Prostaglandin E2 based vitiligo treatment
Prostaglandin E2 is of the prostaglandins, a group of hormone-like substances that participate in a wide range of body functions such as the contraction and relaxation of smooth muscle, the dilation and constriction of blood vessels, control of blood pressure, and modulation of inflammation.
Prostaglandin E2 (PGE-2) is released by blood vessel walls in response to infection or inflammation that acts on the brain to induce fever. The enzyme mPGES-1 is involved in the production of PGE2 and is an important “switch” for activating the fever response.Prostaglandin E2 (PGE2) has stimulant and immunomodulatory effects on melanocytes and regulates their proliferation. In order to study the efficacy and safety of topical PGE2 in treating stable vitiligo patches involving less then 5% body surface here is what researchers from the Lokmanya Tilak Municipal General Hospital, Dept. of Dermatology in Mumbai, India experimented:
“Fifty-six consecutive patients with clinically diagnosed stable vitiligo of types vulgaris, focal, segmental, lip and genital applied a translucent PGE2 (0.25 mg g(-1)) gel twice daily for 6 months. Evaluation was fortnightly for 3 months and monthly thereafter up to 6 months. Assessment was based on degree of repigmentation in treated patches ranging from 0% (no change) to 100% (complete repigmentation). Overall response was graded as: poor, 1-25% repigmentation; moderate, 26-50%; good, 51-75%; excellent, >75%. Vitiligo vulgaris was the most common type (n=22; 39%), followed by focal and lip vitiligo, with lesions being mostly on the face (25%) and lips. Repigmentation was seen in 40 of 56 patients (71%), with mean onset at 2 months. Patients with disease duration of 6 months or less repigmented best, with face and scalp responding earliest (1-1.5 months). Complete clearance occurred in eight of 40 patients, six of the eight having face lesions. Excellent response was seen in 22 of 40 patients. All neck, scalp and trunk lesions, 33% genital, 29% lip vitiligo, 100% segmental and 63% focal patches showed moderate to excellent response. Incidence of side-effects was 18%, mainly a transient burning sensation especially on the lips,”
They concluded that:
“The efficacy and safety of topical PGE2 make it a promising therapy for localized stable vitiligo.”
Source: British Journal of Dermatology (Evaluation of safety and efficacy of topical prostaglandin E2 in treatment of vitiligo. British Journal of Dermatology, 2009;160(4):861-3).