Abstract
BackgroundVitiligo is a disorder with profound heterogeneity in its aetio-pathophysiology. Angiotensin converting enzyme (ACE) plays an important role in the physiology of the vasculature, blood pressure and inflammation. An insertion/deletion (I/D) polymorphism of the ACE gene was reported be associated with the development of vitiligo.ObjectiveOur aim was to evaluate the ACE I/D polymorphism in vitiligo patients and controls. Our second aim was to find a possible association between ACE gene polymorphism and inflammatory mediators (as interleukin (IL)-6) and/or cellular cytotoxicity induced by serum nitrite (as a breakdown product of the cytotoxic nitric oxide) in vitiligo patients.MethodsThis case-control study included 74 vitiligo patients and 75 apparently healthy controls. The distribution of ACE gene I/D genotype was investigated using PCR. Serum ACE, IL-6 and nitrite were measured by colorimetric method, ELISA and Griess assay respectively.ResultsThe ACE allele frequency was significantly different between vitiligo patients and healthy controls (P = 0.026). However there was no significant difference between the ACE genotyping frequency in both groups (P = 0.115). There were statistically significant higher VIDA score (P = 0.007), and serum IL-6 (P < 0.001) in patients with the DD genotype when compared to other genotypes. Serum nitrite in patients with the DD genotype was significantly higher (P = 0.007) when compared to patients with II genotype. Serum levels of ACE, IL-6 and nitrite in vitiligo patients were statistically significantly higher than those in controls.ConclusionAs a conclusion, ACE gene polymorphism might grant susceptibility to develop vitiligo. Serum IL-6 and nitrite levels might have an important role in the pathogenesis of vitiligo. Targeting these two factors might have an implication in the treatment of some resistant cases.
Highlights
The associations of vitiligo with other autoimmune diseases together with the detection of antimelanocyte and other antibodies in vitiligo patients led to the proposal of the theory of melanocyte autoimmune destruction in vitiligo [1]
The Angiotensin converting enzyme (ACE) allele frequency was significantly different between vitiligo patients and healthy controls (P = 0.026)
Serum IL-6 and nitrite levels might have an important role in the pathogenesis of vitiligo
Summary
The associations of vitiligo with other autoimmune diseases together with the detection of antimelanocyte and other antibodies in vitiligo patients led to the proposal of the theory of melanocyte autoimmune destruction in vitiligo [1]. Studying the polymorphisms of certain genes incorporated in the immune system detected a significant role in vitiligo susceptibility [2,3]. ACE has a significant role in the physiology of the blood vessels and inflammatory process and it has been widely studied to detect its association with various autoimmune diseases [4]. An insertion/deletion (I/D) polymorphism in intron 16 of the ACE gene accounts for most of the variability of serum ACE activity and is associated with the development of vitiligo. Angiotensin converting enzyme (ACE) plays an important role in the physiology of the vasculature, blood pressure and inflammation. An insertion/deletion (I/D) polymorphism of the ACE gene was reported be associated with the development of vitiligo
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