Antioxidants and narrow band-UVB in the treatment of vitiligo: a double-blind placebo controlled trial

Authors

  • M. L. Dell'Anna,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • A. Mastrofrancesco,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • R. Sala,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • M. Venturini,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • M. Ottaviani,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • A. P. Vidolin,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • G. Leone,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • P. G. Calzavara,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • W. Westerhof,

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • M. Picardo

    1. San Gallicano Dermatological Institute, IRCCS, Rome, Italy; *Spedali Civili, Brescia, Italy; and †Netherlands Institute for Pigment Disorders, Amsterdam, the Netherlands
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  • Conflict of interest: none declared.

Dr Mauro Picardo, San Gallicano Dermatological Institute, Via San Gallicano 25/A, 00100 Rome, Italy.
E-mail: citolab@ifo.it

Summary

Background.  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.

Aim.  To evaluate the clinical effectiveness of NB-UVB and the repairing of oxidative stress-induced damage, using oral supplementation with an antioxidant pool (AP).

Methods.  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 α-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.

Results.  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.

Conclusions.  Oral supplementation with AP containing α-lipoic acid before and during NB-UVB significantly improves the clinical effectiveness of NB-UVB, reducing vitiligo-associated oxidative stress.

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