Etiopathogenesis and Emerging Methods for Treatment of Vitiligo

Abstract

Vitiligo is an acquired chronic depigmenting disorder of skin. It is mostly asymptomatic and characterized by amelanotic macules and patches that affects 0.5% to 2% of the world’s population. The etiology of vitiligo has not been clearly elucidated and multiple theories have been proposed regarding the causes of the disorder. Among the most prevalent theories, the genetic predisposition, oxidative stress theory, promotion of cellular stress and pathologic influence of lymphocytes T have been highlighted. As a result of increases in in-depth knowledge concerning the pathogenetic processes in vitiligo, we review the most recent information concerning its etiopathogenesis and treatment methods including topical and oral Janus kinase inhibitors, prostaglandins and their analogues, namely afamelanotide, Wnt/β-catenin-signaling agonists and cell-based therapies. Topical ruxolitinib has been registered for vitiligo treatment, whereas other agents as oral ritlecitinib, afamelanotide and latanoprost have been studied in ongoing clinical trials. New highly effective therapeutic strategies may be developed thanks to molecular and genetic studies.

Afamelanotide in protoporphyria and other skin diseases: a review

“…Depigmented skin patches are a result of multifactorial action of autoimmune melanocyte dysfunction as well as genetic, oxidative autoinflammatory and neurogenic factors are involved. Standardized therapy of vitiligo is based on phototherapy and use of topical corticosteroids or calcineurin inhibitors, however new emerging methods of treatment have recently been introduced, including afamelanotide [ 44 ].…”

Antioxidant mechanisms of mesenchymal stem cells and their therapeutic potential in vitiligo

“…Since IFN-γ sends signals to JAK1 and JAK2, Stat1 is activated to produce CD8 + T cell chemokines CXCL9 and CXCL10. Therefore, JAK1/2 inhibitors such as ruxolitinib and baricitinib can currently be used to block the IFN-γ-CXCL9/10-CXCR3 axis to treat vitiligo ( Bishnoi and Parsad, 2018 ; Feng and Lu, 2022 ; Diotallevi et al, 2023 ; Iwanowski et al, 2023 ).…”

Transcutaneous Auricular Vagus Nerve Stimulation Alleviates Monobenzone-Induced Vitiligo in Mice

“…With a global prevalence of less than 1%, the development of vitiligo exhibits a certain degree of unpredictability among individuals. In addition to its aesthetic impact, vitiligo significantly affects the psychological well-being of patients [ 14 ]. Current treatment options for vitiligo, including phototherapy and medication, may lead to side effects that impact patients’ physical health.…”