Clinical Observation And The Effect To Vitiligo Lesions TNF-αof Calcineurin Inhibitors In The Treatment Of Vitiligo

Objective A open study to observe the efficacy of tacrolimus and pimecrolimus in the treatment of vitiligo,and part of the cases included a self-control study to compare the efficacy of the two drug, and investigated the effect of tarcolimus in the secretion of cytokines from the vitiligo lesion keratinocytes.Methods Tacrolimus twice daily,pimecolimus twice a day,to observe and compare of the efficacy of two drugs in the treatment of vitiligo.To investigated the effect of tarcolimus in the secretion of cytokines TNF-α、IL-1β、IL-6、IFN-γ、TGF-β from the vitiligo lesion keratinocytes by ELISA.Result In tacrolimus,there was significantly different in face or neck and truck vitiligo. In lesion area,there was significantly differences respectively compareed with2-9cm2group and>9cm2group in tacrolimus.the effect of topical tacrolimus was no related to the type,the installments and the duration of vitiligo. In pimecolimus,there was significantly different in face or neck and truck vitiligo,and the efficacy of active vitiligo was significantly better than stable vitiligo.The duration<1year group was better efficacy than the duration≥1year group in pimecolimus,and the effect was no related to the installments.,and the<1cm2group was better than>5cm2group in pimecolimus.In tacrolimus and pimecolimus control group, there was significant difference in the>50%efficacy of two drugs,tacrolimus was better efficacy than pimecolimus in the vulgaris vitiligo group, and the stabled vitiligo. FK506reduce the secretion of TNF-a of the lesion keratinocytes,and no change of IL-1β、IL-6、TNF-α、 IFN-γ、TGF-β.Conclusion Two topical calcineurin inhibitors is an effective and well-tolerated therapy for vitiligo especially involving the head and neck and small area lesion,and the efficacy is no retated to the type of vitiligo.In the self-control study tacrolimus was better efficacy than pimecolimus in the vulgaris vitiligo group, and the stabled vitiligo.FK506reduced the secretion of TNF-a produced by cultured vitiligo lesion keratinocytes,which may be one of the mechanisms of tacrolimu in the of vitiligo.