A proliferation-inducing ligand in atopic dermatitis and vitiligo.

BACKGROUND A proliferation-inducing ligand (APRIL) is a tumor necrosis factor (TNF) superfamily member ligand that stimulates B cells in vitro and in vivo. It also plays an important role in T cell activation and survival. OBJECTIVES This study was conducted to evaluate serum levels of APRIL in patients with atopic dermatitis (AD) and vitiligo and their correlation with disease activity. METHODS A total of 100 subjects were included; these comprised 40 AD patients, 40 vitiligo patients, and 20 control subjects. Serum APRIL levels were measured and their relationships with the severity of AD and activity of vitiligo evaluated according to scores on the SCORAD (SCORing of Atopic Dermatitis) and VIDA (Vitiligo Disease Activity) indices, respectively. RESULTS The serum level of APRIL was significantly higher in AD patients than in the control group. Serum APRIL in patients with severe AD showed a statistically significant difference with serum APRIL in patients with either mild or moderate AD. Serum APRIL was significantly higher in vitiligo patients than in the control group. Differences in serum APRIL among patients with different VIDA scores were significant only between patients with VIDA scores of +1 and +4. Statistically significant positive correlations emerged between serum APRIL and activity of AD (r = 0.939) and vitiligo (r = 0.740). CONCLUSIONS APRIL may play a role in the pathogeneses of AD and vitiligo and could be used as an objective marker for the assessment of AD severity and vitiligo activity. Further studies are required to clarify the precise mechanism of APRIL in the pathogeneses of AD and vitiligo and to test the possible use of APRIL inhibitors as novel modalities of therapy.