Abstract：
Improved repigmentation of generalized vitiligo in skin types IV-VI has been reported in clinical response to combined therapy with apremilast and narrowband (NB)-UVB; however, tissue responses to combined therapy versus NB-UVB monotherapy have not been elucidated. We compared the change from baseline in cellular and molecular markers in vitiligo skin after combined therapy versus NB-UVB monotherapy. We assessed lesional and nonlesional skin samples from enrolled subjects and evaluated for immune infiltrates, inflammatory, and melanogenesis-related markers which were compared across different treatment groups. Combined therapy resulted in significant reduction of CD8+T cells and CD11c+ dendritic cells, downregulation of PDE4B and Th17-related markers, and upregulation of melanogenesis markers. This study was limited to small sample size, skin types IV-VI, and high dropout rate. Our molecular findings support the clinical analysis that apremilast may potentiate NB-UVB in repigmentation of generalized vitiligo in skin types IV-VI.
摘要：
据报道，对apremilast和窄带（NB）-UVB联合治疗的临床反应可改善IV-VI型皮肤中的泛发性白癜风的色素沉着；然而，联合治疗与NB-UVB单药治疗的组织反应尚未阐明.我们比较了联合治疗与NB-UVB单药治疗后白癜风皮肤细胞和分子标志物相对于基线的变化。我们评估了来自登记受试者的皮损和非皮损样本，并评估了免疫浸润，炎症，和黑素生成相关标志物，在不同治疗组进行比较。联合治疗导致CD8+T细胞和CD11c+树突状细胞显著减少，PDE4B和Th17相关标志物的下调，和黑素生成标志物的上调。这项研究仅限于小样本量，皮肤类型IV-VI，高辍学率。我们的分子研究结果支持以下临床分析：apremilast可能会增强NB-UVB在IV-VI型皮肤中广泛性白癜风的色素沉着。
