An update on Vitiligo pathogenesis

Abstract

Vitiligo, the most common depigmenting disorder of the skin, is undergoing a period of intense advances in both disease understanding and therapeutic possibilities leading the way to the beginning of a new era for the disorder. Its pathophysiology has gathered the attention of researchers for years, and many advances have been made in the clarification of the interaction between different factors that result in depigmented macule formation. The complex interplay between non‐immunological and immunological factors in vitiligo is key for the development of the disease, and the participation of cells other than melanocytes, such as keratinocytes, fibroblasts, natural killer cells, and innate lymphoid cells, has been shown. Recent advances have also brought to the understanding of the complex part played by a specific subtype of T cells: T‐resident memory cells. This review analyzes some of the most recent insights in vitiligo pathogenesis underlining the interactions between different cell types, which are the basis for the therapeutic approaches under development.

Alterations of the pigmentation system in the aging process

“…Recent advancements have significantly clarified the pathophysiology of disease. In vitiligo, the primary inducing factors include intrinsic and extrinsic defects in melanocytes and their microenvironment, which contribute to aberrant stress response, neo‐antigenicity, susceptibility to apoptosis, and autoimmune response (Seneschal et al., 2020). Vitiligo melanocytes from apparently healthy skin display metabolic alterations, including lower oxygen consumption rate, aberrant mitochondrial complexes I, II, and IV and respiratory responses, low ATP production, altered lipid and metabolite profiles, and increased basal levels of ROS (Sahoo et al, 2017; Dell'Anna et al., 2017).…”

Metabolic Comorbidities in Vitiligo: A Brief Review and Report of New Data from a Single-Center Experience

“…This theory is supported by the recent research and involves genetic susceptibility and the presence of intrinsic abnormalities in melanocytes. These are responsible for greater susceptibility to oxidative stress damage which leads to the release of factors that induce immune activation and, finally, melanocyte loss [5]. Our group has been particularly active in the elucidation of nonimmunological factors in the pathogenesis of vitiligo, confirming the presence of metabolic abnormalities in almost all epidermal cells.…”

“…In 2012, vitiligo was finally classified by the Vitiligo European Taskforce (VETF) to simplify the nomenclature [4]. Furthermore, giant steps have been made in the understanding of the pathophysiology of vitiligo with particular progress in the elucidation of immunologic mechanisms [5].…”

Strategies to Develop a Suitable Formulation for Inflammatory Skin Disease Treatment

“…It can affect the skin on any part of the body but commonly occurs on the face, neck, and hands and in skin creases. It can also affect the hair and the inside of the mouth [ 14 , 15 ]. A T helper 1 cell 1/cytotoxic T (Tc1) cell 1-dominated immune response is well demonstrated in vitiligo.…”