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14.03.2024 | REVIEW

Exploring Therapeutic Approaches for Vitiligo: An Inclusive Review from Translational Modalities to Alternative Therapies

verfasst von: Iqra Khan, Mohammad Kalim Ahmad Khan, Feras M. Almarshad

Erschienen in: Current Dermatology Reports

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Abstract

Purpose of Review

The primary objective of this extensive literature review was to explore emerging therapeutic modalities for Vitiligo, with the aim of identifying promising avenues for treatment. These modalities encompass various techniques such as melanocyte transplantation for repopulation and innovative pharmacological interventions aimed at modulating immune responses. This review aims to shed light on the theories underlying Vitiligo pathogenesis and evaluate the efficacy of a range of therapeutic interventions and preventive measures associated with the condition.

Recent Findings

Cutting-edge research in the field of Vitiligo has uncovered several promising avenues for future investigation. These include the detection of catecholamines in the urine and blood of affected individuals, which may be associated with neural dysfunction and contribute to melanocyte destruction. Another intriguing theory centers on epidermal immune infiltration, which triggers an autoimmunity that targets and eliminates melanocytes. Additionally, regulating the levels of X-box protein 1 (XBP1), which is elevated during oxidative and endoplasmic reticulum stress, may reduce cytokine production, a critical factor in the demise of melanocytes. Finally, the application of genome-wide association studies (GWAS) offers new prospects for simultaneously addressing both the degenerative and autoimmune dimensions of the condition.

