白癜风患者血浆中氧化与抗氧化相关指标的检测

目的通过对白癜风患者及健康对照者血浆中氧化与抗氧化相关指标——超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、维生素E(VitE)及一氧化氮(NO)表达水平的测定,探讨氧化应激在白癜风发病机制及疾病发展中的作用和意义。方法选择60例白癜风患者(患者组)和40名健康志愿者(健康对照组)为研究对象,化学法检测血浆中SOD,CAT,GSH-Px的活性及MDA,VE和NO的含量。结果患者组血浆中MDA含量及SOD活性明显高于健康对照组(P<0.01),而GSH-Px活性明显低于健康对照组(P<0.01);进展期白癜风患者血浆中MDA的含量及SOD的活性明显高于稳定期白癜风组(P<0.01),而GSH-Px活性明显低于稳定期白癜风患者(P<0.01);随MDA含量增加,GSH-Px活性逐渐降低,呈显著负相关关系(r=-0.337,P<0.01),而SOD活性逐渐升高,呈显著正相关关系(r=0.347,P<0.01);而在进展期和稳定期白癜风患者血浆中CAT,VE和NO的含量与健康对照组相比差异无统计学意义(P>0.05)。结论白癜风患者血浆中存在氧化-抗氧化失衡,白癜风的发病及病情活动与氧化应激可能相关。     

白癜风与氧化-抗氧化失衡

白癜风是一种较常见的色素脱失性疾病，临床上以表皮黑素细胞破坏缺失而出现色素脱失斑为主要特征，严重影响患者的外观美容。白癜风的病因学分子机制目前尚无定论，存在多种假说。近年来，对白癜风患者机体抗氧化水平的研究日益增多，越来越多证据提示，机体氧化-抗氧化平衡失调，导致局部微环境中活性自由基大量聚集，引起氧化应激，造成细胞损伤，是引起白癜风发病的一个重要因素。     

白癜风患者血清及皮肤组织液硒元素测定

白癜风的病因不甚清楚,有报道铜锌微量元素与白癜风发病有关^[1],为了探讨硒元素在白癜风发病中的作用,我们采用荧光分光光度法,对29例白癜风患者的血清及白斑部位和无白斑部位通过负压吸疱取材的皮肤组织液中硒元素含量进行了测定。     

白癜风患者血清中甲状腺素的测定

应用放射免疫分析法(RIA),我们对36例白癜风患者血清中甲状腺素T_3、T_4和促甲状腺素(TSH)进行测定,结果表明部分白癜风患者T_4增高,且活动期患者T_4高于静止期,我们认为甲状腺功能的变化可能与白癜风发病有关。     

白癜风患者血清和皮肤组织液IL-18及IFN-γ水平变化的研究

目的　探讨IL 18和IFN γ在不同类型、不同时期白癜风患者血清及皮肤组织液中水平的变化 ,并分析它们的相关性。方法　采用双抗体夹心ELISA法测定 5 7例不同类型、不同时期白癜风患者血清中IL 18和IFN γ的水平 ,并与 2 0例正常对照组比较 ;对其中 45例患者白斑区、非白斑区及 10例正常对照组皮肤组织液同样进行上述细胞因子检测。结果　寻常型白癜风患者血清IL 18和IFN γ(10 0 .41± 40 .0 6pg/ml ,5 5 .0 2± 6.2 8pg/ml)水平均明显高于 (P均 <0 .0 1)正常对照组 (69.15± 18.68pg/ml ,5 1.19± 6.3 5 pg/ml )。寻常型白癜风患者血清IL 18和IFN γ水平进展期高于稳定期 ,二者呈正相关性 ;散发型白癜风白斑区皮肤组织液IL 18(114 .5 4± 2 8.77pg/ml)水平明显高于 (P <0 .0 1)正常对照组 (65 .0 2± 16.3 5 pg/ml)。节段型白癜风患者血清及皮肤组织液中两种细胞因子水平和对照组差异无显著性 (P>0 .0 5 )。结论　寻常型白癜风患者血清或皮肤组织液中两种细胞因子有异常表达 ;血清中IL 18与IFN γ存在高度相关性 ,表明IL -18及IFN -γ可能参与寻常型白癜风的发病。     

