Effect of melanocyte keratinocyte transplantation procedure, using ablative CO2 laser and followed by NB-UVB phototherapy, on the expression of E-Cadherin and matrix metalloproteinase-2 in acral vitiligo: an immunohistochemical study

Abstract

Background Melanocyte keratinocyte transplantation procedure (MKTP) is a multi-procedural intervention that could hypothetically alter the environment surrounding grafted epidermal cells, helping melanocytes’ migration and adherence to keratinocytes in their basal position. Objective To evaluate the effect of MKTP in acral vitiligo skin prepared by total ablative CO2 laser resurfacing and followed by narrow-band ultraviolet B (NB-UVB) phototherapy on matrix metalloproteinase-2 (MMP2) and E-Cadherin expression and the reflection of these changes on repigmentation. Patients and methods Acral lesions in 20 stable nonsegmental vitiligo patients were prepared by full CO2 ablation down to the papillary dermis followed by MKTP and NB-UVB sessions. Two 4 mm punch biopsies were taken: the first at baseline and the second after the onset of repigmentation or after 6 months of phototherapy if no repigmentation occurred. Immunohistochemical staining for evaluation of E-Cadherin and MMP2 expression was performed. Results Eight patients (40%) achieved repigmentation ranging from 10 to 90% with a median of 62.5%. E-Cadherin intensity was significantly increased after treatment (P<00.1). There was also a significant total increase in epidermal (P<0.001) and dermal (P<0.001) MMP2 with diffuse nuclear pattern of staining. In lesions showing repigmentations, the percentage change in dermal MMP2 was significantly higher (P=0.012), while no such difference was present in epidermal MMP2 and E-Cadherin expression. Conclusion MKTP with recipient site prepared by full CO2 laser ablation followed by NB-UVB phototherapy increased the expression of E-Cadherin and MMP2 in acral vitiliginous skin. The increase of dermal MMP2 could play a favorable role in repigmentation.