Summary

Recognizing the increasing importance of patient-centered care, which considers the emotional and social aspects of Vitiligo, calls for a thorough approach to its management. Exploring the complexities of Vitiligo and investigating innovative treatment options hold promise for improved outcomes and enhanced quality of life for those affected.
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Zurück zum Zitat Paul S, Jakhar R, Bhardwaj M, Chauhan AK, Kang SC. Fumonisin B1 induces poly (ADP-ribose) (PAR) polymer-mediated cell death (parthanatos) in neuroblastoma. Food Chem Toxicol. 2021;154:112326.PubMedCrossRef Paul S, Jakhar R, Bhardwaj M, Chauhan AK, Kang SC. Fumonisin B1 induces poly (ADP-ribose) (PAR) polymer-mediated cell death (parthanatos) in neuroblastoma. Food Chem Toxicol. 2021;154:112326.PubMedCrossRef
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Zurück zum Zitat Thakur V, Bishnoi A, Vinay K, Kumaran SM, Parsad D. Vitiligo: Translational research and effective therapeutic strategies. Pigment Cell Melanoma Res. 2021;34:814–26.PubMedCrossRef Thakur V, Bishnoi A, Vinay K, Kumaran SM, Parsad D. Vitiligo: Translational research and effective therapeutic strategies. Pigment Cell Melanoma Res. 2021;34:814–26.PubMedCrossRef
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Zurück zum Zitat Gellatly KJ, Strassner JP, Essien K, Refat MA, Murphy RL, Coffin-Schmitt A, et al. scRNA-seq of human vitiligo reveals complex networks of subclinical immune activation and a role for CCR5 in Treg function. Sci Transl Med. 2021;13:eabd8995.PubMedPubMedCentralCrossRef Gellatly KJ, Strassner JP, Essien K, Refat MA, Murphy RL, Coffin-Schmitt A, et al. scRNA-seq of human vitiligo reveals complex networks of subclinical immune activation and a role for CCR5 in Treg function. Sci Transl Med. 2021;13:eabd8995.PubMedPubMedCentralCrossRef
89.
Zurück zum Zitat Malathi M, Thappa D. Topical therapy in vitiligo: what is new? Pigment Int. 2016;3:1.CrossRef Malathi M, Thappa D. Topical therapy in vitiligo: what is new? Pigment Int. 2016;3:1.CrossRef
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Zurück zum Zitat • Nurfaiqoh E, Arie Kusumawardani. Pulse dose corticosteroid therapy in vitiligo: a narrative literature review. Biosci Med J Biomed Transl Res. 2022;6:2721–9. The review assesses the effectiveness of pulse dose corticosteroid treatment in slowing down the progression of vitiligo and reducing both the expansion of the disease and related side effects. • Nurfaiqoh E, Arie Kusumawardani. Pulse dose corticosteroid therapy in vitiligo: a narrative literature review. Biosci Med J Biomed Transl Res. 2022;6:2721–9. The review assesses the effectiveness of pulse dose corticosteroid treatment in slowing down the progression of vitiligo and reducing both the expansion of the disease and related side effects.
91.
Zurück zum Zitat • Dharmayani GADDA, Pemayun TD. Topical corticosteroid as a treatment for vitiligo. Int J Health Sci. 2022;876–81. A case study about a 43-year-old woman with vitiligo focusing on the application of topical corticosteroids. • Dharmayani GADDA, Pemayun TD. Topical corticosteroid as a treatment for vitiligo. Int J Health Sci. 2022;876–81. A case study about a 43-year-old woman with vitiligo focusing on the application of topical corticosteroids.
92.
Zurück zum Zitat • Nurfaiqoh E, Arie Kusumawardani. Pulse dose corticosteroid therapy in vitiligo: a narrative literature review. Biosci Med J Biomed Transl Res. 2022;6:2721–9. The objective of this literature review is to assess the application of pulse dose corticosteroid therapy in the management of vitiligo. • Nurfaiqoh E, Arie Kusumawardani. Pulse dose corticosteroid therapy in vitiligo: a narrative literature review. Biosci Med J Biomed Transl Res. 2022;6:2721–9. The objective of this literature review is to assess the application of pulse dose corticosteroid therapy in the management of vitiligo.
93.
Zurück zum Zitat Pacifico A, Damiani G, Iacovelli P, Conic RRZ, Young Dermatologists Italian Network (YDIN), Gonzalez S, et al. NB-UVB plus oral Polypodium leucotomos extract display higher efficacy than NB-UVB alone in patients with vitiligo. Dermatol Ther. 2021;34:e14776.PubMedCrossRef Pacifico A, Damiani G, Iacovelli P, Conic RRZ, Young Dermatologists Italian Network (YDIN), Gonzalez S, et al. NB-UVB plus oral Polypodium leucotomos extract display higher efficacy than NB-UVB alone in patients with vitiligo. Dermatol Ther. 2021;34:e14776.PubMedCrossRef
94.
