الفهرس 
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Abstract
Vitiligo is an acquired, a progressive, multifactorial, depigmenting disorder characterized by the appearance of circumscribed white macules in the skin due to chronic, progressive loss of functional melanocytes in the epidermis. Vitiligo affects 0.5–2% of the population worldwide, with no predilection for gender or race, and usually starts in childhood or young adulthood. Manifestations begin before 20 years of age in 50% of the cases, while in 25% the onset is before 14 years of age.
Vitiligo is Multifarious rather than being caused by a single etiology. Stress, genetic factors, mutations, infection, accumulation of toxic metabolites, altered cellular environment, autoimmunity, and defective melanocyte migration may all work together and lead to the pathogenesis of vitiligo.
It has been reported that cytokines may play a role in depigmentation as a result of their alteration of autoimmunity. GNLY has an important role in different autoimmune diseases, however insufficient data are available about its role in vitiligo. In the present study, we aimed to evaluate GNLY- levels in stable and active vitiligo patients in comparison to healthy controls in a case-control study which was carried out on 66 subjects: 22 patients with active vitiligo, 22 with stable vitiligo, and 22 age and sex-matched controls. All patients were recruited from the Dermatology Outpatient Clinic of Ain Shams University hospitals during the period from February 2021 to May 2021.
All patients were subjected to full history taking, general examination, and dermatological examination. The disease characteristics of vitiligo were recorded as regards activity(VIDA), duration, and extent of vitiliginous lesions(VES).
The suction blister procedure was done for every participant in all groups. The collected clear blister fluid was stored in an Eppendorf tube in (- 20 oC) and sent to Ain Shams University immunity lab to measure GNLY level using the ELISA technique.
We found a statistically significant difference between vitiligo patients and controls regarding GNLY levels with higher GNLY-levels among cases as compared to control.
The ROC curve for vitiligo patients and healthy controls revealed that GNLY-level discriminated between the vitiligo patients and control subjects with the area under the curve of 65.7%. Meanwhile, the best cut-off value was > 1.3 that gave a sensitivity of 50.0% and a specificity of 86.36%.
There were no statistically significant relations between GNLY-levels and gender or age of patients, family history, distribution or duration of vitiligo as well as activity or severity of vitiligo disease. This suggests that GNLY has an important role in vitiligo pathogenesis regardless of the activity, severity, and different disease characteristics.
To the best of our knowledge, our study was the first study that measured GNLY-level in vitiligo patients and compare it with controls. Also, compared GNLY level in stable vitiligo versus active vitiligo.
In conclusion, our findings supported the possible role of GNLY in the pathogenesis of vitiligo. However, measurement of GNLY level can not be used as a discriminating marker between stable and active vitiligo.