and 20 in group B). The researchers observed hundred percent re-pigmentation in all group A lesions and eighty percent in 17 out of 20 group B lesions.

Researchers also compared treated lesions with control lesions (which were not treated) on the opposite side of the body and did not observe any re-pigmentation.

The authors wrote that, “A re-pigmentation rate of 75 percent or more was obtained in 16 (70 percent) of the 23 group A lesions and in 4 (20 percent) of the 20 group B lesions.” They noticed that average number of sessions needed to see improvements in re-pigmentation was 10 for group A and 12 for group B.

The researchers concluded that, “The combination of 0.1 percent tacrolimus ointment applied twice daily and 308-nm excimer laser therapy performed twice a week gives excellent results on UV-sensitive and UV-resistant areas. The treatment was well tolerated, and the patients were satisfied.”

Source: http://www.jama.com/

University of Cincinnati (UC) discovered that melanocytes are not the only cells that create differences in skin coloration.  Instead there are some of the basic cells on the skin’s surface that influence pigment production and help control skin color.

This research has presented hope for new approaches to the treatment of skin pigment disorders that leave the skin blemished by light or dark blotches.

Raymond Boissy, PhD, and his team in their preclinical dermatological study, discovered that keratinocytes carry certain characteristics that could control skin pigmentation.

Epidermis (outer layer of skin) is composed of 96 percent of keratinocytes (surface skin cells) and 2 percent of melanocytes (pigment producing cell). keratinocytes give the skin structural integrity and it also helps in protecting the body from infection.

Boissy said that his team’s discoveries can help scientists formulate new drugs that change the physiological processes that cause pigmentation disorders such as vitiligo and melasma. He explained that he and his team isolated particular physiological properties that control the melanocytes functional abilities. This discovery is significant because a lot of pigment diseases are the consequence of malfunctioning of the melanocytes. According to him this set of new molecules can help patients with pigment disorders in creating uniform skin color.

Their previous research showed that keratinocytes play a role in skin coloration of genetic factors regulating the melanocyte. Further they found that there was no informationall difference between the melanosomes in keratinocytes for dark and light skin responsible for sorting within the keratinocyte. These cells arranged themselves based on ethnic background.

For this study they develop a human skin substitute model using a keratinocytes and melanocyte which they obtained from donated light and dark skin. They transplanted this skin in a mouse and allowed it to grow for about three months.

When the researchers transplanted keratinocytes from dark-skinned individuals to skin substitutes they got a darkening skin effect and got lightening skin effect when they transplanted keratinocytes from people with fair complexion into skin substitutes. They obtained intermediate skin color when they combined melanocytes and keratinocytes from light and dark skin together.

In addition, the researchers also discovered that quantity of pigment produced is influenced by keratinocytes. Boissy said that “the effect is subtle but, it shows that it’s not just genetics of the melanocyte that determines skin coloration”.

Source: http://www.uc.edu/