{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:43:16Z","timestamp":1790775796990,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002378","name":"Faculty of Veterinary Medicine, Cairo University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002378","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite exhaustive research, melanocyte disappearance and the evolution of vitiligo remain enigmatic, and although multi\u2010factorial, oxidative stress appears as a major player. The role of cutaneous cholinergic system in vitiligo pathogenesis has also been reported in some studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate and correlate the influence of phototherapy on cutaneous cholinergic system and oxidative stress in vitiligo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Acetyl choline (ACh), its receptors; nicotinic (nAChR) and muscarinic (mAChR); acetylcholine esterase (AChE) and H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> levels were estimated in de\u2010pigmented and re\u2010pigmented lesions of 30 vitiligo patients before and after NB\u2010UVB phototherapy and in 30 controls. ACh and H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> levels were measured by colorimetry. AChE and acetylcholine receptors expression were measured by quantitative real\u2010time PCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean ACh and H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> levels were significantly higher in vitiligo lesions before NB\u2010UVB (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) whereas AChE enzyme level was significantly lower (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) compared to both re\u2010pigmented and control skin. Additionally, mean mAChR was significantly higher and mean nAChR was significantly lower in vitiligo lesions before NB\u2010UVB versus controls and re\u2010pigmented skin (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Also, H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> and AChE showed negative correlation whereas ACh and mAChR showed significant positive correlation. Although all the studied parameters showed significant changes after treatment and subsequent re\u2010pigmentation, a significant difference continued to exist between all vitiligo skin and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cholinergic system is strongly involved in vitiligo pathogenesis through H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> inhibition of AChE which could be reversed by NB\u2010UVB. Moreover, the strong activation of mAChRs may reflect genetic and\/or acquired errors, direct up\u2010regulation by ACh and H<jats:sub>2<\/jats:sub>O<jats:sub>2<\/jats:sub> or both.<\/jats:p><\/jats:sec>","DOI":"10.1111\/phpp.12653","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T15:22:25Z","timestamp":1610032945000},"page":"306-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Oxidative stress and the cholinergic system in non\u2010segmental vitiligo: Effect of narrow band ultraviolet b"],"prefix":"10.1111","volume":"37","author":[{"given":"Eman Raafat","family":"Said","sequence":"first","affiliation":[{"name":"Dermatology Department Faculty of medicine Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha Abd El Rahim","family":"Nagui","sequence":"additional","affiliation":[{"name":"Dermatology Department Faculty of medicine Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila Ahmed","family":"Rashed","sequence":"additional","affiliation":[{"name":"Biochemistry Department Faculty of Medicine Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wedad Zoheir","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Dermatology Department Faculty of medicine Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60763-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2007.01.028"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.2004.00258.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2010.00995.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(51)91975-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.140.6.677"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.14124"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0906-6705.2006.00410.x"},{"issue":"41","key":"e_1_2_8_10_1","first-page":"2806","article-title":"Lowered tissue acetylcholinesterase activity: Possible etiology of vitiligo. 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