Association of serum concentrations of interleukins IL-18, IL-19, IL-21 and IL-22 with the etiopathogenesis and assessment of clinical activity of nonsegmental form of vitiligo

Abstract

Vitiligo je stečeni, kronični idiopatski poremećaj pigmentacije koji se očituje pojavom depigmentiranih makula na koži, a nastaje zbog selektivnog gubitka melanocita. Autoimunosna teorija se smatra vodećom etiopatogetskom teorijom nastanka vitiliga. Citokini su ključni medijatori stanične komunikacije i imaju značajnu ulogu u razvoju, diferencijaciji i regulaciji upalnog odgovora koji dovodi do pojave autoimunosti. Stoga je cilj ovog istraživanja bilo ispitati povezanost nesegmentalnog oblika vitiliga i serumske koncentracije interleukina (IL) IL-18, IL-19, IL-21 i IL- 22 te dobivene vrijednosti usporediti s težinom kliničke slike, aktivnošću te trajanjem bolesti. U istraživanje je bilo uključeno 78 ispitanika, od kojih 52 bolesnika sa nesegmentalnim vitiligom i 26 ispitanika u kontrolnoj skupini. U skupini bolesnika s nesegmentalnim oblikom vitiliga su izmjerene značajno više serumske koncentracije IL-19 i IL-21 te niže serumske koncentracije IL-18 i IL-22 u odnosu na kontrolnu skupinu ispitanika. Nije pronađena značajnija korelacija između težine kliničke slike, aktivnosti i trajanja bolesti. Ovim istraživanjem je prvi puta do sada učinjena analiza serumskih koncentracija kombinacije citokina IL-18, IL-19, IL-21 i IL-22 te su po prvi puta određene serumske koncentracije IL-18 i IL-19. Rezultati ovog istraživanja mogu doprinijeti boljem razumijevanju kompleksne etiopatogeneze vitiliga, ali mogu i poslužiti kao prilog spoznaji za mogući razvoj ciljane terapije, uključivši i proizvodnju monoklonskih protutijela. S obzirom da je u ovo istraživanje bio uključen relativno mali broj ispitanika, potrebne su dodatne studije na većem broju ispitanika u različitim fazama bolesti koje bi razjasnile značenje IL-18, IL-19, IL-21 i IL-22 u etiopatogenezi i kliničkim značajkama ove bolesti, kao i u mogućem razvoju ciljane terapije.Vitiligo is an acquired, chronic idiopathic pigmentation disorder that presenting with depigmented macules, caused by the selective loss of melanocytes. The autoimmune theory is considered to be the leading aetiopathogetic theory of vitiligo. Cytokines are key mediators of cellular communication and play a significant role in the development, differentiation, and regulation of the autoimmune inflammatory response. The aim of this study was to determine the association between the non-segmental form of vitiligo and the interleukins (IL) IL-18, IL-19, IL-21 and IL- 22 by measuring the serum concentration of these interleukins and to compare them with clinical severity, activity and disease duration. Seventy-eight patients were included into this study, out of whom 52 patients with nonsegmental vitiligo and 26 patients in the control group. Significantly higher serum concentrations of IL-19 and IL-21 and lower serum concentrations of IL-18 and IL- 22 were assessed in the group of patients with non-segmental vitiligo compared to the control group. No significant correlation was found between the severity, activity, and duration of the disease. This study was the first so far to analyze serum concentrations of the combination of cytokines IL-18, IL-19, IL-21 and IL-22 and to determine serum concentrations of IL-18 and IL- 19. The results of this research might contribute to the better understanding of the complex aetiopathogenesis of vitiligo, but might also contribute to the development of targeted biological therapy, i.e. the production of monoclonal antibodies. Given that a relatively small number of subjects were included in this study, additional studies are needed on a larger number of patients at different stages of the disease to clarify the role of IL-18, IL-19, IL-21 and IL-22 in the aetiopathogenesis of vitligo, its clinical characteristics and in the potential development of targeted therapy