ascorbic-acid and Vitiligo

Antioxidant status is considered as important factor in the pathogenesis of vitiligo. However, there are controversial findings about serum status of antioxidants in vitiligo patients. The purpose of this study was to systematically review the evidences comparing the serum levels of antioxidant vitamins and minerals between vitiligo patients and controls, and performing meta-analysis of the results.. A comprehensive search was performed for studies comparing the serum status of antioxidant vitamins and minerals using following databases since inception up to 30 April 2020; PubMed, EMBASE, Scopus, and Web of Science. Data extraction was done by two independent reviewers. The data was pooled for serum level of each antioxidant comparing between vitiligo and control groups.. Thirteen studies were included in this systematic review. The serum level of vitamin A, C, E, selenium, zinc and copper were compared between vitiligo patients and controls in these studies. Eleven studies including 570 vitiligo cases and 580 controls were included in the meta-analysis. Serum vitamin A and copper level in vitiligo patients were only evaluated in single studies and not included in meta-analysis. Based on fixed effect model, there were no statistical difference between two groups regarding serum vitamin C (OR = 1.17, 95 % CI, 0.74-1.84, P = 0.495), and vitamin E (OR = 0.61, 95 % CI, 0.30-1.25, P = 0.180). Higher serum zinc can decrease the risk of vitiligo based on sensitivity analysis of the results. (OR = 0.29, 95 % CI 0.15-0.54, P < 0.001). Higher serum selenium level significantly increased the risk of vitiligo (OR = 4.31, 95 % CI, 2.72-6.81, P < 0.001). Vitamin A was not significantly different in two reported groups (6.35 ± 1.53 vs 6.77 ± 1.46 μg/mL, P > 0.05). Copper was significantly higher in vitiligo patients compared to controls (129 ± 33 vs 99 ± 19 μg /100 mL, P = 0.002).. The current meta-analysis of data on serum level of most studied antioxidants (vitamin C, vitamin E, zinc and selenium) in patients suffering vitiligo showed that higher serum selenium (OR = 4.31) and lower zinc level (OR = 0.29) can increased the risk of vitiligo. Potential mechanism associated with preventive effects of zinc and the depigmentation effect of selenium should be more elucidated in further studies.

Topics: Antioxidants; Ascorbic Acid; Humans; Selenium; Trace Elements; Vitamin E; Vitamins; Vitiligo; Zinc

It has been suggested that vitamin C is involved in suppressing stress oxidation signaling in vitiligo disease. However, the effect of vitamin C supplementation on stress oxidative factors has not been investigated in vitiligo subjects. This study was designed to examine the effects on vitamin C supplementation on serum levels of stress oxidative factors and regimentation in vitiligo patients. Forty-four vitiligo patients will be recruited in this study. After block matching for sex and number of phototherapy sessions, they will be randomly assigned to receive 1000 mg/d vitamin C or placebo for 8 weeks. The weight, height, and waist circumference of participants will be measured. Determination of serum stress oxidative indices (CAT, SOD, GPX, MDA, TOS, TAC) will be done at study baseline and at the end of the trial. Also, the regimentation will be determined using the VASI score. This is the first randomized controlled trial that will determine the effect of vitamin C supplementation on serum levels of stress oxidative indices and regimentation in vitiligo patients. The results of this trial will provide clinical evidence on the effectiveness of vitamin C supplementation in controlling oxidative stress in vitiligo patients. Trial registration number: This study is registered in the Iranian Registry of Clinical Trials website (available at http://www.irct.ir , identifier: IRCT20230123057193N1), Registration date: 2023/04/17.