Zurück zum Zitat • Ezzedine K, Peeva E, Yamaguchi Y, Cox LA, Banerjee A, Han G, et al. Efficacy and safety of oral ritlecitinib for the treatment of active nonsegmental vitiligo: a randomized phase 2b clinical trial. J Am Acad Dermatol. 2023;88:395–403. The study is ongoing to evaluate the effectiveness and safety of ritlecitinib, an oral JAK3/TEC inhibitor, in patients with active nonsegmental vitiligo as part of a phase 2b trial (NCT03715829). • Ezzedine K, Peeva E, Yamaguchi Y, Cox LA, Banerjee A, Han G, et al. Efficacy and safety of oral ritlecitinib for the treatment of active nonsegmental vitiligo: a randomized phase 2b clinical trial. J Am Acad Dermatol. 2023;88:395–403. The study is ongoing to evaluate the effectiveness and safety of ritlecitinib, an oral JAK3/TEC inhibitor, in patients with active nonsegmental vitiligo as part of a phase 2b trial (NCT03715829).
95.
Zurück zum Zitat Mehta H, Kumar S, Parsad D, Bishnoi A, Vinay K, Kumaran MS. Oral cyclosporine is effective in stabilizing active vitiligo: results of a randomized controlled trial. Dermatol Ther. 2021;34:e15033.PubMedCrossRef Mehta H, Kumar S, Parsad D, Bishnoi A, Vinay K, Kumaran MS. Oral cyclosporine is effective in stabilizing active vitiligo: results of a randomized controlled trial. Dermatol Ther. 2021;34:e15033.PubMedCrossRef
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Zurück zum Zitat Li L, Li L, Wu Y, Gao X-H, Chen H-D. Triple-combination treatment with oral α-lipoic acid, betamethasone injection, and NB-UVB for non-segmental progressive vitiligo. J Cosmet Laser Ther. 2016;18:182–5.PubMedCrossRef Li L, Li L, Wu Y, Gao X-H, Chen H-D. Triple-combination treatment with oral α-lipoic acid, betamethasone injection, and NB-UVB for non-segmental progressive vitiligo. J Cosmet Laser Ther. 2016;18:182–5.PubMedCrossRef
97.
Zurück zum Zitat Bishnoi A, Vinay K, Kumaran MS, Parsad D. Oral mycophenolate mofetil as a stabilizing treatment for progressive non-segmental vitiligo: results from a prospective, randomized, investigator-blinded pilot study. Arch Dermatol Res. 2021;313:357–65.PubMedCrossRef Bishnoi A, Vinay K, Kumaran MS, Parsad D. Oral mycophenolate mofetil as a stabilizing treatment for progressive non-segmental vitiligo: results from a prospective, randomized, investigator-blinded pilot study. Arch Dermatol Res. 2021;313:357–65.PubMedCrossRef
98.
Zurück zum Zitat Khemis A, Fontas E, Moulin S, Montaudié H, Lacour J-P, Passeron T. Apremilast in combination with narrowband UVB in the treatment of vitiligo: a 52-week monocentric prospective randomized placebo-controlled study. J Investig Dermatol. 2020;140:1533–7.PubMedCrossRef Khemis A, Fontas E, Moulin S, Montaudié H, Lacour J-P, Passeron T. Apremilast in combination with narrowband UVB in the treatment of vitiligo: a 52-week monocentric prospective randomized placebo-controlled study. J Investig Dermatol. 2020;140:1533–7.PubMedCrossRef
99.
Zurück zum Zitat Patra S, Khaitan BK, Sharma VK, Khanna N. A randomized comparative study of the effect of betamethasone oral mini-pulse therapy versus oral azathioprine in progressive nonsegmental vitiligo. J Am Acad Dermatol. 2021;85:728–9.PubMedCrossRef Patra S, Khaitan BK, Sharma VK, Khanna N. A randomized comparative study of the effect of betamethasone oral mini-pulse therapy versus oral azathioprine in progressive nonsegmental vitiligo. J Am Acad Dermatol. 2021;85:728–9.PubMedCrossRef
100.
Zurück zum Zitat Mou KH, Han D, Liu WL, Li P. Combination therapy of orally administered glycyrrhizin and UVB improved active-stage generalized vitiligo. Braz J Med Biol Res. 2016;49:e5354.PubMedPubMedCentralCrossRef Mou KH, Han D, Liu WL, Li P. Combination therapy of orally administered glycyrrhizin and UVB improved active-stage generalized vitiligo. Braz J Med Biol Res. 2016;49:e5354.PubMedPubMedCentralCrossRef
101.
Zurück zum Zitat Singh H, Kumaran MS, Bains A, Parsad D. A randomized comparative study of oral corticosteroid minipulse and low-dose oral methotrexate in the treatment of unstable vitiligo. Dermatology. 2015;231:286–90.PubMedCrossRef Singh H, Kumaran MS, Bains A, Parsad D. A randomized comparative study of oral corticosteroid minipulse and low-dose oral methotrexate in the treatment of unstable vitiligo. Dermatology. 2015;231:286–90.PubMedCrossRef
102.
