Higher Plasma Catecholamine and Metabolite Levels in the Early Phase of Nonsegmental Vitiligo

Abstract

The etiology of vitiligo is still being debated, although neural factors seem to play a pivotal role in its pathogenesis. In our search for a link between vitiligo and the activity of monoaminergic systems, we used high-pressure liquid chromatography and electrochemical detector (HPLC-ED) methods to measure the plasma levels of the following substances in 35 healthy subjects and in 70 patients suffering from nonsegmental vitiligo at the different stages of the disease: catecholamines [norepinephrine (NE), epinephrine (E), and dopamine (DA)], their precursor 3,4-dihydroxyphenylalanine (DOPA), their metabolites [3-methoxy-4-hydroxyphenylglycol (MHPG), normetanephrine (NMN), metanephrine (MN), and homovanillic acid (HVA)], and 5-hydroxyindolacetic acid (5-HIAA) as the major metabolite of serotonin. We found that the levels of NE, E, NMN, MN, HVA, and 5-HIAA were significantly higher in patients compared to controls. The patients at an active phase of the disease (n = 49/70) showed significantly higher levels of NE, NMN, MHPG, and HVA than ones at a stable phase. The patients with progressive vitiligo and at its more recent onset (< 1 year) showed significantly increased levels of E, NE, and MN in comparison with longer-term sufferers. No significant differences were observed when the patients were subdivided according to the type of vitiligo or their age at its onset. The higher catecholamine and metabolite levels in the early phase of the disease may reflect increased activity by monoaminergic systems, probably due to stressful events, including the onset of vitiligo itself.

Erythrocyte Malondialdehyde and Glutathione Levels in Vitiligo Patients

“…Our results suggested that erythrocyte MDA levels were not altered in vitiligo patients regardless of disease activity. Previous studies have shown higher MDA levels in both serum and tissues in vitiligo patients compared to healthy controls 3,4,6,[8][9][10]15 .…”

“…In this study, we measured erythrocyte MDA, a well-known indicator of oxidative stress, to evaluate the level of reactive oxygen species (ROS). Studies have shown that the level of catecholamines and their metabolites are increased in the skin lesions, plasma and urine of vitiligo patients [8][9][10] . It has also been reported that catecholamine-induced oxidative stress may involve free radical damage.…”

Factores psicobiológicos en vitiligo infantil: Posible rol en su génesis e impacto en la calidad de vida

“…3) Existe una alta concordancia entre el alza de mediadores séricos durante estados de ansiedad o durante la respuesta fisiológica al estrés mental con los mediadores postulados como patogénicos en vitiligo. Estos incluyen a la norepinefrina 8,28,29,30 , epinefrina, cortisol 31,32,33 , IL-6 34,35 , TNF-alfa 36,37 , betaendorfina 38,39 . En general, los autores de estos reportes atribuyen un efecto tóxico a las catecolaminas contra los melanocitos y queratinocitos, fundamentalmente a través de la producción de metabolitos tóxicos y radicales libres.…”

Surgical management of vitiligo

“…In a study conducted to search for a link between vitiligo and the activity of monoaminergic systems, the levels of catecholamines and metabolites were significantly higher in vitiligo patients compared with controls. This may reflect the increased activity of monoaminergic systems in the early phase of the disease [8];…”