Association of AKT expression with melanocyte restoration in vitiligo: A comparative study of platelet-rich plasma and Fr CO2 laser.

The skin, the body's largest organ, defends against ultraviolet (UV) radiation primarily through melanin produced by melanocytes. Complex signaling pathways, especially the PI3K/AKT pathway, regulate melanogenesis, which is required during pigmentation and melanocyte survival. Any disturbance in melanocyte function may result in pigmentary disorders, including vitiligo, a common depigmenting disorder with significant psychological impact. By examining histological, immunohistochemical, ultrastructural, and molecular events controlling melanocyte activity, we aimed to compare histological, immunohistochemical, ultrastructural, and molecular changes associated with Fr CO2 laser and platelet-rich plasma (PRP) treatment in stable vitiligo. Thirty-two patients with vitiligo and five healthy volunteers were enrolled. Lesions on each patient's limbs were divided into two groups, each receiving six treatment sessions at one-month intervals over six months. Four groups were studied: control (I) from healthy volunteers, vitiligo before treatment (II), Fr CO2 laser (III), and PRP (IV). Punch biopsy specimens were obtained before and after treatment for histological, immunohistochemical, and western blot analysis. Compared with the control group, the vitiligo group (II) showed epidermal degenerative alterations, loss of melanin, apoptotic melanocytes, down-regulation of Melan-A and IL-10 expression, ultrastructural changes, and down-regulation of p-AKT/AKT. Both treatment groups showed tissue-level improvement in melanin distribution, Melan-A-positive melanocyte counts, IL-10 expression, and ultrastructural features. The PRP group had better ultrastructural improvements. Western blotting showed that both treatment groups had elevated p-AKT/AKT levels, with the PRP group exhibiting the highest p-AKT level. Overall, PRP was associated with greater histological, ultrastructural, and molecular improvement than Fr CO2 laser under the conditions of the present study.