Study of the Immunological Status of Iraqi Vitiligo Patients


Vitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-α) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-α) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Assay (ELISA); while immunoglobulins (IgM, IgG and IgA) were detected by using Single Radial Immunodiffusion (SRID) method. The results showed that the mean levels of serum IL-17A and TNF-α in both untreated and NB-UVB treated vitiligo patients were increased significantly (p ≤ 0.05) as compared with healthy control. The mean levels of serum IgG and IgA in untreated vitiligo patients showed non significant decreased (P<0.05) as compared to healthy control; while serum IgM and IgE levels were found to be increased, but the increase was statistically non significant (P<0.05). The mean levels of serum IgM and IgG in NB-UVB treated vitiligo patients showed a significant increased (p ≤ 0.05) as compared to both untreated vitiligo patients and healthy control, while serum IgA level found to be increased, but the increase was statistically non significant (P<0.05) as compared to untreated vitiligo patients. From these findings we can conclude that marked high serum levels of IL-17A and TNF-α in vitiligo patients clarify their important participation in the pathogenesis of vitiligo, also the alteration in the mean levels of serum immunoglobulins indicate the role of humoral immunity in vitiligo patients. Among the treatment options available in vitiligo, phototherapy especially NB-UVB was one of the safest and most effective especially in patients with generalized vitiligo.