Regenerative Medicine-Based Treatment for Vitiligo: An Overview

Abstract

Vitiligo is a complex disorder with an important effect on the self-esteem and social life of patients. It is the commonest acquired depigmentation disorder characterized by the development of white macules resulting from the selective loss of epidermal melanocytes. The pathophysiology is complex and involves genetic predisposition, environmental factors, oxidative stress, intrinsic metabolic dysfunctions, and abnormal inflammatory/immune responses. Although several therapeutic options have been proposed to stabilize the disease by stopping the depigmentation process and inducing durable repigmentation, no specific cure has yet been defined, and the long-term persistence of repigmentation is unpredictable. Recently, due to the progressive loss of functional melanocytes associated with failure to spontaneously recover pigmentation, several different cell-based and cell-free regenerative approaches have been suggested to treat vitiligo. This review gives an overview of clinical and preclinical evidence for innovative regenerative approaches for vitiligo patients.

Caracterización de aspectos clínicos y tratamento de paciente con vitíligo

“…Actualmente se desconoce por completo la causa del vitíligo, pero se han realizado diversas investigaciones sobre los factores que pueden atribuirse e interactuar para desencadenar la manifestación de esta enfermedad, en particular cuando se menciona que puede estar directamente influida por los antecedentes familiares o factores ambientales y genéticos (Utria, 2018). Su etiología incluye varias teorías que pueden estar relacionadas con la aparición de estas manchas blancas, tales como: teoría del defecto de adhesión, teoría autoinmune, factor ambiental y la teoría bioquímica, que son difíciles de analizar porque aún siguen siendo tema de constante investigación (Bellei et al, 2022). A continuación, se describe brevemente estos aspectos importantes relacionados con el desarrollo de la enfermedad: Genética El vitíligo es una enfermedad con rasgos poligénicos.…”

The Role of Oxidative Stress in Vitiligo: An Update on Its Pathogenesis and Therapeutic Implications

“…However, around 40% of patients experience a relapse within a year after stopping treatment [ 99 ]. Recently, new cell-based and cell-free regenerative approaches have been proposed as alternative treatments for vitiligo [ 53 , 100 , 101 ] These innovative regenerative approaches may help regenerate melanocytes and balance T-cell subsets, and are currently being tested.…”

Evaluation the Efficacy of NB-UVB Treatment Alone in Comparison with Combination Therapy of NB-UVB and Oral Prednisolone in Treatment of Vitiligo

“…However, it's essential to acknowledge that long-term use of oral steroids carries potential risks and side effects [7,8]. While complete re-pigmentation might not be attained in all cases, a consistent achievement of 50-75% re-pigmentation can be anticipated, particularly in cases of vitiligo that have recently developed [9]. It's important to acknowledge that a significant subset of patients may only attain partial repigmentation even when subjected to the most advanced therapeutic methods available [10].…”