Topics: Ascorbic Acid; Humans; Hypopigmentation; Iran; Oxidative Stress; Skin; Vitiligo

Vitiligo is an acquired depigmenting disease with uncertain aetiopathogenesis, possibly associated with oxidative stress. Narrowband ultraviolet B phototherapy (NB-UVB) is the most widely used and effective treatment.. To evaluate the clinical effectiveness of NB-UVB and the repairing of oxidative stress-induced damage, using oral supplementation with an antioxidant pool (AP).. Patients (n = 35) with nonsegmental vitiligo were enrolled in a randomized, double-blind, placebo-controlled multicentre trial. The treatment group received, for 2 months before and for 6 months during the NB-UVB treatment, a balanced AP containing alpha-lipoic acid, vitamins C and E, and polyunsaturated fatty acids. The area and number of lesions, as well as some parameters of the oxidation-reduction (redox) status of the peripheral blood mononuclear cells (PBMCs) were estimated at the beginning, after 2 months, and at the end of the trial.. In total, 28 patients completed the study. After 2 months of AP supplementation, the catalase activity and the production of reactive oxygen species (ROS) were 121% and 57% of the basal values (P < 0.05 and P < 0.02 vs. placebo, respectively). The AP increased the therapeutic success of NB-UVB, with 47% of the patients obtaining > 75% repigmentation vs. 18% in the placebo group (P < 0.05). An increase in catalase activity to 114% (P < 0.05 vs. placebo) and decrease in ROS level of up to 60% (P < 0.02 vs. placebo) of the basal value was observed in PBMCs. Finally, the AP intake maintained the membrane lipid ratio (saturated : unsaturated fatty acids 1.8 : 3.1; P < 0.05), counteracting phototherapy-induced saturation.. Oral supplementation with AP containing alpha-lipoic acid before and during NB-UVB significantly improves the clinical effectiveness of NB-UVB, reducing vitiligo-associated oxidative stress.

Topics: Adult; Antioxidants; Ascorbic Acid; Combined Modality Therapy; Double-Blind Method; Drug Combinations; Female; Humans; Male; Middle Aged; Oxidation-Reduction; Severity of Illness Index; Skin Pigmentation; Thioctic Acid; Treatment Outcome; Ultraviolet Therapy; Vitamin D; Vitiligo

Vitiligo is a refractory disease in which treatment modalities are not yet established. We aim to assess results obtained 10 years after the initiation of a therapeutic protocol which combines very potent topical corticosteroids (TCS), vitaminotherapy (B12 and C), and suppression of microtraumas in the management of nonsegmental vitiligo in Madagascar.. It was a prospective and descriptive study over a period of 6 years (2011-2016) in the Department of Dermatology, Joseph Raseta Befelatanana, Antananarivo, Madagascar. The diagnosis of vitiligo was based on clinical data. Patients who agreed to follow the treatment protocol, which combined very potent TCS (two applications/day for 10 days, and then one application/day for the following 10 days), oral vitamin C 500 mg/day for 20 days, and oral vitamin B12 100 mg/day for 20 days, were included in the study. Two successive courses of treatment were made 10 days apart.. The details of 308 vitiligo patients were analyzed. The mean age of patients was 33.3 years. There was a female preponderance (sex ratio: 0.6). The duration of treatment in our patients varied from 3 to 18 months. Two hundred and thirty-nine patients had good therapeutic compliance and attended regular follow-up. Excellent repigmentation (more than 76% area repigmented) was noted in 50 patients (65.7%) less than 14 years of age. Lesions evolving in less than 1 year in 31 patients (36.9%) had excellent response to treatment. Localized lesions responded favorably to treatment with excellent repigmentation in 108 patients.. These results show that therapeutic response is better in young people, lesions less than 1 year of evolution, and for localization of vitiligo in the face and neck.

Topics: Administration, Oral; Adolescent; Adult; Age Factors; Ascorbic Acid; Child; Clobetasol; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Glucocorticoids; Humans; Madagascar; Male; Middle Aged; Prospective Studies; Skin Cream; Treatment Outcome; Vitamin B 12; Vitiligo; Young Adult

