Evaluation of Subtypes of Peripheral Blood Lymphocytes in Patients with Vitiligo

Document Type : Research Paper

Authors

1 Associate Professor of Pathology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Professor of Dermatology, Mashhad University of Medical Sciences, Mashhad, Iran

3 Professor of Immunology, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Associate Professor of Dermatology, Mashhad University of Medical Sciences, Mashhad, Iran

5 Assistant Professor of Dermatology, Mashhad University of Medical Sciences, Mashhad, Iran

6 Specialist in Social Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

7 Pathology departmentResident of Mashhad University of Medical Sciences, Mashhad, Iran

8 Dermatologist, Mashhad, Iran

Abstract

Introduction
Vitiligo is characterized with white patches on the skin and alteration of melanocytes in dermoepidermal junction. Autoimmune mechanisms with an underlying genetic predisposition are the most likely causes of vitiligo. This study was performed to evaluate immune disturbance in vitiligo and clarify its more details.
Materials and Methods
A total of 29 vitiligo patients and 21 healthy controls were included in this case control study.
Complete blood count was measured and peripheral blood samples were evaluated flowcytometrically for surface antigenic markers including CD3, CD4, CD8, CD19, CD16, CD56 and CD25 for determining the percentage and total number of various lymphocyte subgroups. Patients with different clinical subtypes were compared with each other and controls in terms of the flowcytometry results. Obtained information was assessed by SPSS statistical software.
Results
Total numbers of CD3+, CD8+ T cells, B cells and CD25+ cells were significantly increased in generalized type vitiligo patients in comparison with localized type. CD25+ cells were also increased significantly in generalized and stable types of vitiligo compared with healthy controls and finally the total number of lymphocytes was significantly decreased in localized type vitiligo patients in comparison with healthy controls.
Conclusion
Our data indicate cellular immune disturbance in vitiligo. Disorders of immune regulatory system may play a major role in this context. Significant CD25+ or regulatory T cells increment in different clinical subtypes of the disease is in favor of the above hypothesis. Later and larger studies may result in new and effective routs of treatment for vitiligo acting through regulating immune system.

Keywords


1- Bleehen SS, Anstey AV. Disorders of skin color. In : Burn T, Breathnach S, Cox N, Griffiths C. Rook’s textbook of
Dermatology. 7th ed. Oxford: Blackwell science; 2004.p. 39.1-39.68.
2- Cindy L, James J. Vitilgo. In: John H, Arnold O, Neil P. Textbook of pediatric dermatology. 6 th ed .Oxford:
Blackwell science; 1998.p.1802 -1805.
3- Spievogel RL, Kantor GR. Pigmentary disorders of the skin. In: Elder DE, Elenitsas R, Sohnson BL, Murphy GF.
Lever’s histopathology of the skin. 9th ed. Philalelphia: Lippincott Williams & Wilkins; 2005.p.705-713.
4- Boissy RE, Nordlund IJ. Vitiligo. In: Arndt KA, LeBoit. PE, Robinson JK, Wintroub BU. cutaneous medicine and
surgery. 1st ed. Philadelphia. saunders; 1996.p.1210- 1218.
5- Halder RM, Taliaferro SJ. Vitiligo in: Wolff K, Gold smith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ.
Dermatology in general medicine. 7th ed. McGraw – Hill; 2008. P.616-621.
6- Nordlund JJ, Lerner AB. Vitiligo-It is important? Arch Dermatol 1982; 118: 5–8.
7- Garbelli S, Mantovani S, Palermo B,Giachino C.Melanocyte-specific, cytotoxic T cell responses in vitiligo:the
effective variant of melanoma immunity? Pigment cell res 2005; 18:234- 242.
8- Lengagne R, Legal FA,Garcette M.Spontaneous vitiligo in an animal model for human melanoma: role of tumorspecific
CD8 T cells. Cancer Res 2004; 64:1496-501.
9- Mahmoud F, Abul H, Haines D, Al-Saleh C. Decresed total number of peripheral blood lymphocytes with elevated
percentages of CD4+, CD4SRO+ and CD4 CD25+ of T-helper cells in nonsegmental vitiligo . J Dermatol 2002; 29:68-73.
10- Halder RM, Walters CS, Johnson BA, Chakrabarty SG. Abberation in T lymphocytes and natural killer cell in
vitiligo: a flowcytometric study. J Am Acad Dermatol 1986; 14:733-737.
11- Basak P, Adiloglu A, Koc I, Tas T, Akkaya V. Evaluation of activatory and inhibitory natural killer cell receptors
in non-segmental vitiligo: a flow cytometric study. J Eur Acad Dermatol Venereol 2008; 22:970-976.
12- Ghorban K, Dadmanesh M, Masood A, Mansori P. B and T Lymphocyte and subsets in the peripheral blood in
vitiligo patients. JAUMS 2006; 3:891-394.
13- Ongenae K,Van Geel N, Naeyaert J. Evidence for an autoimmune pathogenesis of vitiligo. Pigment. Cell Res
2003; 16:90-100.
14- Passeron T, Ortonne JP. Physiopathology and genetics of vitiligo. J Autoimmun 2005; 25:63-8. Epub 2005 Nov 18.
15- Abbas AK, Litchman AH. Cellular and Molecular Immunology.5th ed.Saunders:Philadelphia; 2004.p.216-274.
16- Askenasy N, Kaminitz A, Yarkoni S. Mechanisms of T regulatory cell function. Autoimmun Rev 2008; 7:370-375.
17- Zwar TD, Van Driel IR, Gleeson. Guarding the immune system: Supression of autoimmunity by CD4+
 CD25+
immunoregulatory T cells. Immunol Cell Biol 2006; 84: 487–501.
18- Zeiser R, Negrin RS. Interleukin-2 receptor downstream events in regulatory T cells: implications for the choice of
immunosuppressive drug therapy. Cell Cycle 2008; 7:458-462.
19- Basak PY, Adiloglu AK, Ceyhan AM, Tas T, Akkaya VB. The role of helper and regulatory T cells in the
pathogenesis of vitiligo. J Am Acad Dermatol 2009; 60:256-260.