PDF(Pubmed)
Abstract：
BACKGROUND: Surgical intervention is the main therapy for refractory vitiligo. We developed a modified autologous cultured epithelial grafting (ACEG) technique for vitiligo treatment. Between January 2015 and June 2019, a total of 726 patients with vitiligo underwent ACEG in China, with patient characteristics and clinical factors being meticulously documented. Using a generalized linear mixed model, we were able to assess the association between these characteristics and the repigmentation rate.
RESULTS: ACEG demonstrated a total efficacy rate of 82.81% (1754/2118) in treating 726 patients, with a higher repigmentation rate of 64.87% compared to conventional surgery at 52.69%. Notably, ACEG showed a better response in treating segmental vitiligo, lesions on lower limbs, age ≤ 18, and stable period > 3 years. A keratinocyte:melanocyte ratio below 25 was found to be advantageous too. Single-cell RNA sequencing analysis revealed an increase in melanocyte count and 2 subclusters of keratinocytes after ACEG, which remained higher in repigmented sites even after 1 year.
CONCLUSIONS: ACEG is a promising therapy for refractory vitiligo. Patient age, clinical type, lesion site, and stability before surgery influence repigmentation in ACEG. The mechanism of repigmentation after ACEG treatment is likely not confined to the restoration of melanocyte populations. It may also involve an increase in the number of keratinocytes that support melanocyte function within the affected area. These keratinocytes may aid the post-transplant survival and function of melanocytes by secreting cytokines and extracellular matrix components.
BACKGROUND: registered with Chictr.org.cn (ChiCTR2100051405).
RESULTS: ACEG demonstrated a total efficacy rate of 82.81% (1754/2118) in treating 726 patients, with a higher repigmentation rate of 64.87% compared to conventional surgery at 52.69%. Notably, ACEG showed a better response in treating segmental vitiligo, lesions on lower limbs, age ≤ 18, and stable period > 3 years. A keratinocyte:melanocyte ratio below 25 was found to be advantageous too. Single-cell RNA sequencing analysis revealed an increase in melanocyte count and 2 subclusters of keratinocytes after ACEG, which remained higher in repigmented sites even after 1 year.
CONCLUSIONS: ACEG is a promising therapy for refractory vitiligo. Patient age, clinical type, lesion site, and stability before surgery influence repigmentation in ACEG. The mechanism of repigmentation after ACEG treatment is likely not confined to the restoration of melanocyte populations. It may also involve an increase in the number of keratinocytes that support melanocyte function within the affected area. These keratinocytes may aid the post-transplant survival and function of melanocytes by secreting cytokines and extracellular matrix components.
BACKGROUND: registered with Chictr.org.cn (ChiCTR2100051405).
摘要：
背景：手术干预是难治性白癜风的主要治疗方法。我们开发了一种改良的自体培养上皮移植（ACEG）技术用于白癜风治疗。2015年1月至2019年6月，中国共有726例白癜风患者接受了ACEG，精心记录患者特征和临床因素。使用广义线性混合模型，我们能够评估这些特征与色素沉着率之间的关联.
结果：ACEG治疗726例患者的总有效率为82.81％（1754/2118），与常规手术的52.69％相比，色素沉着率为64.87％。值得注意的是,ACEG在治疗节段性白癜风方面表现出更好的反应，下肢病变,年龄≤18岁，稳定期>3年。发现低于25的角质形成细胞:黑素细胞比率也是有利的。单细胞RNA测序分析显示，ACEG后黑素细胞计数和2个角质形成细胞亚簇增加，即使在1年后，色素沉着部位仍然较高。
结论：ACEG是治疗难治性白癜风的一种有希望的治疗方法。患者年龄,临床类型,病变部位,手术前的稳定性会影响ACEG的色素沉着。ACEG治疗后色素沉着的机制可能不限于黑素细胞群的恢复。它还可能涉及支持受影响区域内黑素细胞功能的角质形成细胞数量的增加。这些角质形成细胞可以通过分泌细胞因子和细胞外基质成分来帮助移植后黑素细胞的存活和功能。
背景：已注册Chictr.org。cn(ChiCTR2100051405)。
结果：ACEG治疗726例患者的总有效率为82.81％（1754/2118），与常规手术的52.69％相比，色素沉着率为64.87％。值得注意的是,ACEG在治疗节段性白癜风方面表现出更好的反应，下肢病变,年龄≤18岁，稳定期>3年。发现低于25的角质形成细胞:黑素细胞比率也是有利的。单细胞RNA测序分析显示，ACEG后黑素细胞计数和2个角质形成细胞亚簇增加，即使在1年后，色素沉着部位仍然较高。
结论：ACEG是治疗难治性白癜风的一种有希望的治疗方法。患者年龄,临床类型,病变部位,手术前的稳定性会影响ACEG的色素沉着。ACEG治疗后色素沉着的机制可能不限于黑素细胞群的恢复。它还可能涉及支持受影响区域内黑素细胞功能的角质形成细胞数量的增加。这些角质形成细胞可以通过分泌细胞因子和细胞外基质成分来帮助移植后黑素细胞的存活和功能。
背景：已注册Chictr.org。cn(ChiCTR2100051405)。