Currently accepted that oxidative stress is a triggering event in the melanocytic destruction and is probably involved in the etiopathogenesis of vitiligo disease. Despite numerous investigations, contradictory results were reported about the levels of oxidative stress biomarkers measured in the skin and blood of vitiligo patients. By Electron Paramagnetic Resonance spectroscopy (EPR) and spectrophotometry, we have investigated and compared some oxidative stress biomarkers in the blood of vitiligo patients' before and after UVB Narrow Band 311 nm phototherapy combined with the antioxidant nutritional supplement containing - Vitamin C, Vitamin B1, L -Cysteine, Lipoic Acid, and polyunsaturated fatty acids. Before therapy was found significantly higher levels of CAT activity and MDA compared to the patients after therapy and control group (p < 0.05). Moreover, levels of Asc* radicals in patients before therapy were significantly lower than those measured in controls and patients undergoing therapy (p < 0.05). Our finding, the combined therapy applied to vitiligo patients provoked an increase in the Asc* levels and a decrease in MDA products and also initial repigmentation in the vitiligo spots, made us believe that a combined antioxidant therapy, enriched with vitamin C could lead to improvement of the oxidant-antioxidant balance in vitiligo patients treated with UVB 311 phototherapy.

Topics: Antioxidants; Ascorbic Acid; Biomarkers; Catalase; Cysteine; Dietary Fats, Unsaturated; Female; Humans; Male; Malondialdehyde; Oxidative Stress; Phototherapy; Reactive Oxygen Species; Thiamine; Thioctic Acid; Vitamin E; Vitamins; Vitiligo

Despite of numerous investigations, carried out practically in all countries of the world for the study of vitiligo and the search for its new effective therapies, pathogenic mechanisms of vitiligo are still poorly understood, and the proposed treatments are not perfect. One of the most accepted theories of the pathogenesis of vitiligo is an oxidative stress theory, according to which a series of biochemical anomalies cause oxidative stress, leading to accumulation of melanocytotoxic substances and inhibition of natural processes of detoxification with subsequent destruction of melanocytes in vitiligo focus. On the other hand, the use of antioxidants in combination with ultraviolet therapy of dermatological diseases, has been theoretically proved by biophysical studies, according to which- the antioxidants inhibit the oxidation of products, formed in the skin after ultraviolet irradiation and greatly reduce erythema sensitivity (1.5-2 times). Due to this effect, the power of radiation exposure can be approximately increased many times. Based on the foregoing, the use of antioxidants during phototherapy of vitiligo pathogenetically is justified. The aim of the study was to evaluate the therapeutic efficacy of Se ACE in treatment of patients with various forms of vitiligo. 35 patients (23 women and 12 men) aged 18 to 40 years with duration of the pathological process from 2 months to 15 years were under observation. 17 of these were diagnosed with a form of non segmental vitiligo (NSV), 18- segmental vitiligo. In 11 patients onset of the disease was not connected with any other problem, 24 noted the appearance of white spots after stress. Vitiligo patients were divided into 2 groups: the study group and the group of comparison. The study group included 17 patients (9 women and 8 men) aged 18 to 40 years with duration of the disease from 2 months to 5 years. The comparison group consisted of 18 patients (10 women and 8 men). Distribution of patients in both groups was homologous by the sex, age, duration and clinical forms of dermatosis. All patients underwent phototherapy. In the study group Selenium was used as an antioxidant, which was administered at a dose of 1 capsule 2 times a day for a month. Phototherapy was performed by means of MEDlight OCTAderm (3 times per week, the course of treatment - 15 procedures). After a course of phototherapy in combination with Selenium (study group), 1 patient had complete regimentation, in 43.5%of patients with NSV wh

Topics: Adolescent; Adult; Antioxidants; Ascorbic Acid; Carotenoids; Combined Modality Therapy; Drug Combinations; Female; Humans; Lycopene; Male; Phototherapy; Selenium; Treatment Outcome; Ultraviolet Rays; Vitamin E; Vitiligo; Young Adult

Vitiligo is an acquired skin disease, characterized by white areas on the skin due to loss of functional melanocytes. The pathogenesis of the disease is still unclear. Published data show the involvement of oxidative stress in the pathophysiology of vitiligo. A total of 30 vitiligo patients and 30 healthy controls were included in this study. We estimated serum levels of malondialdehyde (MDA), vitamins E and C, total antioxidant activity and whole blood levels of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in vitiligo patients and controls. We found significantly higher levels of MDA and significantly lower levels of SOD, GPx, vitamins C and E and total antioxidant activity in vitiligo patients compared with controls. This study is a maiden attempt to report on antioxidant parameters of both generalized/localized-type Indian vitiligo patients. Our results confirmed that oxidative stress may play an important role in the pathogenesis of vitiligo and cause melanocyte damage in vitiligo.