Zurück zum Zitat •• Pazyar N, Hatami M, Yaghoobi R, Parvar SY, Radmanesh M, Hadibarhaghtalab M. The efficacy of adding topical 5-fluorouracil to micro-needling in the treatment of vitiligo: a randomized controlled trial. J Cosmet Dermatol. 2023;22:1513–20. This paper outlines a study designed to compare the effectiveness of micro-needling combined with topical 5-fluorouracil (5-FU) versus the application of topical tacrolimus ointment in treating vitiligo patches. •• Pazyar N, Hatami M, Yaghoobi R, Parvar SY, Radmanesh M, Hadibarhaghtalab M. The efficacy of adding topical 5-fluorouracil to micro-needling in the treatment of vitiligo: a randomized controlled trial. J Cosmet Dermatol. 2023;22:1513–20. This paper outlines a study designed to compare the effectiveness of micro-needling combined with topical 5-fluorouracil (5-FU) versus the application of topical tacrolimus ointment in treating vitiligo patches.
103.
Zurück zum Zitat •• Basak AK, Debnath J, Das A. Effectiveness of topical tacrolimus treatment in vitiligo patients. Cent Med Coll J. 2023;6:44–8. The effectiveness of topical tacrolimus treatment in individuals with vitiligo is assessed in this paper, and the conclusion suggests that tacrolimus ointment may serve as a safe and effective choice for managing the condition. •• Basak AK, Debnath J, Das A. Effectiveness of topical tacrolimus treatment in vitiligo patients. Cent Med Coll J. 2023;6:44–8. The effectiveness of topical tacrolimus treatment in individuals with vitiligo is assessed in this paper, and the conclusion suggests that tacrolimus ointment may serve as a safe and effective choice for managing the condition.
104.
Zurück zum Zitat Watabe A, Yamasaki K, Asano M, Kanbayashi Y, Nasu-Tamabuchi M, Terui H, et al. Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: a blinded randomized clinical trial. J Dermatol. 2018;45:456–62.PubMedCrossRef Watabe A, Yamasaki K, Asano M, Kanbayashi Y, Nasu-Tamabuchi M, Terui H, et al. Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: a blinded randomized clinical trial. J Dermatol. 2018;45:456–62.PubMedCrossRef
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Zurück zum Zitat • Rosmarin D, Passeron T, Pandya AG, Grimes P, Harris JE, Desai SR, et al. Two phase 3, randomized, controlled trials of ruxolitinib cream for vitiligo. N Engl J Med. 2022;387:1445–55. The outcomes from two phase 3 trials indicate that the use of ruxolitinib cream led to more significant repigmentation of vitiligo lesions compared to the control vehicle over 52 weeks. However, it was associated with acne and pruritus at the application site. • Rosmarin D, Passeron T, Pandya AG, Grimes P, Harris JE, Desai SR, et al. Two phase 3, randomized, controlled trials of ruxolitinib cream for vitiligo. N Engl J Med. 2022;387:1445–55. The outcomes from two phase 3 trials indicate that the use of ruxolitinib cream led to more significant repigmentation of vitiligo lesions compared to the control vehicle over 52 weeks. However, it was associated with acne and pruritus at the application site.
106.
Zurück zum Zitat Juntongjin P, Sangganjanavanich P. Efficacy of the combined excimer light and topical calcipotriol for acral vitiligo: a randomized double-blind comparative study. Dermatol Ther. 2021;34:e14886.PubMedCrossRef Juntongjin P, Sangganjanavanich P. Efficacy of the combined excimer light and topical calcipotriol for acral vitiligo: a randomized double-blind comparative study. Dermatol Ther. 2021;34:e14886.PubMedCrossRef
107.
Zurück zum Zitat Udompataikul M, Boonsupthip P, Siriwattanagate R. Effectiveness of 0.1% topical tacrolimus in adult and children patients with vitiligo. J Dermatol. 2011;38:536–40.PubMedCrossRef Udompataikul M, Boonsupthip P, Siriwattanagate R. Effectiveness of 0.1% topical tacrolimus in adult and children patients with vitiligo. J Dermatol. 2011;38:536–40.PubMedCrossRef
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Zurück zum Zitat Ho N, Pope E, Weinstein M, Greenberg S, Webster C, Krafchik BR. A double-blind, randomized, placebo-controlled trial of topical tacrolimus 0·1% vs. clobetasol propionate 0·05% in childhood vitiligo. Br J Dermatol. 2011;165:626–32.PubMedCrossRef Ho N, Pope E, Weinstein M, Greenberg S, Webster C, Krafchik BR. A double-blind, randomized, placebo-controlled trial of topical tacrolimus 0·1% vs. clobetasol propionate 0·05% in childhood vitiligo. Br J Dermatol. 2011;165:626–32.PubMedCrossRef
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Zurück zum Zitat Nguyen S, Chuah SY, Fontas E, Khemis A, Jhingan A, Thng STG, et al. Autologous cell suspension grafting using recell in vitiligo and piebaldism patients. Dermatol Ther. 2017;30(1). Nguyen S, Chuah SY, Fontas E, Khemis A, Jhingan A, Thng STG, et al. Autologous cell suspension grafting using recell in vitiligo and piebaldism patients. Dermatol Ther. 2017;30(1).
110.
