Assessment of Serum CXCL10 in the Sera of Patients with Active Vitiligo before and after Treatment with Oral Mini-Pulse Steroid Therapy versus Parenteral Corticosteroids Therapy: An Interventional Prospective Clinical Study

Abstract Background Vitiligo is the most common depigmenting skin disorder. The complexity of its pathogenesis, influenced by genetic factors, oxidative stress and abnormal cell adhesion that collectively impact melanocyte survival and trigger immune system attacks, resulting in melanocyte death. Melanocytes in vitiligo are believed to exhibit genetic susceptibility and defects in cellular mechanisms, such as defects in autophagy, that reduce their ability to resist oxidative stress. leading to increased expression of the pro-inflammatory protein HSP70. The low expression of adhesion molecules, such as DDR1 and E-cadherin, accelerates melanocyte damage and antigen exposure. Consequently, autoimmune attacks centered on IFN-γ-CXCR9/10-CXCR3-CD8+ T cells are initiated, causing vitiligo Objective To study the difference between weekend oral mini-pulse steroids or depot triamcinolone acetonide injection given every 3 weeks in stabilization of active vitiligo by measuring serum level of CXCL10 Methods This study was an interventional prospective clinical trial study that included 46 cases with active vitiligo divided as 23 cases in group A received low dose oral minipulse dexamethasone 2.5 mg on two consecutive days per week and 23 cases in group B received IM triamcinolone acetonide injection every 3 weeks. Both groups were evaluated at baseline, 4,8 and 12 weeks using activity scores as VIDA, VASI, VES, Score/7and at laboratory level by measuring serum CXCL10 Results When comparing both regimens as regarding halting vitiligo activity, both treatments could stop disease activity as assessed by activity scores and serum level of CXCL10 this effect was as early as week 4 in both groups with no statistically significant difference Conclusion We concluded that the level of CXCL10 was elevated in active vitiligo patients and decreased after the treatment with systemic steroids both low dose oral minipulse dexamethasone and Triamcinolone acetonide intramuscular injection. These findings may point to the role of CXCL10 in the activity of vitiligo which should be furtherly investigated