title: New insights into the pathogenesis of vitiligo: imbalance of epidermal cytokines at sites of lesions.
abstract: Vitiligo is a skin disease that is caused by selective destruction of melanocytes and is characterized by white spots. Melanocytes and keratinocytes seem to exhibit a functional close relationship, mediated at least in part by keratinocyte-derived cytokines, which seem important for survival and activity of melanocytic cells. We wanted to investigate the hypothesis that in vitiligo the expression of epidermal cytokines may be modified compared with normal skin. In 15 patients with active, non-segmental vitiligo, biopsies were obtained from lesional, perilesional and non-lesional skin; normal skin from five healthy donors was also tested. Tissue sections were tested using immunohistochemistry for the expression of keratinocyte-derived cytokines with stimulating activity, such as granulocyte-monocyte colony stimulating factor (GM-CSF), basic fibroblastic growth factor (bFGF), and stem cell factor (SCF) or with inhibiting activity, such as interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) on melanocytes. Cytokine receptors and specific melanocytic markers were also investigated. No melanocyte was identified in lesional skin by means of specific markers or c-kit receptor, whereas in perilesional, non-lesional and healthy skin, melanocytes were found in similar number. In vitiligo skin a significantly lower expression of GM-CSF, bFGF and SCF was found, and a significantly higher expression of IL-6 and TNF-alpha was detected, compared with perilesional, non-lesional and healthy skin. In conclusion, we provided evidence that a significant change of epidermal cytokines exists in vitiligo skin compared with perilesional, non-lesional and healthy skin, suggesting that the cytokine production of epidermal microenvironment may be involved in vitiligo.
authors.affiliation: 2nd Dermatology Unit, SM Nuova Hospital, Azienda Sanitaria di Firenze, Florence, Italy. moresilvia@virgilio.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Moretti
authors.forename: Adelina
authors.initials: A
authors.lastname: Spallanzani
authors.forename: Lauretta
authors.initials: L
authors.lastname: Amato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Hautmann
authors.forename: Isabella
authors.initials: I
authors.lastname: Gallerani
authors.forename: Massimo
authors.initials: M
authors.lastname: Fabiani
authors.forename: Paolo
authors.initials: P
authors.lastname: Fabbri
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016207:Cytokines / Q000096:biosynthesis / Q000378:metabolism*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D015603:Keratinocytes / Q000378:metabolism; D008297:Male; D008544:Melanocytes / Q000378:metabolism; D008875:Middle Aged; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D012867:Skin / Q000378:metabolism* / Q000473:pathology; D019089:Stem Cell Factor / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014820:Vitiligo / Q000209:etiology* / Q000378:metabolism
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D019089:Stem Cell Factor; D014409:Tumor Necrosis Factor-alpha; D016222:Fibroblast Growth Factor 2; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D019009:Proto-Oncogene Proteins c-kit