الفهرس 
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Abstract
Summary
Vitiligo, an acquired pigmentary condition of unclear origin, causes white macules owing to the loss of functional melanocytes in the skin or hair, or both with 1% prevalence (Ezzedine et al., 2015). Males and females are afflicted equally by vitiligo before age 20 (Ezzedine et al., 2009). Vitiligo involves genetic, environmental, metabolic, and immunological variables. Impaired melanocyte regeneration and/or proliferation imply a melanocyte defect (Dell’anna et al., 2006). Clinically, patients have one to many chalky or milky white amelanotic macules with a normal or hyperpigmented border (Wolff et al., 2007).
Face, chest, hands, axillae, and groin are usually afflicted. Mouth, eyes, umbilicus, and vulva often have vitiligenous macules. Lesions also can occur on elbows and knees after trauma (James et al., 2006).
Using melanocyte-specific stains, histopathologists have found few melanocytes in early vitiligo lesions and none in well-established lesions (Schwartz et al., 19997).
Vitiligo is classified into SV and NSV. Acrofacial, generalised, and universal vitiligo are NSV (Ezzedine et al., 2012).
Recent study has connected vitiligo and disease activity to various indicators. In clinical trials and regular practise, activity markers can assess disease activity (Speeckaert et al., 2017).
Vitiligo is difficult to manage owing to its unexpected, stable-to-active course. Biomarker analysis can improve patient care and predict disease progression (Speeckaert et al., 2017).
Stability is important for selecting vitiligo surgical and medicinal therapy candidates and predicting outcome (Abdallah et al., 2014). Stable vitiligo is defined by non-progressive old lesions within two years preceding examination, no new lesions, absence of Koebner phenomenon, re-pigmentation of depigmented areas either spontaneously or upon medical intervention, and a positive Minigraft test with no ’Koebnerization’ at donor site (Falabella et al., 1995).
The sCD27 is expressed on T lymphocytes, B lymphocytes, and NK cells and promotes lymphocyte survival and T-cell proliferation (Speeckaert et al., 2016). Also sCD molecules are linked to autoimmune diseases. Activated and proliferating lymphocytes emit sCD molecules, making them effective immunologic markers (Speeckaert et al., 2011).
Vitiligo is a T-cell-mediated autoimmune illness, which may explain sCD27’s role (Ezzedine et al., 2015).
Chemokine CXCL10 is a chemokine generated by IFN- in neutrophils, lymphocytes, endothelial cells, fibroblasts, and epithelial cells (Luster et al., 1987). The CXCL10 controls immunological responses by activating T cells, monocytes, and natural killer cells. The receptors CXCR3 and CXCL10 are upregulated in autoimmune disorders and have a role in tissue destruction (Groom et al., 2011).
This cross sectional study was conducted on 70 cases with vitiligo (35 active cases and 35 stable ones) and 20 controls vary from 10 to 60 years old to assess the role of serum CXCL-10 and sCD27 levels as activity biomarkers in vitiligo patients
All patients were subjected to medical history, general examination and dermatological evaluation.
There was no statistical significance as regard age, sex and marital status among the three groups. 33% of patients have positive family history of vitiligo and 86.7% of them were with vulgaris type.
There was very highly statistical significant difference between active, stable cases and controls as regard measuring of serum CXCL10 and serum CD 27 as they were significant elevation in cases than controls .
There was significant statistical difference of serum CD 27 and CXCL10 between active cases and controls also, between controls and stable cases. There was significant difference of serum CXCL10 between active and stable cases while no significant difference of serum CD27 between active and stable cases.
Conclusion
Conclusion
from this study, we can conclude that vitiligo is associated with increased serum levels of CXCL10 and sCD27, indicating that CXCL10 and sCD27 may play a significant role in the pathogenesis of vitiligo and may be predictive biomarkers for disease activity.
Recommendations
Recommendations
According to the present findings we suggest using Serum CXCL10 samples as an approprial ,accurate and non invasive marker to monitor vitiligo activity and as useful indicator of therapeutic action in active vitiligo
we suggest future studies be conducted on a greater number of vitiligo patients to confirm the role of both CXCL10 and sCD27 in the pathogenesis of vitiligo and using tissue samples of CXCL10 and sCD27 to monitor disease activity .
We suggest further studiesbe conducted to reveal other biomarkers of vitiligo biomarkers considering that stability of the disease is predictive to the disease outcome.
Additional studies focusing on new alternative therapeutic approach that target CXCL10 or its receptors and sCD27 may provide new options in the treatment of vitiligo.