Topics: Adult; Ascorbic Acid; Female; Glutathione Peroxidase; Humans; India; Lipid Peroxidation; Male; Malondialdehyde; Oxidative Stress; Pigmentation; Superoxide Dismutase; Vitamin E; Vitiligo

While oral psoralen plus ultraviolet A (PUVA) remains the most popular therapeutic modality for vitiligo, recent reports have shown that narrowband ultraviolet B (UVB) also induces significant repigmentation. In this study we evaluated the efficacy of broadband UVB on actively spreading, progressive vitiligo in patients who had been followed for many months (12 or more) in our practice, who continued to depigment despite treatment.. Nine patients with actively spreading vitiligo were exposed to broadband UVB 2-3 times per week at a starting dose of 20-30 mJ/cm(2). Radiation was increased by 10-20 mJ/cm(2) per session with adjustments for symptomatic erythema or missed visits. In addition, patients took vitamin C 500 mg twice a day (BID), vitamin B(12) 1000 microg BID and folic acid 5 mg BID. The response to treatment and side-effects were assessed at each visit. The patient's response to treatment and progress were assessed by photographs and by physician evaluation of body surface area (BSA) (using the Rule of 9s) involved at monthly intervals. Photographs were taken and estimations of BSA by physical examination made at the start and finish of the trial and then compared by the physicians involved in the study.. Broadband UVB halted the progression of vitiligo in all nine patients and in general induced repigmentation early after 8-12 treatments (6-8 weeks). After 2-8 months of treatment, nine of nine patients achieved good (51-75%) or excellent response (76-100%). The percentage of repigmentation varied with length of treatment and anatomic site.. This study confirms the only published report that broadband UVB is effective on actively spreading vitiligo. Since it is more cost effective than narrowband UVB and has numerous advantages compared to oral PUVA, broadband UVB may offer an alternative for future treatment of vitiligo. The role of vitamins in this therapy remains to be determined.

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Radiation Dosage; Risk Assessment; Sampling Studies; Severity of Illness Index; Treatment Outcome; Ultraviolet Therapy; Vitamin B 12; Vitiligo

When compared with the normal population, patients with vitiligo often showed diminished blood levels of folic acid. In a group of fifteen patients with vitiligo, folic acid levels were below normal in the serum of eleven patients, in the whole blood of five patients, and in the erythrocytes of six patients. Vitamin B12 serum levels were below normal in five of the fifteen patients. Ascorbic acid plasma levels were also lowered in four of the patients. In eight patients prolonged oral administration of folic acid with simultaneous parenteral treatment with vitamin B12 and oral ascorbic acid was followed by definite repigmentation without side effects.

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency; Vitiligo

Topics: Ascorbic Acid; Humans; Vitiligo

The ascorbic acid contents of skin, plasma and urine were estimated in 12 vitiligo cases, one albino and 10 normal subjects. All the estimations were repeated after saturation with ascorbic acid. There was no difference between the two groups with regard to the ascorbic acid contents of their plasma or urine. The ascorbic acid level of vitiliginous skin was decreased; however, this difference just falls short of significance at the level P = 0-05. Further investigations with a larger group of patients are indicated.

Topics: Albinism; Ascorbic Acid; Female; Humans; Male; Melanins; Pigmentation Disorders; Skin; Vitiligo

Topics: Adolescent; Adult; Ascorbic Acid; Chlorides; Creatinine; Female; Humans; Male; Middle Aged; Nitrogen; Sulfur; Uric Acid; Vitiligo

Topics: Adenosine Triphosphatases; Animals; Antioxidants; Ascorbic Acid; Dihydroxyphenylalanine; Guaiacol; Guinea Pigs; Histocytochemistry; Pigmentation; Skin; Skin Absorption; Skin Transplantation; Transplantation, Autologous; Tyrosine; Vitamin E; Vitiligo