Clinical Application of Cultured Stratified Epithelial Sheets Grown Under Feeder or Feeder-Free Conditions for Stable Vitiligo

BACKGROUND Autologous cultured therapy has emerged as an effective treatment for stable vitiligo. However, culture methods may include harmful agents and be unsuitable for therapeutic use in humans. OBJECTIVE To investigate the safety and efficacy of autologous cultured epithelial sheets propagated under serum-free and feeder-free conditions for the treatment of stable vitiligo. METHODS Twenty-eight patients with stable vitiligo were included in this study. Keratinocytes and melanocytes from 14 patients were cultured under serum-free, feeder-free conditions (Group A). Epithelial cells from the remaining 14 patients were cultured according to Rheinward and Green's technique (Group B). Patients were followed up at 1, 3, 6, and 12 months after transplantation. RESULTS The epithelial sheets cultured in Group A were thinner and more fragile than Group B, but there were no significant differences in repigmentation between the 2 groups. At 12-month follow-up, in Group A, repigmentation at graft sites was classified as excellent in 9 patients and good in 2 patients. In Group B, repigmentation was excellent in 8 patients and good in 4 patients. Scars at the donor sites were the most frequent adverse events associated with the procedure. CONCLUSION Autologous epithelial sheet cultured in serum-free, feeder-free conditions is a safe and efficacious approach to cure stable vitiligo. Address correspondence and reprint requests to: Jinhua Xu, MD, PhD, Department of Dermatology, Huashan Hospital of Fudan University, No. 12 Wulumuqi Zhong Road, Shanghai 200040, China, or e-mail: lijian1979@medmail.com.cn Supported by Medical Guide Subject of Shanghai Science and Technology Committee (subject number: 124119a1002) and Clinical Priority Specialized Subject of the Ministry of Health of China (2013). The authors have indicated no significant interest with commercial supporters. J. Li and S. Chen have contributed equally to this work. In this current study, patients and skin samples were collected according to Huashan Hospital of Fudan University Research Ethics Service Study Protocol (Ethical approval number: Huashan ethics committee 2012(007)), and this study was approved by Huashan Hospital of Fudan University ethics committee. Written informed consent was obtained from all patients. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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