Comparison of the effect of 8-methoxypsoralen (8-MOP) plus UVA (PUVA) on human melanocytes in vitiligo vulgaris and in vitro.

In this study, we examined the various effects of PUVA treatment on cultured human melanocytes, and it revealed that 1) the higher the dose of PUVA treatment, the more significant the inhibition of cell DNA and protein synthesis; 2) the higher the dose of PUVA treatment, the more significant the depletion of epidermal growth factor receptor (EGFR) expression; 3) PUVA treatment at 124 mJoule/cm2 depleted the vitiligo-associated melanocyte antigens (VAMA) immediately after irradiation, and both the VAMA and EGFR expression progressively recovered at 24 or 72 h after PUVA; 4) PUVA treatment stimulated tyrosinase activity, but not in a dose-dependent fashion. In vitiligo vulgaris, PUVA treatment may stimulate the regrowth of melanocytes from hair follicles, but deplete the epidermal Langerhans cells in depigmented lesion of patients with stable vitiligo. Comparing the above results obtained from in vivo and in vitro studies, it reveals significantly different biologic responses. Although the precise therapeutic mechanism of PUVA treatment in vitiligo is still not well known, it is proposed that 1) PUVA treatment may stimulate the other components of skin, such as keratinocytes, to release inflammatory mediators and some of them may act as melanocyte growth-stimulatory factors (MGSF), which further enhance the proliferation of remaining melanocytes in hair follicle; and 2) PUVA treatment may deplete the VAMA expression on cell membrane of melanocytes and also deplete epidermal Langerhans cells, which may result in blocking the progressing of antibody-dependent cell-mediated cytotoxicity to melanocytes in vitiligo.