白癜风患者血清及皮肤组织液铜锌含量测定

本文用感应藕合等离子发射光谱仪,测定了27例白癜风患者和36例健康人血清中铜锌两种微量元素的含量,并对其中24例白癜风患者无病变部位和白斑部位的皮肤吸力水疱疱液进行了测定。结果显示白癜风患者血清中铜锌的含量均低于正常对照组,病人白斑部位组织液铜含量明显低于无病变部位,提示白癜风发病与铜锌两种微量元素有关。     

白癜风患者血清和皮肤组织液粒细胞巨噬细胞集落刺激因子水平的检测

目的 :探讨粒细胞巨噬细胞集落刺激因子 (GM -CSF)在不同类型、不同时期白癜风患者血清及皮肤组织液中水平变化。方法 :采用放射免疫测定法检测 5 7例不同类型、不同时期白癜风患者血清中GM -CSF的水平 ,并与 2 0例正常对照组比较 ;对其中 45例患者白斑区、非白斑区及 1 0例正常对照组皮肤组织液同样进行上述细胞因子检测。结果 :散发型白癜风血清GM -CSF水平 ( 0 5 3± 0 1 4)低于正常对照组 ( 0 65± 0 1 0 ) (P <0 0 1 ) ,且进展期低于稳定期。寻常型白癜风白斑区及散发型白癜风非白斑区皮肤组织液GM -CSF水平 (分别为 0 3 5± 0 1 1及 0 49± 0 1 2 )均低于正常对照组 ( 0 62± 0 1 2 )(P <0 0 5 )。节段型白癜风患者皮肤组织液GM -CSF水平与正常对照组比较无显著性差异。结论 :GM -CSF可能参与寻常型白癜风的发病     

白癜风患者血清中转化生长因子β水平的研究

目的探讨转化生长因子β(TGF-β)与白癜风之间的关系。方法血清中TGF-β和免疫球蛋白IgG、IgA、IgM的检测分别采用酶联免疫吸附试验法(ELISA)和单向免疫定量扩散法。结果①白癜风患者组的血清TGF-β水平均低于正常对照组;同时血清免疫球蛋白IgG、IgA、IgM水平均高于正常对照组。②寻常型白癜风患者中,进展期患者血清TGF-β水平低于稳定期患者。结论 TGF-β可能在白癜风的发病机制中发挥重要作用。     

白癜风患者血清中甲状腺系的测定

应用放射免疫分析法（RIA），我们对36例白癜风患者血清中甲状腺素T3、T4和促甲状腺素（TSH）进行测定，结果表明部分白癜风患者T4增高，且活动期患者T4高于静止期，我们认为甲状腺功能的变化可能与白癜风发病有关。     

白癜风白斑和复色斑氧化一抗氧化物水平比较分析

目的:确定体内氧化一抗氧化状态与白癜风发病的关系.方法:对24例白癜风患者白斑、非白斑(正常皮肤)、11例白癜风患者复色斑和10例健康对照者的皮肤负压吸疱,抽取组织液,检测过氧化氢(H2O2)、过氧化氢酶(CAT)与谷胱甘肽过氧化物酶(GSH-PX)水平.结果:白斑组H2O2含量为(53.97±19.03)mmol/L,明显高于健康对照组的(28.98±22.81)mmol/L、非白斑的(33.41±21.53)mmol/L和复色斑的(23.82±16.28)mmol/L(P＜0.01);白斑组CAT含量为(17.34±11.05)U/mL,明显低于健康组的(41.29±16.57)U/mL、非白斑的(39.46±19.88)U/mL和复色斑的(33.66±10.51)U/mL(P分别＜0.01,＜0.05,P＜0.01).H2O2和CAT含量在健康组、非白斑和复色斑之间无显著性差异(P＞0.05);复色斑中的GSH-PX浓度高于健康组(P＜0.05),其余各组相互比较GSH-PX水平无差异(P＞0.05).结论:白癜风发病可能与体内H2O2增高、CAT降低密切相关,而与GSH-PX无关.     

