Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;143(6):2095-2107.
doi: 10.1016/j.jaci.2018.11.031. Epub 2018 Dec 18.

Blood endotyping distinguishes the profile of vitiligo from that of other inflammatory and autoimmune skin diseases

Tali Czarnowicki  1 , Helen He  2 , Alexandra Leonard  2 , Hyun Je Kim  2 , Naoya Kameyama  2 , Ana B Pavel  2 , Randall Li  2 , Yeriel Estrada  2 , Huei-Chi Wen  2 , Grace W Kimmel  2 , Hee J Kim  2 , Margot Chima  2 , Mark Lebwohl  2 , James G Krueger  3 , Emma Guttman-Yassky  4
Affiliations

Blood endotyping distinguishes the profile of vitiligo from that of other inflammatory and autoimmune skin diseases

Tali Czarnowicki et al. J Allergy Clin Immunol. 2019 Jun.

Abstract

Background: Peripheral blood skin-homing/cutaneous lymphocyte antigen (CLA)+ T cells emerge as biomarkers of cutaneous immune activation in patients with inflammatory skin diseases (atopic dermatitis [AD] and alopecia areata [AA]). However, blood phenotyping across these subsets is not yet available in patients with vitiligo.

Objective: We sought to measure cytokine production by circulating skin-homing (CLA+) versus systemic (CLA-) "polar" CD4+/CD8+ ratio and activated T-cell subsets in patients with vitiligo compared with patients with AA, AD, or psoriasis and control subjects.

Methods: Flow cytometry was used to measure levels of the cytokines IFN-γ, IL-13, IL-9, IL-17, and IL-22 in CD4+/CD8+ T cells in the blood of 19 patients with moderate-to-severe nonsegmental/generalized vitiligo, moderate-to-severe AA (n = 32), psoriasis (n = 24), or AD (n = 43) and control subjects (n = 30). Unsupervised clustering differentiated subjects into groups based on cellular frequencies.

Results: Patients with Vitiligo showed the highest CLA+/CLA- TH1/type 1 cytotoxic T-cell polarization, with parallel TH2/TH9/TH17/TH22 level increases to levels often greater than those seen in patients with AA, AD, or psoriasis (P < .05). Total regulatory T-cell counts were lower in patients with vitiligo than in control subjects and patients with AD or psoriasis (P < .001). Vitiligo severity correlated with levels of multiple cytokines (P < .1), whereas duration was linked with IFN-γ and IL-17 levels (P < .04). Patients and control subjects grouped into separate clusters based on blood biomarkers.

Conclusions: Vitiligo is characterized by a multicytokine polarization among circulating skin-homing and systemic subsets, which differentiates it from other inflammatory/autoimmune skin diseases. Future targeted therapies should delineate the relative contribution of each cytokine axis to disease perpetuation.

Keywords: T(H)1; T(H)17; T(H)2; T(H)22; Vitiligo; alopecia areata; atopic dermatitis; biomarkers; endotypes; psoriasis; regulatory T.

PubMed Disclaimer

MeSH terms