Melanocyte-keratinocyte transplantation procedure in the treatment of vitiligo: The experience of an academic medical center in the United States

Huggins, Richard H.; Henderson, Marsha; Mulekar, Sanjeev V.; Ozog, David M.; Kerr, Holly; Jabobsen, Gordon; Lim, Henry W.; Hamzavi, Iltefat

doi:10.1016/j.jaad.2011.05.002

Cited by 70 publications

(77 citation statements)

References 22 publications

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“…26 Huggins et al (2012) observed a lower satisfactory response, of only 48%, with 17% presenting excellent results and 31% presenting good results. 22 One recent study conducted by Komen et al (2015), using the ReCell™ device to obtain cell suspension, reported a satisfactory response in 60% of the patients, which was also slightly lower than that observed in the present study. 27 A greater percentage of satisfactory responses was observed by Bao et al (2015) when treating patients with segmental and non-segmental vitiligo with melanocyte transplantation.…”

Section: Discussioncontrasting

confidence: 71%

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Evaluation of treatment response to autologous transplantation of noncultured melanocyte/keratinocyte cell suspension in patients with stable vitiligo

Ramos

Ramos³

2017

An. Bras. Dermatol.

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BackgroundVitiligo is a chronic disease characterized by the appearance of achromic macules caused by melanocyte destruction. Surgical treatments with melanocyte transplantation can be used for stable vitiligo cases. ObjectivesTo evaluate treatment response to the autologous transplantation of noncultured epidermal cell suspension in patients with stable vitiligo.MethodsCase series study in patients with stable vitiligo submitted to noncultured epidermal cell suspension transplantation and evaluated at least once, between 3 and 6 months after the procedure, to observe repigmentation and possible adverse effects. The maximum follow-up period for some patients was 24 months.ResultsOf the 20 patients who underwent 24 procedures, 25% showed an excellent rate of repigmentation, 50% good repigmentation, 15% regular, and 10% poor response. The best results were observed in face and neck lesions, while the worst in extremity lesions (88% and 33% of satisfactory responses, respectively). Patients with segmental vitiligo had a better response (84%) compared to non-segmental ones (63%). As side effects were observed hyperpigmentation of the treated area and the appearance of Koebner phenomenon in the donor area.Study limitationsSome limitations of the study included the small number of patients, a subjective evaluation, and the lack of long-term follow-up on the results. CONCLUSION: Noncultured epidermal cell suspension transplantation is efficient and well tolerated for stable vitiligo treatment, especially for segmental vitiligo on the face and neck.

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Section: Discussioncontrasting

confidence: 71%

“…For better results, the recommended treatment is a ratio of 1:5, that is, to treat an area that is five times greater than the donor area. 21,22 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of treatment response to autologous transplantation of noncultured melanocyte/keratinocyte cell suspension in patients with stable vitiligo

Ramos

Ramos³

2017

An. Bras. Dermatol.

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“…Depigmentation arises from the loss of functioning melanocytes38. Treatment is often a tough challenge and involves a wide range of therapies39 including UV radiation, laser40-42, transplant43, 44, and complementary medicine45-47. The most efficient therapy remains autologous skin graft, performed successfully daily in some of the dermatology clinics.…”

Section: Discussionmentioning

confidence: 99%

Novel approaches to vitiligo treatment via modulation of mTOR and NF-κB pathways in human skin melanocytes

Wan

Lin²,

Zhang

et al. 2017

Int. J. Biol. Sci.

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Vitiligo is a skin depigmentation disorder with an increasing prevalence. Among recognized mechanisms is the oxidative stress that affects melanocytes which are responsible for skin pigmentation. Studies have shown that high concentration of hydrogen peroxide, or H2O2, induces apoptotic activities. Few studies have been done with lower doses of H2O2. Using human skin melanocytes, we investigated the effect of moderate concentration of H2O2 on melanocyte dendrites. Confocal data show that H2O2 at 250 µM induces loss of dendrites, as indicated by cytoskeletal proteins. α-melanocyte stimulating hormone or α-MSH pretreatment protects against H2O2-induced loss of dendrites, while α-MSH alone enhances dendrites. PI3K/AKT inhibitor LY294002 and mTORC1 inhibitor Rapamycin inhibit α-MSH-induced dendrites. In this study, we also investigated the effect of TNFα on cultured human skin melanocytes, since TNFα plays important roles in vitiligo. Confocal data demonstrate that TNFα induces NFκB activation. Western blot analysis shows that TNFα induces IκB phosphorylation and degradation. Interestingly, α-MSH does not have any effect of TNFα-induced IκB degradation and NF-κB activation. α-MSH, however, activates mTORC1 pathway. TNFα induces p38 but not AMPKα activation. Collectively, our data suggest that modulation of mTOR and NF-κB pathways may be a novel approach for better clinical management of vitiligo.

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“…2a,b) and SV, respectively. Huggins et al 39 conducted a prospective, uncontrolled, open label study in which 28 patients underwent 36 procedures. Of these patients, 23 patients who underwent 29 procedures completed the 3-6-month follow-up period.…”

Section: Cultured and Noncultured Cellular Transplantation Methodsmentioning

confidence: 99%

Surgical interventions for vitiligo: an evidence-based review

Mulekar¹,

Isedeh

2013

Br J Dermatol

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SummaryBackground Vitiligo is a disfiguring disease, characterized frequently by the presence of de-pigmented macules and/or patches. Traditional therapies are essentially medical and are most preferred by dermatologists. Surgical therapies, however, are amongst the most effective interventions for vitiligo but are limited by their invasive nature, as well as the training and expertise needed to perform specific procedures. Objectives To assess the evidence for the effectiveness, safety and applicability of the various surgical methods in the treatment of vitiligo. Methods For this systematic review of vitiligo surgical therapies, our searches included: PubMed, MEDLINE and Cochrane databases. Results We reviewed research studies reporting on split thickness skin grafts (STSG), punch/mini-graft, blister roof grafting, cultured and non-cultured cellular transplantation (MKTP). While all methods vary in their repigmentation outcomes, STSG is found to have the highest repigmentation success rate. Overall, post-operative complications included milia, scarring, cobblestone appearance or hyperpigmentation of treated areas. Conclusion This review highlights the need for more randomized controlled trials in this field, underpinned by a more standardized objective approach to the assessment of repigmentation following surgical interventions.

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Melanocyte-keratinocyte transplantation procedure in the treatment of vitiligo: The experience of an academic medical center in the United States

Cited by 70 publications

References 22 publications

Evaluation of treatment response to autologous transplantation of noncultured melanocyte/keratinocyte cell suspension in patients with stable vitiligo

Evaluation of treatment response to autologous transplantation of noncultured melanocyte/keratinocyte cell suspension in patients with stable vitiligo

Novel approaches to vitiligo treatment via modulation of mTOR and NF-κB pathways in human skin melanocytes

Surgical interventions for vitiligo: an evidence-based review

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