Day 1 :
Keynote Forum
Jing Shang
China Pharmaceutical University, China
Keynote: The pathogenetic analysis of HPA axis regulated skin disorders new inspiration on related drug development
Biography:
Jing Shang is a Professor of Pharmacology working on the evaluation of Natural Medicine for decades. Her initial interest started in 2000 when she accomplished her PhD degree in Free University of Berlin in Germany. She is the Academic Leader of State Key Laboratory of Natural Medicines. She has published 100 papers, including 24 SCI papers in journals of pharmacology and related fields such as Hepatology, Free Radical Biology and Medicine and Diabetes/Metabolism Research and Reviews. She owns seven patents and completes the preclinical study of three Chinese traditional medicines and natural drugs. She is the Deputy Director of Center for Drug Screening in China Pharmaceutical University. She is the Secretary General of Applied Pharmacology Committee, Chinese Pharmaceutical Association. She is also a Member of the Deutsch-Chinesische Dermatologische Gesellschaft.
Abstract:
Skin disease belongs to a complex disease, such as vitiligo, psoriasis, alopecia areata, atopic dermatitis, etc. Its specific mechanism is so far unclear. There is a great difficulty in treatment, enough to cause much pain to the patient. Skin is as the largest organ of the human body. Its existence is not just for the body barrier to the outside threatened homeostasis and the skin and its accessories is widely innervated, the sensory nerve in the skin is directly upward to the cerebral cortex. The skin can be independent to synthetize and secret the stress hormones to maintain local and systemic homeostasis and is also one of the biggest target organs of these hormones. Taken together, the skin is as the body's largest neuroendocrine and immune organs. Clinical survey found that the onset and development of many skin diseases were closely related to mental factors. A variety of skin diseases are contributed to the liability under psychological stress, such as urticant, atopic dermatitis, urticaria, psoriasis, acne, hair loss, etc. Mental stress can induce or aggravate the skin disorders. Psychological soothing and keeping a good state of mind can both help to alleviate these diseases. Now, for the pathogenesis analysis of these diseases, a preliminary study suggests that these skin diseases including psoriasis, vitiligo, alopecia areata, atopic dermatitis, etc., indeed have associations with mental stress. When the body responds to mental stress, the skin will present a corresponding change, such as hot flashes, sweating, etc. In addition to these visible external reactions, we also found that the skin showed significantly increased immune cells and mast cell degranulation. Large number of experimental and clinical studies proved that mental stress involved in the development and progression of many skin diseases. In response to mental stress, the body starts the hypothalamus pituitary adrenal (HPA) axis to combat stress conditions. Meanwhile, skin has its own HPA axis to respond to external stress and regulate skin function such as melanogenesis. Therefore, there is a problem that how HPA axis mediates the effect of mental stress on skin function, so as to promote the occurrence and development of skin diseases. To study the skin's response in face of mental stress and to explore the etiology and pathogenesis of skin diseases related to mental factors, it is of great significance and importance to the exploration of treatment targets and methods involved in skin disease. This topic aims to study on the role of HPA axis in mental stress affecting skin functions and investigate the mechanism of natural medicine HZCZ for regulating skin functions in a multi-target manner. This study provides a new idea of drug development for complex disease.
- Vitiligo treatment and therapy l Skin pigmentation disease l Vitiligo and associated auto immune disease l Diagnostic and clinical analysis l Tissues grafting of vitiligo l Skin Diseases and Vitiligo
Session Introduction
Pranab Kumar Das
University of Amsterdam, Netherlands
Title: An enigmatic disease by the name of vitiligo: Autoimmune manifestation
Biography:
Pranab Kumar Das has received his PhD degree in Biochemistry from London University in 1969 and gained extensive research and teaching experiences in different countries globally and finally settled down in Immunological Research in Netherlands covering diverse field with a focus on the inflammation and immunity. One of his main interests had been skin diseases such as leprosy and idiopathic diseases like vitiligo and psoriasis and skin cancer. He has developed a strong interest in correlating tissue reactivity and systemic immunity of hosts. He has published more than 230 articles in peer viewed journals and book chapters in diverse field of life/medical sciences. He is retired in 2006 but still active in Honorary capacity.
Abstract:
Vitiligo is characterized by complete loss of UV protective pigment producing cells melanocytes. Due to the appearance of white depigmented patches causing ugly look, the disease, though not life threatening, could be psychologically debilitating despite the demonstration of the presence of mild inflammatory infiltrate in the skin paralleling the loss of melanocytes, vitiligo is not an inflammatory dermatoses. Interestingly, however, the disease is often associated with the presence of classical autoimmune diseases in the same patient. Various theories on the etiology of vitiligo are discussed among the experts. Since last decade the autoimmune mechanism is being subscribed by the investigators. Indeed, our own work demonstrated that the loss of melanocytes in some vitiligo patients is caused most likely by melanocyte specific autoreactive T cells and in addition, in some patients auto-antibodies against melanocytes can also be demonstrated. Nevertheless, vitiligo as such is not always perceived as one of the classical autoimmune diseases. However, studying vitiligo as a model autoimmune disease has opened up to develop novel therapeutics for melanoma. Various investigators had been investing much effort during last decade in designing targeted therapeutics with debatable success. This presentation would attempt to summarize and discuss some of the results in literature, including our own and those of the collaborators to have fresher look in this respect.
