September 23, 2008

Understanding Disorder that Causes Skin to Lose Color Might Also Help in the Fight Against Deadly Skin Cancer

Loyola Researcher Wins $1.7 Million Grant to Study Immune System's Role in Vitiligo and Melanoma

MAYWOOD, Ill. - About 1 million Americans suffer a skin disorder called vitiligo, which causes unsightly white patches on the face, hands and other parts of the body.

A Loyola University Hospital researcher has won a five-year, $1.7 million federal grant to investigate a new way to treat vitiligo. This research also could point the way to new treatments for melanoma, the deadliest form of skin cancer.

Vitiligo appears to be an auto-immune disease, in which the immune system goes into overdrive and kills pigment cells, which give skin its color. Loyola researcher Caroline Le Poole, PhD, is studying how to stop vitiligo. The goal is to adjust the immune system so that it stops attacking pigment cells. Conversely, melanoma would be treated by revving up the immune system to attack malignant pigment cells.

"Things we learn from vitiligo could apply to melanoma, and vice versa," Le Poole said. Le Poole is an associate professor in the Oncology Institute of Loyola University Chicago Stritch School of Medicine.

Although melanoma accounts for less than 5 percent of skin cancers, it is responsible for most of the skin cancer deaths. There will be more than 62,000 new melanoma cases in the United States this year, and more than 8,000 deaths, the American Cancer Society said.

Vitiligo (vit-ill-EYE-go) affects about 0.5 percent of the world's population. It affects both sexes and all races. However, "the darker the skin, the more noticeable it is," said Loyola dermatologist Dr. Anthony Peterson, an assistant professor at Stritch. "The contrast is what people notice."

In the most common form of vitiligo, white patches form on both sides of the body. In 1993, singer Michael Jackson told Oprah Winfrey he has symptoms consistent with vitiligo. Last year, Lee Thomas, an African American TV anchor/reporter in Detroit, published a memoir about vitiligo titled "Turning White."

Vitiligo also can be distressing to Caucasians. Cathy Kalnicky, 47, has had vitiligo since she was 30. It's on her face, arms, legs and hands. The patches are more noticeable during the summer, when Kalnicky develops a deep tan while watching her three daughters play softball. "I get a lot of questions when I'm out in public," she said. "And some occasional stares."

Kalnicky, a registered nurse at Loyola, has provided skin cell samples for Le Poole's research. "It would be really nice if there was a way to stop vitiligo," Kalnicky said.

Steroid creams return some color to affected skin. But this treatment also thins the skin, and can cause streaks or lines. Bright lights, similar to tanning booths, also can return color, but can cause sunburns and other side effects. Skin grafts transfer skin from unaffected areas to the white patches, but can be painful and expensive, Peterson said.

None of the existing treatments prevent vitiligo from progressing. But the approach Le Poole is studying potentially could stop vitiligo in its tracks.

In people who are susceptible to vitiligo, an injury to the skin, such as sunburn, can trigger pigment cells to generate stress proteins. Immune cells absorb these proteins and, in turn, signal killer T cells to destroy pigment cells.

Le Poole hopes to throw a wrench into this overactive immune response. In collaboration with Assay Designs, Inc. of Ann Arbor, Mi., she is developing blockers that would stop immune cells from absorbing stress hormones and triggering the immune response.

"An active immune response can be bad for vitiligo patients, but good for melanoma patients," Le Poole said. "We hope to be able to adjust the immune system in ways that would benefit both groups of patients."

 

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Based in the western suburbs of Chicago, Loyola University Health System is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb hospital campus and 22 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus, Loyola University Hospital, is a 570-licensed bed facility. It houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Health & Fitness. Loyola's Gottlieb campus in Melrose Park includes the 250-bed community hospital, the Gottlieb Health & Fitness Center and the Marjorie G. Weinberg Cancer Care Center.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.