Researchers discover 'vitiligo gene', paving the way for new treatments

Vitiligo Genetic Study: Dr Richard Spritz

By now many of you have read, heard about, or participated in Dr Richard Spritz's vitiligo genetic research. Below is his most recent report.

If you have not participated, I encourage you to do so here and now. This costs nothing and you can participate without leaving your home.

From Dr Spritz:

The international VitGene consortium project, aiming to identify susceptibility genes for generalized vitiligo is the largest vitiligo research study ever undertaken. Funded by a major grant from the U.S. National Institutes of Health, this "genomewide association" study offers the best hope to discover the true biology underlying vitiligo, and thus to open up paths to new treatments and cures. The project will take 4 years, and will have three phases.

Phase 1, taking place now, is the initial genome-wide screening stage, with 1500 Caucasian patients and 1500 unaffected peoples ("controls") from the USA, Canada, and United Kingdom (UK).

Phase 2, (sample collection is going on now), will follow up promising results from the Phase 1 in ~2750 different Caucasian patients and controls from the USA, UK, and continental Europe, as well as in ~400 additional Caucasian vitiligo families (patients and relatives).

Phase 3, (sample collection going on now) will test genes proved out in the first phases in non-Caucasian groups, including USA and Colombia Hispanic/Latino, African-Americans and Nigerian blacks, middle-eastern Arabs, Indians and Pakistanis, and Asians. Currently, VitGene includes 20 countries (USA, Canada, Colombia, UK, Belgium, Holland, France, Italy, Spain, Germany, Czech Republic, Sweden, Jordan, Saudi Arabia, Bahrein, Nigeria, Pakistan, Japan, S. Korea, and Taiwan), with additional sites being considered.

Thanks to the many of you who have sent in study entry questionnaires. We very much appreciate your support; We still need additional samples from BOTH patients and unrelated, unaffected 'controls'. We especially need minority study participants! If you haven't sent in a questionnaire, Click here to Participate. (you must save this to your local computer to fill out, and return via mail or email to richard.spritz@ucdenver.edu).

YOU MUST PROVIDE FULL CONTACT INFORMATION, INCLUDING NAME, EMAIL, MAILING ADDRESS, AND TELEPHONE NUMBER. IF WE CANNOT CONTACT YOU, YOUR QUESTIONNAIRE IS USELESS.

Please, just one questionnaire per family; if you already sent in a questionnaire, please do not ask others in your family to send in additional questionnaires. If you are not in one of the countries listed above, please do not send in a questionnaire.

If you have already sent in a questionnaire and received a saliva DNA kit or kits, PLEASE SEND THEM BACK , and PLEASE make sure all paperwork is filled out and signed. Likewise, if you once sent in a questionnaire but received no response at all (probably because you gave insufficient contact information or moved), please send in a new questionnaire, noting that you sent one in previously. In a very real sense, this is YOUR research; we cannot do this without you.

Thanks again.

Richard A. Spritz, MD

Professor and Director

Human Medical Genetics Program

University of Colorado Denver

Aurora, CO 80045 USA

22.03.2007

In a study appearing in the March 22 edition of The New England Journal of Medicine, researchers at St George’s, University of London, the University of Colorado at Denver and Health Sciences Center (UCDHSC) and the Barbara Davis Center for Childhood Diabetes have discovered a connection between a gene and the chronic skin condition vitiligo, as well as a possible link to an array of other autoimmune diseases.

Supported by grants from the National Institutes of Health and funding from the Vitiligo Society (UK) and the National Vitiligo Foundation (USA), the study analysed two independent groups of families enrolled between 1996 and 2005. Samples were obtained from a total of 656 Caucasian individuals from 114 extended families with vitiligo and other epidemiologically associated autoimmune and autoinflammatory diseases from the United States and the United Kingdom.

The researchers began with a study of vitiligo, a distressing condition causing loss of pigment resulting in irregular pale patches of skin, which is visibly detectable in the 0.5% to 1% of people affected by it. The researchers found that persons with vitiligo also have a risk of developing other autoimmune diseases, as do their close relatives, even those without vitiligo. By searching the genome, the researchers discovered that NALP1 – a gene that controls part of the immune system that serves to alert the body to viral and bacterial attacks – was a key gene involved in predisposing to vitiligo and all the other autoimmune diseases that ran in these families.

“The findings give us a clue to why the immune system attacks one of the body’s own tissues: if the sensor NALP1 is over-reactive, it could trigger a response to the wrong stimulus,” said Professor Dorothy Bennett, Professor of Cell Biology at St George’s, University of London, and investigator for the UK arm of this study. “We hope to study exactly how this works, and to learn even more from the other genes that we are working to identify.

“We are enormously grateful to the patients for their enthusiastic participation, and it’s a great pleasure to find that the first major gene identified is one that suggests new approaches to treatment.”

St George’s, University of London, recruited around half the families who took part in this research, working with the Vitiligo Society. Clinical Co-ordinator Anita Amadi-Myers, of St George’s, worked with patients to get family information and samples. These were sent for analysis to the University of Colorado.

“What’s really exciting for us is that NALP1 hasn’t been specifically implicated in autoimmune diseases before,” said Richard Spritz, MD, director of the Human Medical Genetics Program at UCDHSC and lead investigator for this study. “Since NALP1 appears to be part of our body’s early-warning system for viral or bacterial attack, this gives us ideas about how to try to discover the environmental triggers of these diseases. This finding may also open up new approaches to treatment, possibly for many different autoimmune diseases.”

As a group of approximately 80 disorders that can involve almost any tissue, organ or system, autoimmune and autoinflammatory diseases affect 15 million to 25 million people in the United States. In women, they rank among the top ten causes of death.

Dr. Spritz and his team hope to soon begin organising a clinical trial of a new treatment for vitiligo, based on their NALP1 discovery. Spritz foresees research labs using the information from the UCDHSC study to replicate or test the results in patients with other autoimmune diseases to see how broad potential applications might be. His hope is that the gene NALP1 is also found to be involved in autoimmune and autoinflammatory diseases such as Type 1 diabetes, Addison’s disease, thyroid disease and lupus, among others.

“All diseases are complex, the result of different genes and environmental risk factors acting together in concert. But if NALP1 turns out to be one of the major genes involved in numerous autoimmune diseases, and if we can interrupt its negative effects, we may have the chance to treat many different chronic autoimmune disorders like vitiligo, lupus and psoriasis and perhaps eventually eliminate them altogether,” said Dr. Spritz.