ADVERSE COURSE OF VITILIGO:MANAGEMENT TACTICS OF PATIENTS FROM RISK GROUPS

Abstract

Introduction. Vitiligo is one of the most common hypomelanoses, in which the destruction of functioning melanocytes
causes depigmentation of the skin, hair and mucous membranes. The genes encrypting brain-derived neurotropic factor
(BDNF) and corticotropin-releasing hormone (CRH) might be the conceivable contributors to the development of vitiligo.
Objective. This study was aimed at investigation of the association between psychoemotional disorders,
neurotransmitters and their gene polymorphism with the area of depigmentation in patients with vitiligo in order to identify risk
groups for the progressive course of the disease and develop an algorithm. 

Materials and methods. The study included 93 patients with vitiligo. The area of depigmentation was calculated using
the Vitiligo Extent Score (VES) online program. The psychological status of the participants was assessed using the PHQSADS scale. Serum levels of BDNF and CRH were measured by enzyme-linked immunosorbent assay (ELISA) technique.
Genotyping for the rs11030094 polymorphism of the BDNF gene and rs242924 of the corticotropin-releasing hormone
receptor 1 (CRH-R1) gene was performed by real-time polymerase chain reaction (PCR).
Results. Our investigation showed that the T allele and the TT genotype of the CRH-R1 rs242924 gene polymorphism at
3-4 times increase the risk of a progressive course of the vitiligo, while the G allele and the GT genotype, on the contrary,
indicate its resistance. In addition, patients with mild and moderate anxiety were in 1.6 times more likely to progress the
disease.
Conclusion. Thus, the T allele and TT genotype of the CRH-R1 rs242924 gene polymorphism mediated by anxiety may
be factors in the progressive course of vitiligo. The results of the study of the psychological status and neurogenetic features
of the presented sample made it possible to develop an algorithm for managing patients with a progressive course of vitiligo.