Vitiligo, from Pathogenesis to Therapeutic Advances: State of the Art

Diotallevi, Federico; Gioacchini, Helena; Simoni, Edoardo De; Marani, Andrea; Candelora, Matteo; Paolinelli, Matteo; Molinelli, Elisa; Offidani, Annamaria; Simonetti, Oriana

doi:10.3390/ijms24054910

Cited by 25 publications

(21 citation statements)

References 128 publications

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“…However, most experts concur that vitiligo etiology and progression are significantly influenced by immune response and T-cell tolerance abnormalities ( 27 ). Furthermore, vitiligo is defined by the presence of an altered immunological balance, which is predominantly seen in an imbalance between the cytokines expressed by Treg/Th2 lymphocyte subsets (IL-4) and Th1/Th17 lymphocyte subsets (TNF-α, IFN-γ, IL-17, and IL-8) ( 28 , 29 ). Early histopathology of vitiligo lesions indicated CD8+ T cell-dominant lymphocytic infiltrated around the margin of the depigmented lesions, where the disease was most active, in a prior analysis ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

A Mendelian randomization study on the causal effects of circulating cytokines on the risk of vitiligo

Liu,

Xin

et al. 2024

Front. Med.

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BackgroundAccumulating evidence reveals an association between circulating cytokine levels and vitiligo. However, the causal association between circulating cytokine levels and vitiligo remains unrevealed.MethodsWe performed a two-sample Mendelian randomization (MR) analysis using a genome-wide association study of the 41 cytokines dataset, which was conducted with 3 Finnish cohorts (n = 8,293). Vitiligo data were acquired from strictly defined vitiligo data collected by FinnGenbiobank analysis, which included 207,613 European ancestors (131 vitiligo patients, 207,482 controls). The inverse-variance weighted (IVW) method, weighted median (WME), simple model, weighted model, and MR-Egger were used to determine the changes in vitiligo pathogenic cytokine taxa, followed by sensitivity analysis, including horizontal pleiotropy analysis. The MR Steiger test evaluated the strength of a causal association, and the leave-one-out method was used to assess the reliability of the results. The possibility of reverse causality was also investigated using a reverse MR study.ResultsWe observed that rising IL-4 levels generated an enhanced probability of vitiligo in IVW (OR 2.72, 95%CI 1.19–6.22, p = 0.018). According to the results of the MR analysis, there were causal links between IL-4 and vitiligo. Results were steady after sensitivity and heterogeneity analyses.ConclusionOur research reveals that a genetically determined increased level of circulating IL-4 may be linked to a higher risk of developing vitiligo. The development of innovative treatment approaches (such as tofacitinib or dupilumab) that focus on blocking IL-4 as a novel way of preventing and treating vitiligo is significantly impacted by our findings.

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Section: Discussionmentioning

confidence: 99%

A Mendelian randomization study on the causal effects of circulating cytokines on the risk of vitiligo

Liu,

Xin

et al. 2024

Front. Med.

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“…Vitiligo is an autoimmune skin lesion induced by dysfunction of pigment-producing melanocytes attacked by immune cells, which ultimately ends in achromic macules and patches. In recent years, there are numerous therapeutic modalities available, that aim to stop progression and induce skin re-pigmentation [9] . It has been demonstrated that vitiligo treatment is challenging considering its complicated pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between the Efficacy of Trichloroacetic Acid 30% versus Intradermal 5 Fluorouracil Injection in Treatment of Vitiligo with or without Narrow Band Ultraviolet B Phototherapy

2023

The Egyptian Journal of Hospital Medicine

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Background: Vitiligo is a challenging disease, which significantly impaired quality of life (QoL). In recent years, there are numerous therapeutic modalities available that aim to stop progression with a subsequent induction of skin repigmentation. Combination among different modalities could improve the response, reduces the adverse events, and reduces the course required to achieve re-pigmentation in vitiligo. Objective: To compare the efficacy of trichloroacetic acid (TCA) chemical peel (30% concentration) versus intradermal injection of 5 Fluorouracil Injection (5-FU) both with and without Narrow Band Ultraviolet B (NB-UVB) Phototherapy (PT) in management of stable non-segmental vitiligo (NSV). Patients and Methods: This comparative prospective interventional study comprised 60 patients with stable NSV. Patients were divided into two equal groups: Group I and group II. Lesion 1 in both groups was treated with only TCA 30%, while, lesion 2 was treated with only intradermal injection of 5-FU. In group II, each lesion was followed by the application of NBUVB sessions twice/week. Results: Based on the Physician's Global Assessment (PGA) score, the present study demonstrated a highly statistically significant increase in the percentage of improvement among group II compared to group I. According to the PGA score, our study demonstrated a statistically significant increase in the percentage of improvement among the subgroup 5-FU II+ NBUVB compared to 5-FU I. Conclusion: It could be concluded that the combination therapies of each of TCA or 5-FU with NBUVB ranked higher than monotherapy with either TCA or 5-FU in inducing successful re-pigmentation in stable NSV patients.

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“…Non-segmental vitiligo clinically occupies the skin surface regardless of the dermatomes. Skin lesions in the course of vitiligo impinge on the patient's quality of life, leading to psychic discomfort, social withdrawal and stigmatization [64][65][66][67][68]. Certain exogenous and/or endogenous factors in genetically predisposed individuals lead to cellular stress within melanocytes, which promotes the migration of CD8+ T lymphocytes into the epidermis.…”

Section: Non-segmental Vitiligomentioning

confidence: 99%

Novel Janus Kinase Inhibitors in the Treatment of Dermatologic Conditions

Ryguła,

Pikiewicz,

Kaminiów

2023

Molecules

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Janus kinase inhibitors, also known as JAK inhibitors, JAKinibs or JAKi, are a new group of disease-modifying drugs. They work by inhibiting enzymes involved in the transmission of information from receptors located in the cell membrane to the cell interior, specifically to the cell nucleus, thus disrupting the JAK-STAT pathway. This pathway plays a role in key cellular processes such as the immune response and cell growth. This feature is used in the treatment of patients with rheumatological, gastroenterological and hematological diseases. Recently, it has been discovered that JAK-STAT pathway inhibitors also show therapeutic potential against dermatological diseases such as atopic dermatitis, psoriasis, alopecia areata and acquired vitiligo. Studies are underway to use them in the treatment of several other dermatoses. Janus kinase inhibitors represent a promising class of drugs for the treatment of skin diseases refractory to conventional therapy. The purpose of this review is to summarize the latest knowledge on the use of JAKi in dermatological treatment.

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Vitiligo, from Pathogenesis to Therapeutic Advances: State of the Art

Cited by 25 publications

References 128 publications

A Mendelian randomization study on the causal effects of circulating cytokines on the risk of vitiligo

A Mendelian randomization study on the causal effects of circulating cytokines on the risk of vitiligo

Comparative Study between the Efficacy of Trichloroacetic Acid 30% versus Intradermal 5 Fluorouracil Injection in Treatment of Vitiligo with or without Narrow Band Ultraviolet B Phototherapy

Novel Janus Kinase Inhibitors in the Treatment of Dermatologic Conditions

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