| Objective:Vitiligo is a skin disease that can occur at any age and anywhere in the body.It is a depigmented disease caused by the disorder of melanin synthesis.Due to the impact of white plaques lesions on beauty,mental health and normal life of patients has caused great trouble,affecting daily living activities and interpersonal relationships,a large number of patients with vitiligo have depression symptoms,so we still need to seek effective treatment.Lack of copper ions will affect the activity of tyrosinase,so that it is reduced or disappeared,tyrosinase as a key enzyme to generate melanin,thereby affecting melanin metabolism,leading to the occurrence of disease.Local and external application of GHK-Cu can locally supplement copper ions,and has no side effects.The purpose of this study was to provide a new scientific basis for seeking safe and efficient drug therapy for patients with vitiligo by studying the effect of tyrosinase activity and the clinical efficacy and safety of GHK-Cu gel.Methods:Experimental part: Samples were prepared with 0.08%,0.2%,0.4%,0.8%,2%,4%,8%GHK-Cu solution,10 mg/ml,8 mg/ml,6 mg/ml,4 mg/ml cupric displacement solution（GHK-Cu 0.1% combined with cupric sulfate 0.5%）,cupric displacement and weah dew original solution.Add sample solution 50μL,tyrosinase solution 30μL and L-tyrosine solution 100μL to the 96-well plate,and measure the absorbance（OD value）at 475 nm with a microplate reader,and compare the OD values of different samples.Clinical part: a total of 80 patients with vitiligo were selected,who were admitted to the dermatology department of our hospital from September 2019 to April 2021,divided into the GHK-Cu group（n = 40）and combined use group（n = 40）.The therapeutic effects of 12 weeks and 24 weeks were observed,and the differences of therapeutic effects among different groups were compared.The basic information of the patients was recorded to analyze whether the patients’ age,gender,classification,stage,course of disease,invasion site,family history were correlated with the treatment effect of vitiligo.Patients returned every three months,before the first treatment,every three months at the time of the return visit of vitiligo patients were photographed,while the treatment effect,adverse drug reactions and other conditions were recorded,and the efficacy was evaluated.Statistical software SPSS23.0 was used for statistical analysis.P < 0.05 showed statistical difference.Results:The OD value of 0.08% GHK-Cu solution is 0.0238,The OD value of 0.2%GHK-Cu solution is 0.0301,0.4% GHK-Cu solution is 0.0328,0.8% GHK-Cu solution is0.0421,2% GHK-Cu solution is 0.0373,4% GHK-Cu solution is 0.0305,8% GHK-Cu solution is 0.0291.The OD value of 10 mg/ml copper-flooding solution is 0.055,that of 8mg/ml copper-flooding solution is 0.0396,that of 6 mg/ml copper-flooding solution is0.0373,that of 4 mg/ml copper-flooding solution is 0.0298.The OD value of the GHK-Cu gel combined with weah dew is 0.0735,and that of weah dew is 0.0171.After 12 weeks of treatment,in the combined use group,4 cases were cured,7 cases were obviously effective,12 cases were improved,and 17 cases were ineffective,with an effective rate of 57.7%.In the GHK-Cu group,2 cases were cured,2 cases were obviously effective,10 cases were improved,and 26 cases were ineffective.The effective rate was35.0%.The effective rate of GHK-Cu combined with weah dew group was significantly higher than that of GHK-Cu group（57.7% > 35.0%）,and the rank-sum test showed that P=0.001（P < 0.05）,and the difference in efficacy between two groups was statistically significant.After 24 weeks of treatment,in the combined use group,5 cases were cured,9cases were significantly improved,16 cases were improved,and 10 cases were ineffective,with an effective rate of 75.0%.In GHK-Cu group,4 cases were cured,2 cases were obviously effective,13 cases were improved,21 cases were ineffective,the effective rate was 47.5%.The effective rate of GHK-Cu combined with weah dew group was significantly higher than that of GHK-Cu group（75.0% > 47.5%）,and the rank-sum test showed that P=0.001（P < 0.05）,and the difference in efficacy between the two groups was statistically significant.The rate of adverse reaction was 5.0% in the combined group.There were no adverse reactions in the white copper flooding group.The adverse reaction of weah dew was greatly reduced when combined with GHK-Cu.Conclusion:By comparing the OD difference of each sample in the laboratory,it can be found that GHK-Cu can promote the activity of tyrosinase when the concentration of GHK-Cu is0.08%-8%,and when the concentration is between 0.8%-2%,the promotion effect is the strongest.Copper flooding solution can promote the activity of tyrosinase,and different concentrations of copper ions have different effects on the activity of tyrosinase,the higher the concentration,the stronger the promotion effect.The effect of weah dew combined with GHK-Cu drive on the activity of tyrosinase was greater than that of weah dew alone.The clinical effective rate of GHK-Cu combined with weah dew was significantly higher than that of GHK-Cu alone,and the combined medication had definite efficacy.Meanwhile,GHK-Cu had skin repair effect,and the adverse reactions caused by weah dew were reduced when combined,and debridement of weah dew alone was safe and effective in the treatment of vitiligo,which could repair the damaged skin to a certain extent. |
