Evaluation of phosphodiesterase 4 enzyme levels in lesional skin and serum of vitiligo patients

Abstract

Background Vitiligo is the most commonly acquired depigmenting disorder. It has a negative psychological impact on affected individuals. The pathogenesis of vitiligo is complex and not yet fully revealed. Phosphodiesterase (PDE) inhibitors are widely used in many medical diseases and dermatological conditions, for example, psoriasis and atopic dermatitis. Recently, a case report showed that Apremilast (PDE4 inhibitor) resulted in significant repigmentation in a female patient with recalcitrant vitiligo. Objective To evaluate PDE4 levels in the tissues and serum of vitiligo patients and to compare them to the levels of controls to assess its role in the pathogenesis of the disease. Patients and methods In this case-control study, skin biopsies of vitiliginous lesions and blood samples were taken from 20 vitiligo patients and 20 controls. The PDE4 enzyme level was measured in both skin and serum samples. Results PDE4 enzyme levels in both the skin and serum of vitiligo patients were significantly higher than those in controls. PDE4 enzyme tissue levels were significantly higher than serum levels of both groups (patients and controls). A significant positive correlation was found between PDE4 tissue and serum levels of vitiligo patients. Conclusion High PDE4 levels in tissue and serum of vitiligo patients compared with controls suggest that it may contribute to the pathogenesis of vitiligo. Hence, PDE4 inhibitors may be a promising therapeutic modality of this disease.