Zurück zum Zitat Lim HW, Grimes PE, Agbai O, Hamzavi I, Henderson M, Haddican M, et al. Afamelanotide and narrowband UV-B phototherapy for the treatment of vitiligo: a randomized multicenter trial. JAMA Dermatol. 2015;151:42–50.PubMedCrossRef Lim HW, Grimes PE, Agbai O, Hamzavi I, Henderson M, Haddican M, et al. Afamelanotide and narrowband UV-B phototherapy for the treatment of vitiligo: a randomized multicenter trial. JAMA Dermatol. 2015;151:42–50.PubMedCrossRef
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Zurück zum Zitat Grimes PE, Hamzavi I, Lebwohl M, Ortonne JP, Lim HW. The efficacy of afamelanotide and narrowband UV-B phototherapy for repigmentation of vitiligo. JAMA Dermatol. 2013;149:68.PubMedCrossRef Grimes PE, Hamzavi I, Lebwohl M, Ortonne JP, Lim HW. The efficacy of afamelanotide and narrowband UV-B phototherapy for repigmentation of vitiligo. JAMA Dermatol. 2013;149:68.PubMedCrossRef
112.
Zurück zum Zitat • Bouceiro Mendes R, Alpalhão M, Filipe P. UVB phototherapy in the treatment of vitiligo: state of the art and clinical perspectives. Photodermatol Photoimmunol Photomed. 2022;38:215–23. This article discusses the progress in technology for creating novel phototherapy devices, along with various medical and surgical therapeutic options. The integration of these advancements with phototherapy can result in achieving optimal treatment outcomes. • Bouceiro Mendes R, Alpalhão M, Filipe P. UVB phototherapy in the treatment of vitiligo: state of the art and clinical perspectives. Photodermatol Photoimmunol Photomed. 2022;38:215–23. This article discusses the progress in technology for creating novel phototherapy devices, along with various medical and surgical therapeutic options. The integration of these advancements with phototherapy can result in achieving optimal treatment outcomes.
113.
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Zurück zum Zitat Bae JM, Jung HM, Hong BY, Lee JH, Choi WJ, Lee JH, et al. Phototherapy for vitiligo: a systematic review and meta-analysis. JAMA Dermatol. 2017;153:666–74.PubMedPubMedCentralCrossRef Bae JM, Jung HM, Hong BY, Lee JH, Choi WJ, Lee JH, et al. Phototherapy for vitiligo: a systematic review and meta-analysis. JAMA Dermatol. 2017;153:666–74.PubMedPubMedCentralCrossRef
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Zurück zum Zitat Hossain C, Porto DA, Hamzavi I, Lim HW. Camouflaging agents for vitiligo patients. J Drugs Dermatol. 2016;15:384–7.PubMed Hossain C, Porto DA, Hamzavi I, Lim HW. Camouflaging agents for vitiligo patients. J Drugs Dermatol. 2016;15:384–7.PubMed
116.
Zurück zum Zitat Elbuluk N, Ezzedine K. Quality of life, burden of disease, co-morbidities, and systemic effects in vitiligo patients. Dermatol Clin. 2017;35:117–28.PubMedCrossRef Elbuluk N, Ezzedine K. Quality of life, burden of disease, co-morbidities, and systemic effects in vitiligo patients. Dermatol Clin. 2017;35:117–28.PubMedCrossRef
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Zurück zum Zitat Kikuchi K, Tagami H. Dermatological benefits of cosmetics. In: Cosmetic science and technology. Elsevier; 2017. p. 115–9.CrossRef Kikuchi K, Tagami H. Dermatological benefits of cosmetics. In: Cosmetic science and technology. Elsevier; 2017. p. 115–9.CrossRef
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Zurück zum Zitat • Grochocka M, Wełniak A, Białczyk A, Marek-Jozefowicz L, Tadrowski T, Czajkowski R. Management of stable vitiligo—a review of the surgical approach. J Clin Med. 2023;12:1984. This review provides a comprehensive look at clinical evidence related to the efficacy of vitiligo treatment approaches, whether they involve cellular or tissue-based methods. • Grochocka M, Wełniak A, Białczyk A, Marek-Jozefowicz L, Tadrowski T, Czajkowski R. Management of stable vitiligo—a review of the surgical approach. J Clin Med. 2023;12:1984. This review provides a comprehensive look at clinical evidence related to the efficacy of vitiligo treatment approaches, whether they involve cellular or tissue-based methods.
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Zurück zum Zitat Bilal A, Anwar I. Guidelines for the management of vitiligo. J Pak Assoc Dermatol. 2014;24:68–78. Bilal A, Anwar I. Guidelines for the management of vitiligo. J Pak Assoc Dermatol. 2014;24:68–78.
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Metadaten
Titel
Exploring Therapeutic Approaches for Vitiligo: An Inclusive Review from Translational Modalities to Alternative Therapies
verfasst von
Iqra Khan
Mohammad Kalim Ahmad Khan
Feras M. Almarshad
Publikationsdatum
14.03.2024
Verlag
Springer US
Erschienen in
Current Dermatology Reports
Elektronische ISSN: 2162-4933
DOI
https://doi.org/10.1007/s13671-024-00425-z

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