Lymphocyte imbalance in vitiligo patients indicated by elevated CD4+/CD8+ T-cell ratio

Abstract

Vitiligo is a disorder of pigmentation associated with an autoimmune-mediated loss of melanocytes from the epidermis. Humoral immunity and the involvement of cellular immunity have been investigated in the pathogenesis of vitiligo. We evaluated the role of pro-inflammatory cytokines and lymphocyte fractions in peripheral blood in a cohort of Austrian patients with vitiligo. Morning blood samples from 40 patients with vitiligo were collected. Twenty-one patients had active and 19 had stable vitiligo disease. All patients were suffering from non-segmental vitiligo at different stages of the disease. Sixteen persons presented with an additional autoimmune thyroid disease. To evaluate a possible involvement of proinflammatory cytokines in vitiligo we measured sTNF-RI (soluble tumour necrosis factor receptor I), IL-6 and additionally CIC (circulating immune complexes). We compared these findings to the data from matched normal persons. To investigate the mechanisms of cellular immunity, peripheral blood cell count and lymphocyte subtype analysis by flow cytometry were done. sTNF-RI, IL-6 and CIC serum levels were in the normal range. In the patient group median sTNF-RI level was 1.5 ng/ml and median CIC level was 35.2 microg/ml, and no statistically significant differences to the control group were observed. Median IL-6 level in vitiligo patients was 2.7 pg/ml and in the normal range-but higher than the median level of 0.5 pg/ml observed in normal persons (p < 0.001). Absolute and relative counts of lymphocyte subtypes were normal. The ratio of CD4+/CD8+ T-cells had an elevated median value of 2.6 [quartiles 2.0; 3.1]. 61% of the vitiligo patients had a ratio higher than 2.4, which was the normal cut-off point. In most vitiligo patients the balance of cytotoxic/suppressor and helper/inducer T-cells in peripheral blood is disturbed which might lead to a predominance of T-cell subtypes in the intracutaneous site of autoimmune melanocyte loss.

Vitiligo, reactive oxygen species and T-cells

“…Total T-cells were relatively higher in generalized than in acral/acrofacial vitiligo, and CD45RO + T-cells were higher in acral/acrofacial disease. Unlike former studies, Pichler et al [154] found an increased CD4 + /CD8 + ratio in peripheral blood, but noted that the ratio in tissues could be different.…”

“…A recent flow cytometric study of these cells in vitiligo did not show a pathological distribution of B cells, suggesting that T-cells might have a more dominant role. Circulating immune complexes were not elevated either [154]. Cases of generalized vitiligo in recipients of bone marrow transplants from donors with vitiligo have been reported, illustrating the role of bone marrow-derived cells in disease pathogenesis [155].…”

Role of Corticosteroids in Treatment of Vitiligo

“…Regarding the autoimmune hypothesis, antibodies develop against melanocyte surface antigens (Mahmoud et al, 2008 and their components (Yaghoobi et al, 2011b). In a study, an elevated ratio of CD4 + /CD8 + T cells was seen, which was a sign of imbalanced lymphocyte immune response (Pichler et al, 2009). In another study, small amount of IgG and C3 deposits in the basement-membrane zone and keratinocytes were seen in vitiligo lesions .…”

“…Table 3. Disorders associated with vitiligo (Alkhateeb et al, 2003;Birlea et al, 2008;Bolognia et al, 2008;Burn's et al, 2004;Daneshpazhooh et al, 2006;James et al, 2006;Lebwohl et al, 2006;Pichler et al, 2009;Yaghoobi et al, 2011b;Zhang et al, 2009) …”

Cocaine administration increases CD4/CD8 lymphocyte ratio in peripheral blood despite lymphopenia and elevated corticosterone

“…The CD4/CD8 lymphocyte ratio in blood is used in the diagnosis of HIV infection [8][9][10], evaluation of pathogenesis of HCV infection [11] and autoimmune disorders such as rheumatoid arthritis or vitiligo [12,13]. The present study aimed to evaluate changes in the numbers and proportions of the peripheral blood B, NK, T CD3 + , T CD4 + and T CD8 + lymphocyte subsets, and CD4/CD8 ratio following repeated intravenous cocaine administration in rats.…”