Clinical Significance of Serum Oxidative Stress Markers to Assess Disease Activity and Severity in Patients With Non-Segmental Vitiligo

Shuli Li,Wei Dai,Peng Han,Pan Kang,Chunying Li,Kang Zeng,Zhubiao Ye,Sijia Wang

doi:10.3389/fcell.2021.739413

Abstract

Non-segmental vitiligo (NSV) is a chronic autoimmune disease characterized by progressive depigmentation of the skin. Oxidative stress (OS) has been proposed as one among the main principal causes in the development and establishment of a sustained autoimmune state in patients with NSV. However, the disease-associated OS biomarkers in clinical practice are not well studied. In this study, we found significantly reduced antioxidant enzymes [catalase (CAT) and superoxide dismutase (SOD)], total antioxidant capacity (TAC), and increased levels of lipid oxidation product malondialdehyde (MDA) and oxidative DNA damage byproduct [8-hydroxy-2-deoxyguanosine (8-OHdG)] in serum of NSV patients compared with healthy controls (HC). Serum TAC, MDA, and 8-OHdG levels were correlated with disease activity in all patients with NSV and much lower in patients receiving conventional treatment in the past 1 year compared to that without treatment. In addition, both serum MDA and 8-OHdG levels were significantly correlated with CXCL10 expression in patients with NSV. And the serum TAC, MDA, and 8-OHdG levels were also correlated with affected body surface area and Vitiligo Area Scoring Index score in patients with NSV. This study demonstrates dysregulated OS status in patients with NSV and provides the evidence that the serum TAC, MDA, and 8-OHdG have a capacity to indicate the activity and severity in patients with NSV.

Highlights

Vitiligo is a chronic autoimmune skin disease characterized by depigmented skin due to loss of epidermal melanocytes, affecting 0.5%–2% of the world population (Picardo et al, 2015)
This study demonstrates lower levels of antioxidative capacity and higher values of oxidative stress (OS) damage markers in the serum of patients with non-segmental vitiligo (NSV) and points to their beneficial use as indicators of disease activity and severity
In this study, decreased serum CAT and superoxide dismutase (SOD) activity as well as total antioxidant capacity (TAC) were found in patients with NSV, indicating an impairment of antioxidative capacity in vitiligo

Summary

Introduction

Vitiligo is a chronic autoimmune skin disease characterized by depigmented skin due to loss of epidermal melanocytes, affecting 0.5%–2% of the world population (Picardo et al, 2015). The exact etiology of non-segmental vitiligo (NSV) is not fully understood, studies suggest that oxidative stress (OS) plays a critical role in vitiligo initiation and development (Picardo et al, 2015). 2012; Li et al, 2017; Rezk et al, 2017; Li et al, 2020), initiating or promoting the autoimmune reaction toward melanocytes. The critical role of OS in the development and establishment of an autoimmune state in vitiligo has been widely accepted; limited evidence is available on disease-associated OS markers that are associated with the vitiligo activity or severity. Additional research is needed to identify the possible OS markers to guide the management and treatment for vitiligo

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