Surgical procedures and innovative approaches for vitiligo regenerative treatment and melanocytorrhagy

Abstract

Surgical treatments for vitiligo are a safe and effective treatment modality for select patients with vitiligo. Many techniques of vitiligo surgery exist, each with unique advantages and disadvantages. We reviewed the various surgical therapies and innovative approaches for vitiligo regenerative treatment reported in the literature. Surgical therapies can be subdivided into tissue grafting methods and cellular grafting methods. Tissue grafting methods mainly include mini punch grafts, suction blister roof grafts, and hair follicle grafts. Cellular grafting methods include cultured and non-cultured treatments. The efficacy needs to be improved largely due to the poor proliferation and quality of the autologous melanocytes. Rho-associated protein kinase inhibitor enhances primary melanocyte culture proliferation from vitiligo patients to prevent apoptosis. Innovative approaches using stem cell methods could prove invaluable in developing a novel cell therapy for patients suffering from vitiligo. We succeeded in inducing melanin pigmentation in mice skin in vivo using our human induced pluripotent stem cell-derived melanocytes. In addition, we reviewed melanocytorrhagy, detachment and transepidermal loss of melanocytes, and melanocyte-related adhesion molecules. These adhesion molecules include epithelial cadherin, discoidin domain receptor tyrosine kinase 1, glycoprotein non-metastatic melanoma protein B, macrophage migration inhibiting factor, 17β-hydroxysteroid dehydrogenase 1, and E26 transformation-specific 1.

Generating Functional and Highly Proliferative Melanocytes Derived from Human Pluripotent Stem Cells: A Promising Tool for Biotherapeutic Approaches to Treat Skin Pigmentation Disorders

“…However, one of the most important factors known to activate melanomagenesis is ultraviolet light [ 30 , 31 ]. Although narrow-band UV-B phototherapy is used in the context of autologous melanocyte cell transplantation to enhance pigmentation with no side effects reported [ 3 , 32 , 33 ], additional UV exposure experiments of mel-CSP must be assessed before grafting.…”

“…Surgical therapy consists of the re-introduction of melanocytes in depigmented lesions. Primary melanocytes can be isolated from pigmented skin of the same person by different procedures (e.g., tissue grafts or cellular grafts) [ 3 ]. However, these techniques require surgical biopsy and can induce the depletion of the site donor.…”

Melanocytes in regenerative medicine applications and disease modeling

“…The inhibitory effect of fucoxanthin on melanin production was confirmed using spheroids produced with skin melanocytes [ 215 ]. Recently, P-TESSs produced with hiMels provide a better model for in vitro experiments and could reduce animal testing (reviewed in [ 216 ]).…”

Stimulatory effects of Lycium shawii on human melanocyte proliferation, migration, and melanogenesis: In vitro and in silico studies

“…These white patches can disturb the cosmetic aspect and psychosocial functioning, which could result in depression ( Cupertino et al, 2017 ; Varma et al, 2019 ). Vitiligo is treated by several modalities, including phototherapy (i.e., psoralen and ultraviolet A (PUVA); 8-methoxypsoralen; narrowband ultraviolet B (NB-UVB); laser therapy (i.e., 308-nm xenon chloride excimer laser); surgical therapy (i.e., melanocyte-rich tissue grafting and melanocyte grafting); and immunosuppression therapy (i.e., corticosteroids) ( Frisoli and Harris, 2017 ; Kawakami, 2022 ). Multiple surgical modalities have offered patients significant benefits, but the effectiveness of these treatments, especially in the long term, remains distressingly poor, and the side effects are a cause for concern ( Abdel-Malek et al, 2020 ; Lotti et al, 2020 ).…”