| Background:Vitiligo is a common skin disease characterized by acquired depigmented macules.The disease can occur at any age, often in childhood or adolescence, limited or extensive,and the worldwide prevalence rate is 1%-2%, while that of our country is 0.1%-2.7%. Its etiology and pathogenesis are not completely clear, the autoimmunity theory is agreed by most scholars. Numerous studies have shown that the T cells involves the melanocyte destruction of patients with vitiligo, and the cellular immunity play an important role in the pathogenesis of vitiligo. The patients with vitiligo always have other autoimmune diseases,among which the autoimmune thyroid disease has the highest concomitant rate. Studies have shown that TPOAb and TGAb positive rates of patients with vitiligo are significantly higher than that of healthy people, while the change of thyroid hormone levels is debatable.In addition, there are gender differences in most autoimmune diseases; sex hormone is not only the root cause of gender difference, and it will affect the body’s immune system as a kind of neuroendocrine hormone that is related to most autoimmune diseases. Some reports show that the prolactin of patients with vitiligo is higher than that of healthy people, and there is no report about the correlation between sex hormones and vitiligo at home and abroad.Objective:This study aims to further discuss the correlation between the vitiligo and cell-mediated immunity, autoimmune thyroid disease, sex hormone concentrations through testing the peripheral blood T cell subset proportion, thyroid hormones level, TPOAb and TGAb and sex hormone level of patients with vitiligo, in order to provide scientific theoretical basis for determining the vitiligo pathogenesis and its early intervention.Method:1. Research object: 52 cases adult patients with vitiligo in Suzhou University Affiliated First People’s Hospital from October 2013 to October 2014, and 50 cases ofhealthy people of the same age and gender. All patients have no treatment history of vitiligo 3 months before the visit, 28 male cases(53.85%), 24 female cases(46.15%) with an average age of 35.48±12.36.2. Methods: Design the clinical enumeration form of patients with vitiligo, including name, contact phone number, gender, age, clinical classification, staging, course of the disease, skin lesion part, lesion area, family history, other immune or systemic disease history and laboratory results. Test the cellular immunity, thyroid hormone level, TPOAb,TGAb and sex hormone levels of all research objects. Use the flow cytometry to test the proportion of CD3+, CD4+, CD8+, CD3-CD19+, CD(16+56)+ in the peripheral blood lymphocytes and the ratio of CD4+/CD8+; use the electrochemical luminescence method to detect T3, T4, FT3, FT4, TSH, TPOAb and TGAb level in serum, use chemiluminescence method to test the LH, FSH, T, PRL, Pg, E2 level in serum. Compare according to the stage, parting, and gender.3. Statistical analysis: all data adopts SPSSl2.0 software for χ2test and t test. P<0.05 is the difference with statistical significance.Result:1. Cell-mediated immunityIn the vitiligo group, CD4+, CD4+/CD8+ is significantly lower than that of healthy control; CD8+, CD(16+56)+is significantly higher than that of healthy control, and the remaining indicators have no statistical significance; compared to the patients with vitiligo in stable phase, peripheral blood CD4+, CD4+/CD8+of the patients with vitiligo in progressive stage is significantly lower; there is no significant statistical differences between the common type and segmental type; in the common type, universal CD4+/CD8+is significantly lower than that of local and sporadic type; CD8+ increases more than local type, CD4+is lower than sporadic type; there is no obvious difference among other types.2. Thyroid function and thyroid autoantibodySerum TSH level of patients with vitiligo is obviously higher than that of healthy control group, and other indicators have no statistical significance; there is no significant statistical difference of the patients between the progressive stage and the stable stage.Commom type vitiligo TSH is significantly higher than the segmental type; in common type, the local T4 is significantly higher than in acra and sporadic type, and others have no obvious difference; peripheral blood TPOAb and TGAb positive rate of patients withvitiligo is significantly higher than that of healthy controls, and the positive rate of female patients with vitiligo is significantly higher than that of male.3. Sex hormone concentrationsSerum estradiol and progesterone level of adult male patients with vitiligo are relatively higher than that of healthy people, and there is no statistical difference for the remaining sex hormone concentrations. There is no statistical difference between the progressive stage and stable stage, and between the segment type and common type, and among all kinds of common type. Serum estradiol of adult female patients with vitiligo in follicular phase is significantly higher than that of healthy control; serum estradiol and progesterone luteal in luteal phase is significantly higher than that of healthy control;testosterone in menopause is significantly lower than that of healthy controls, and there is no statistical difference of the remaining sex hormone concentrations.Conclusion:1. Patients with vitiligo have obvious cell dysimmunity, and the pathogenesis may be related to it.2. Vitiligo is closely related to the autoimmune thyroid disease.3. Progesterone and estradiol may affect the attack and development of vitiligo. |
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