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Vitiligo skin disorder could yield clues in fight against melanoma

MAYWOOD, Ill. About 1 million Americans suffer a skin disorder called vitiligo, which causes unsightly white patches on the face, hands and other parts of the body.

A Loyola University Hospital researcher has won a five-year, $1.7 million federal grant to investigate a new way to treat vitiligo. This research also could point the way to new treatments for melanoma, the deadliest form of skin cancer.

Vitiligo appears to be an auto-immune disease, in which the immune system goes into overdrive and kills pigment cells, which give skin its color. Loyola researcher Caroline Le Poole, PhD, is studying how to stop vitiligo. The goal is to adjust the immune system so that it stops attacking pigment cells. Conversely, melanoma would be treated by revving up the immune system to attack malignant pigment cells.

"Things we learn from vitiligo could apply to melanoma, and vice versa," Le Poole said. Le Poole is an associate professor in the Oncology Institute of Loyola University Chicago Stritch School of Medicine.

Although melanoma accounts for less than 5 percent of skin cancers, it is responsible for most of the skin cancer deaths. There will be more than 62,000 new melanoma cases in the United States this year, and more than 8,000 deaths, the American Cancer Society said.

Vitiligo (vit-ill-EYE-go) affects about 0.5 percent of the world's population. It affects both sexes and all races. However, "the darker the skin, the more noticeable it is," said Loyola dermatologist Dr. Anthony Peterson, an assistant professor at Stritch. "The contrast is what people notice."

In the most common form of vitiligo, white patches form on both sides of the body. In 1993, singer Michael Jackson told Oprah Winfrey he has symptoms consistent with vitiligo. Last year, Lee Thomas, an African American TV anchor/reporter in Detroit, published a memoir about vitiligo titled "Turning White."

Vitiligo also can be distressing to Caucasians. Cathy Kalnicky, 47, has had vitiligo since she was 30. It's on her face, arms, legs and hands. The patches are more noticeable during the summer, when Kalnicky develops a deep tan while watching her three daughters play softball. "I get a lot of questions when I'm out in public," she said. "And some occasional stares."

Kalnicky, a registered nurse at Loyola, has provided skin cell samples for Le Poole's research. "It would be really nice if there was a way to stop vitiligo," Kalnicky said.

Steroid creams return some color to affected skin. But this treatment also thins the skin, and can cause streaks or lines. Bright lights, similar to tanning booths, also can return color, but can cause sunburns and other side effects. Skin grafts transfer skin from unaffected areas to the white patches, but can be painful and expensive, Peterson said.

None of the existing treatments prevent vitiligo from progressing. But the approach Le Poole is studying potentially could stop vitiligo in its tracks.

In people who are susceptible to vitiligo, an injury to the skin, such as sunburn, can trigger pigment cells to generate stress proteins. Immune cells absorb these proteins and, in turn, signal killer T cells to destroy pigment cells.

Le Poole hopes to throw a wrench into this overactive immune response. In collaboration with Assay Designs, Inc. of Ann Arbor, Mi., she is developing blockers that would stop immune cells from absorbing stress hormones and triggering the immune response.

"An active immune response can be bad for vitiligo patients, but good for melanoma patients," Le Poole said. "We hope to be able to adjust the immune system in ways that would benefit both groups of patients."


Contact: Jim Ritter
Loyola University Health System

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