Pieter Spee
FibroTx LLC, Estonia
Title: Development of a non-invasive skin diagnostic test for guiding vitiligo treatment
Biography:
Pieter Spee has completed his PhD at the Graduate School of Oncology, at the Netherlands Cancer Institute and the University of Leiden in the Netherlands. He has worked eleven years at Novo Nordisk as the Director and Scientific Director of Translational Immunology, and where he made significant contributions to Lirilumab and Monalizumab, currently in clinical development for various cancers. Currently, he serves as a Chief Technology Officer of FibroTx where he brought the non-invasive biomarker test FibroTx TAP to the market and where he oversees the clinical development of FibroTx SELF, a non-invasive skin diagnostic test intended as point-of-care device for catering personalized skin treatment.
Abstract:
Vitiligo is a chronic and as yet incurable disease characterized by depigmentation of skin. Disease progression often follows the typical pattern of disease-active periods that are alternated by periods of relative stability. There are no specific treatments for vitiligo, with the exception of skin transplantation, which success critically depends on stable disease to avoid depigmentation of transplanted skin. Treatments for active disease typically suppress inflammation, a critical component of vitiligo pathology, with the aim to inhibit the expansion of skin lesions. Treatment options include steroids, calcineurin inhibitors, as well as phototherapy, which only have effect on active disease, but not on stable disease. Although the status of disease activity is an important parameter for treatment decision-making, assessment of disease activity remains difficult. Either, dermatologists monitor the expansion of lesions, a rather lengthy process or dermatologists rely on patient testimonies. Both methods have proven unsatisfactory and thus there is an unmet medical need for diagnostic tools that can monitor disease activity to guide disease management. FibroTx TAP and SELF are novel molecular diagnostic platform technologies that can measure protein biomarkers directly from skin. These non-invasive platform technologies are currently being tested in clinical studies for the development of a skin diagnostic tool that can assess the activity status of skin lesions of vitiligo patients. The aim of the studies is to develop the first point-of-care device that can markedly improve vitiligo treatment, which is cost-efficient and does not require the need for clinical laboratory expertise.
Seyed Mohhamed Radmanesh
Ahvaz Jundishapur University of Medical Sciences, Iran
Title: The melanocytes of different body areas have different susceptibility for vitiligo involvement
Biography:
Seyed Mohammad Radmanesh has completed his Medicine and Dermatologic Residency in Shiraz University of Medical Sciences, Shiraz Iran previously known as Pahlavi University and received the National Board of Dermatology in 1993. From 1993, he is an Academic Member of Ahvaz University of Medical Sciences, Iran. He is currently the Associate Professor of Dermatology. One of the fields of his interest is vitiligo. He has published several papers in the literature, some are the reference papers.
Abstract:
Monobenzyl ether of hydroquinone is a melanocytotoxic drug which is used for depigmentation of normally pigmented patches in extensive and generalized vitiligo. Cases have been reported that following application of MBEH depigmention has developed in remote areas not directly in contact with MBEH. The term chemical vitiligo has been applied to this situation. I visited four patients who developed generalized vitiligo after using MBEH for the treatment of intractable melasma. The lesions were started first as mottled depigmented patches on the face, where the MBEH was applied for a long time followed by development of vitiligo patches on the fingers, dorsum of the hands and forearm and then extended to other areas. The MBEH was reported to induce some immunological changes through which it may exert its melanocytotoxic activities. These melanocytotoxic activities may be used as an alternative therapy for melanomas. This finding supports the theory that not all vitiligos are inherited immune-genetic in nature, some may develop as a result of exposure to toxic chemicals such as MBEH or other unknown chemicals. These melanocytotoxic chemicals may exert their effects through changing the immunological profile of the tissue and subsequent death of melanocytes and vitiligo development.
- Immune mediators and thier role in vitiligo l Theories for Vitiligo pathogenesis l New insights in segmental vitiligo l Surgical management of vitiligo
Location: Sylt 3
Session Introduction
Seyed Mohhamed Radmanesh
Ahvaz Jundishapur University of Medical Sciences, Iran
Title: Generalized vitiligo development in the patients who has used monobenzone for the treatment of melasma
Biography:
Seyed Mohammad Radmanesh has completed his Medicine and Dermatologic Residency in Shiraz University of Medical Sciences, Shiraz Iran previously known as Pahlavi University and received the National Board of Dermatology in 1993. From 1993, he is an Academic Member of Ahvaz University of Medical Sciences, Iran. He is currently the Associate Professor of Dermatology. One of the fields of his interest is vitiligo. He has published several papers in the literature, some are the reference papers.
Abstract:
The melanocytes of different body areas have different susceptibility for vitiligo involvement. In the case of non-segmental vitiligo, many areas are more prone to develop vitiligo earlier than other sites. The areas that develop vitiligo earlier and are more prone to vitiligo are periorbital, perioral, mucosal genitalia in men and distal extremities and the areas that usually involved by vitiligo later are more resistant to vitiligo are thighs, trunk, particularly the lower trunk and arms. For these reasons the areas that are more resistant to vitiligo are chosen to harvest melanocytes or tissue autograft. Any cell or tissue autograft including the suction blister autograft is performed when the vitiligo is in a stable state. The stable vitiligo is defined as a condition in which there is no extension of the previous lesions and development of no new lesions within the past 6-12 months. For many cases of stable vitiligo we have done suction blister autograft. Years later the disease became flared up in some of those who received suction blister autograft. The vitiligo started to develop from different areas as well as the areas surrounding the grafted areas but surprisingly spared the grafted areas. This finding supports the hypothesis that melanocytes from different areas have different susceptibility to vitiligo.