银屑病和湿疹患者皮损内花生四烯酸代谢差异的比较

目的:比较花生四烯酸(AA)在银屑病(Ps)和湿疹患者体内代谢特点的异同.方法:实验组60例包括进行期、静止期和退行期Ps患者各10例和急性、亚急性和慢性湿疹患者各10例,对照组10例.采用ELISA方法分别检测实验组皮损中和对照组正常皮肤中LTB4、LTE4、TXB2、6-k-PGF1α、PGE2水平.结果:Ps患者LTB4、LTE4水平进行期组＞静止期组＞退行期组＞对照组.进行期Ps患者组TXB2水平轻度升高(P＜0.05).湿疹患者LTE4、PGE2水平急性组＞亚急性组＞慢性组＞对照组.急性和亚急性湿疹患者组LTB4、TXB2、6-k-PGF1α水平高于对照组.结论:Ps患者AA代谢紊乱以5-脂氧合酶(5-LO)途径为主,湿疹患者AA代谢5-脂氧合酶途径和环氧化酶(COX)途径均明显增强.     

Melanocyte detachment after skin friction in non lesional skin of patients with generalized vitiligo

BACKGROUND: In vitiligo, melanocytes are gradually lost in depigmented macules of the skin. The disappearance of melanocytes has, however, not been clearly observed and consequently the aetiology of the disease (autoimmune, neural, cytotoxic) is still elusive. The starting point of vitiligo macules is frequently determined by local conditions such as wounds and excoriations, but may also follow minor traumas such as pressure or repeated friction. This prominent feature is often neglected. OBJECTIVES: To clarify the biological consequences of repeated friction on the attachment and survival of melanocytes in non lesional vitiligo skin. METHODS: Light reproducible skin friction was performed for 4 min on the volar forearm of 18 patients with extensive vitiligo and five controls with normal healthy skin. Biopsies from the test area and control skin were taken at 1, 4, 24 and 48 h following friction. Serial sections were examined with standard light microscopy, transmission electron microscopy, histochemistry and immunohistochemistry (dihydroxyphenylalanine, HMB-45, E-cadherin and an early apoptosis marker, M30 cytoDEATH antibody). RESULTS: The observation of sections at 1 and 48 h after friction on vitiligo skin and at all time points in controls revealed no changes. In contrast, in vitiligo skin at 4 and 24 h after friction, several melanocytes had undergone detachment and were found in various suprabasal positions, including the stratum spinosum, granular layer, and within and outside the stratum corneum. CONCLUSIONS: Detachment and transepidermal elimination of melanocytes following minor mechanical trauma in non lesional vitiligo skin is probably the cause of depigmentation occurring in the isomorphic response (Koebner phenomenon). We propose that transepidermal elimination of melanocytes in vitiligo should be regarded as a possible mechanism of chronic loss of pigment cells, perhaps previously damaged by another process.     

白癜风650例临床研究

分析了650例白癜风病人的临床和实验室资料，发现发病诱因中的局部因素占重要位置，以及同形反应在发病中的重要作用，结合血中自身抗体、外周血T细胞亚群、皮损中郎格罕细胞变化等，为白癜风自身免疫发病机制提供了新的证据。提出本病是一个系统疾病的新概念。在治疗方面，采用中西医结合治疗，有效率77．24％，显效率43．31％。     

