부산대학교 도서관

Background. Recent evidence suggests that systemic psoralen plus ultraviolet A (PUVA) therapy may have a stimulatory effect on melanocytes, not only locally but also systemically. Aim. We aimed to assess endothelin-1 (ET-1), a potent melanocyte mitogen, in plasma of PUVA-treated paients with vitiligo. Methods. ET-1 was sequentially assessed (using ELISA) in patients with nonsegmental vitiligo treated with PUVA ( n = 20), at 8, 16 and 24 h following the PUVA session. Evaluations took place at 0, 1 and 3 months of therapy. Patients with psoriasis ( n = 15) treated identically and healthy subjects not receiving any therapy ( n = 15) served as controls. Vitiligo Area Scoring Index (VASI) and Psoriasis Area Severity Index (PASI) scores were simultaneously evaluated. Results. ET-1 was significantly lower in vitiligo than in psoriasis at month 0 (8.2 ± 3.6 vs. 13.7 ± 5.4 pg/mL; P = 0.03) and it was significantly higher in both than in healthy controls at all time points of the PUVA sessions ( P < 0.001). In vitiligo, it significantly increased at month 3 at 8 (8.2 ± 3.6 vs. 10.8 ± 2.7 pg/mL; P = 0.02) and 16 h (8.2 ± 3.6 vs. 11.5 ± 3.9 pg/mL; P < 0.01), whereas in psoriasis, it significantly decreased at month 3 at 8 (13.7 ± 5.4 vs. 3.5 ± 0.4 pg/mL; P < 0.01) and 16 h (13.7 ± 5.4 vs. 6.3 ± 4 pg/mL; P = 0.01). In contrast to psoriasis, sequential values of vitiligo revealed insignificant variance ( P > 0.05). VASI score significantly decreased at month 3 (19 ± 9.6 vs. 11.9 ± 7.3; P < 0.01), whereas PASI score significantly decreased at months 1 (38.2 ± 16.1 vs. 13.8 ± 3; P < 0.05) and 3 (38.2 ± 16.1 vs. 7 ± 2.6; P = 0.03). There was a significant indirect correlation of ET-1 with VASI score ( P < 0.01) and a significant direct correlation with PASI score ( P < 0.01). Conclusion. Systemic PUVA therapy in vitiligo may have a generalized mitogenic effect on melanocytes through the release of ET-1 into the circulation. [ABSTRACT FROM AUTHOR]