Altered levels of lymphocyte enhancer-binding factor-1 modulates the pigmentation in acral and non-acral lesions of non-segmental vitiligo patients: a follow-up-based study in North India

Abstract

Background Lymphocyte enhancer-binding factor-1 (LEF1) is responsible for melanocyte proliferation, migration and differentiation and its downregulation may result in depigmentation in vitiligo. Narrowband UVB (NB-UVB) phototherapy is known to enhance melanocyte migration from hair follicles to lesional epidermis; hence, it may have a role in the upregulation of LEF1. Objectives We intended to assess the expression of LEF1 both before and after NB-UVB therapy and correlate it with the extent of re-pigmentation. Materials and methods In this prospective cohort study, 30 patients of unstable non-segmental vitiligo were administered NB-UVB phototherapy for 24 weeks. Skin biopsies were obtained from acral and non-acral sites in all patients, both prior to initiation and after completion of phototherapy and LEF1 expression was measured. Results Amongst the 16 patients who completed the study, at 24 weeks, all patients achieved > 50% re-pigmentation. However, > 75% re-pigmentation was achieved in only 11.1% of acral patches, whereas it was achieved in a significantly higher number of non-acral patches (66.6%) ( p = 0.05). A significant increase was observed in the mean fluorescent intensity of the LEF1 gene in both acral as well as non-acral areas at 24 weeks as compared to baseline ( p = 0.0078), However, no difference was observed between acral and non-acral lesions in the LEF1 expression at 24 weeks or the change in LEF1 expression from baseline. Conclusion LEF1 expression modulates the re-pigmentation of vitiligo lesions after treatment with NBUVB phototherapy.

Phototherapy for vitiligo: A narrative review on the clinical and molecular aspects, and recent literature

“…Lymphocyte enhancer‐binding factor‐1 (LEF1) plays a crucial role in melanocyte proliferation, migration, and differentiation. A significant rise in the mean fluorescent intensity of the LEF1 protein was observed after 24 weeks of NBUVB 148 …”

“…A significant rise in the mean fluorescent intensity of the LEF1 protein was observed after 24 weeks of NBUVB. 148 Experimental studies have shown a significant increase in serum vitamin D3 levels in animals who had received controlled lowdose irradiation from 308 nm wavelength light emitting diode. 149 1,25(OH)₂D₃ deficiency correlated with hyperactivity of CD8+ T cells in vitiligo.…”

The role of aryl hydrocarbon receptor in vitiligo: a review

“…In addition, it was found that the expression of Wnt pathway components such as LEF1, CDH2, and CDH3 was downregulated in the lesional skin of vitiligo ( 118 ). One study showed that narrow-band UVB could activate the Wnt/β-catenin pathway and strongly promote vitiligo repigmentation ( 119 ). Moreover, the Wnt pathway also has significant effects in regulating immunity and protecting melanocytes from oxidative stress, indicating that Wnt/β-catenin signaling is likely to be a valuable target to treat vitiligo ( 40 ).…”