β-Endorphin serum levels in patients with vitiligo

Aim The aim of this study is to correlate the β-endorphin levels at the early and more chronic stages of the disease in an attempt to find or confirm an etiological factor of vitiligo. Background The exact pathogenesis of vitiligo is still unclear. The most important theories are the self destruction, the autoimmune and the neural theories. Methods Patients with vitiligo (n= 28) were divided into two groups according to the duration of their disease. A group of 15 members of medical staff was the control group. β-endorphin levels were determined with a radioimmunoassay (¹²⁵I-β-endorphin IncstarCo). Results The mean β-endorphin levels (11.88 ± 2.25 pmol/l) in patients at the early years of the disease (Group A) were statistically elevated compared to those of patients with ‘chronic’ vitiligo (9.27 ± 2.73 pmol/l) and to those of controls (8.53 ± 2.53) pmol/l). Conclusion We suggest that high β-endorphin levels play a role in the pathogenesis of vitiligo as well as in the prognosis of the disease.     

Depigmentation therapy for vitiligo in patients with Fitzpatrick skin type VI

Vitiligo is a depigmenting disorder characterized by the progressive loss of melanocytes. In cases of extensive vitiligo that is unresponsive to treatment and involves noticeable areas, such as the face and hands, total depigmentation is a clinical option. The choice to depigment is a difficult one for the patient given the irreversible nature of treatment and the psychosocial implications of skin color change. This issue can be particularly complex for black patients. Depigmentation has been practiced for decades and documented in the literature, but the practice in Fitzpatrick skin type VI is not well-documented. We present a case of depigmentation in a patient with Fitzpatrick skin type VI, as well as technical options for depigmentation, the clinical approach, patient preparation, and psychosocial issues involved with this treatment option.     

Irritancy of dithranol in normally pigmented and depigmented skin of patients with vitiligo

In order to ascertain the extent to which the pigmentary system plays a protective role in dithranol-induced irritancy, a within-subject comparison was carried out between normally pigmented and depigmented skin of patients with vitiligo. In open patch tests, various concentrations of dithranol in a cream base were applied to the normally pigmented and depigmented skin of 6 patients with vitiligo. The responses were assessed 48 h after application. A mild to moderate inflammation occurred in the pigmented and depigmented skin and no statistically significant difference was shown between the two test areas. The present study does not support the hypothesis that the pigmentary system might be involved in dithranol-induced irritancy.     

A comparative study of superoxide dismutase, catalase, and glutathione peroxidase activities and nitrate levels in vitiligo patients

BACKGROUND: Several groups have shown the involvement of oxidative stress in the pathophysiology of vitiligo. METHODS: In this study, we examined the erythrocyte and plasma activities of glutathione peroxidase and Cu/Zn superoxide dismutase, plasma nitrite/nitrate levels, and erythrocyte catalase activity in 23 vitiligo patients and 25 controls. RESULTS: The results show that erythrocyte superoxide dismutase activity and plasma nitrite/nitrate levels are high in vitiligo patients. CONCLUSIONS: Our study confirms that oxidative stress is involved in the pathophysiology of vitiligo, as indicated by the high levels of erythrocyte superoxide dismutase activity and plasma nitrite/nitrate.     

The perilesional skin in vitiligo: a colorimetric in vivo study of 25 patients

Background: The aim of this work was to study in vivo the perilesional skin in vitiligo with a colorimetric method. Methods: Twenty‐five patients affected by vitiligo were included. For each patient, three different areas were considered: the lesional, the perilesional and the normal skin as far as 5 cm from the nearest vitiligo spot. Skin pigmentation measurements were performed with a chromameter. Results: The results showed that luminance L^* decreased significantly in relation to increasing distance from the vitiligo spot. As expected, L^* in the vitiligo spot was significantly higher than in the perilesional (P<0.0001) and normal skin (P<0.0001). There was a small difference in L^* between normal skin as far as 5 cm from the nearest vitiligo spot and perilesional skin. In contrast, the pigmentation index (b^*) gradually increased from lesional to perilesional to normal skin. Furthermore, the comparison of the b^* value between the normal skin as far as 5 cm from the nearest vitiligo spot was higher than perilesional skin and it was statistically significant (P<0.0001). Conclusion: Our results in vivo underline that the perilesional skin near the vitiligo spot is lighter than normal skin as far as 5 cm from the vitiligo spot.