The occurrence of cutaneous nerve endings and neuropeptides in vitiligo vulgaris: a case-control study

Abstract

Pioneering studies both in humans and animals have demonstrated an association between the peripheral nervous system and epidermal melanocyte destruction. The presence of certain neuropeptides and neuronal structural markers in peripheral nerve fibres was investigated in involved and uninvolved vitiligo skin and compared with normal healthy skin. A group of 18 vitiligo vulgaris patients and matched healthy volunteers participated in the investigation. The indirect immunofluorescence technique was employed. There was a tendency for a reduction in the number and intensity of low affinity (p75) nerve growth factor receptor immunoreactive (NGFr-IR) basal keratinocytes in involved vitiliginous skin (P < 0.06) compared with control skin, while the number of NGFr-IR nerve fibres was significantly increased (P < 0.01). The number of calcitonin gene-related peptide (CGRP)-IR nerve fibres in the epidermis and papillary dermis was dramatically increased in involved skin as compared with control skin (P < 0.01) and with uninvolved skin (P < 0.05). No clear difference could be found in the distribution of vasoactive intestinal polypeptide (VIP)- and neuropeptide tyrosine (NPY)-IR nerve fibres. A different structural appearance of the peripheral nervous system as well as a changed balance of neuropeptides in vitiliginous skin point to a critical role of the nervous system in the pathogenesis of vitiligo.

Increased Expression of Nerve Growth Factor Receptor and Neural Endopeptidase in the Lesional Skin of Melasma

“…[2][3][4][5] In previous work, neuropeptides have been found in vitiligo lesions but were not evaluated in relation to melasma. [8][9][10] The results of this study demonstrate that the sensory nerves, containing certain neuropeptides and their receptors, such as NGFR and NEP, innervate the lesional skin of melasma.…”

“…6,7 Additionally, in previous works, neuropeptides have been found in hypopigmentary diseases, including vitiligo lesions, but their roles in the pathogenesis of hyperpigmentation were not evaluated in relation to hyperpigmentatary diseases such as melasma. [8][9][10] In this study, we first investigated the involvement of some neuropeptides nad neurotrophins and their receptors in the pathogenesis of melasma.…”

Expression pattern of p75 neurotrophin receptor protein in human scalp skin and hair follicles: Hair cycle-dependent expression

“…[15][16][17][18][19] In our series, the strong p75NTR protein expression in the epidermis (stratum corneum) concurs with previous studies and suggests a possible role for p75NTR in the keratinocyte cell growth and renewal. [18][19][20] The transplanted psoriatic plaques and normal-appearing skin demonstrated variable proliferation of p75NTR-positive nerve fibers. 21 Because p75NTR protein is highly expressed in psoriasis, one could speculate that this protein may play a role in the mechanisms associated with this and other hyperproliferative skin conditions, including cancer.…”

The Pathogenesis of Vitiligo

“…Used electron microscope to examine marginal and central skin samples from lesional and nonlesional skin from vitiligo patients and skin from healthy controls Gokhale and Mehta, 1983 40 74 vitiligo patients; number of controls not provided Examined biopsies from affected depigmented areas and contralateral unaffected areas from vitiligo patients and compared to skin biopsies from healthy control skin from corresponding sites Bose, 1994 43 5 stable type A vitiligo patients; used patients' unaffected breast skin as control Used monoclonal antibody trophectoderm specific monoclonal antibody-1 (TROMA-1) for indirect immunofluorescence to analyze biopsies from lesional skin and adjacent nonlesional skin and compared to unaffected control skin Laties and Lerner, 1975 44 28 brown-eyed Dutch belted rabbits Animal study; sympathectomy via resection of superior cervical ganglion on one side in 10 rabbits and via interrupting the preganglionic nerve trunk in the remaining 18 rabbits Al'Abadie et al, 1994 45 12 vitiligo patients (active in 7 patients, static in 2, unknown in 3), 7 healthy controls Biopsies from lesional, nonlesional, marginal, and control skin were frozen with cryospray and cut on a cryostat and subjected to fluorescence immunohistochemistry Lazarova et al, 2000 46 10 vitiligo patients, 10 controls Indirect immunofluorescence Liu et al, 1996 47 18 vitiligo patients Case control study Rateb et al, 2004 48 20 vitiligo patients ( 52 10 patients with stable facial segmental-type vitiligo and 2 groups of controls:…”

“…As further confirmation of these results, Liu and colleagues carried out a case-control study looking for the same neuropeptides in cutaneous peripheral nerve fibers and had similar findings, further supporting a role for NPY and CGRP as neuronal markers for vitiligo. 47 Rateb and colleagues studied 48 the role of nerve growth factor (NGF), 49 an amino acid peptide hormone that is required for the sympathetic nervous system to function. They found significantly increased levels of NGF in the lesional skin of affected patients when compared to nonlesional and control skin.…”