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T helper 17 and Tregs: a novel proposed mechanism for NB‐UVB in vitiligo

Narrowband ultraviolet (NB‐UV)B is accepted as corner stone therapy for vitiligo. Its influence on the expression of IL‐17, IL‐ 22 and FoxP3 as markers for the Th17 and Tregs lineages has not been studied before in the context of non‐segmental vitiligo (NSV). The study included 20 active NSV patients who received 36 NB‐UVB sessions and 20 controls. Clinical evaluation Vitiligo Area Scoring Index (VASI) and determination of tissue expression of IL‐17, IL‐22 and FoxP3 by qRT‐PCR (lesional, perilesional) were carried out before and after therapy. Baseline levels of IL‐17 and IL‐22 were significantly higher in patients, whereas FoxP3 was significantly lower. After therapy, IL‐17 and IL‐22 significantly dropped, whereas FoxP3 significantly increased (lesional, perilesional). Baseline and post‐treatment VASI showed significant positive correlations with IL‐17 and IL‐22 and significant negative correlation with FoxP3 expression. Restoration of the balance between Th17 and Tregs might represent a novel pathway for the improvement that NB‐UVB exerts in vitiligo patients.