New perspectives in vitiligo treatment

Vitiligo is a chronic depigmentation disease. It is characterized by damage or destruction of melanocytes (melanin-producing cells). The desease affects about 2% of population. The pathogenesis is complex and not fully understood. Recent insights into vitiligo pathognenesis highlight impact of vario...

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Main Authors: Alicja Konieczna, Andrzej Winnicki, Jerzy Krysiński
Format: Article
Language:Polish
Published: Polish Pharmaceutical Society 2020-07-01
Series:Farmacja Polska
Subjects:
Online Access:https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2020%2F6%2F04_SZ_Bielactwo_n.pdf
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author Alicja Konieczna
Andrzej Winnicki
Jerzy Krysiński
author_facet Alicja Konieczna
Andrzej Winnicki
Jerzy Krysiński
author_sort Alicja Konieczna
collection DOAJ
description Vitiligo is a chronic depigmentation disease. It is characterized by damage or destruction of melanocytes (melanin-producing cells). The desease affects about 2% of population. The pathogenesis is complex and not fully understood. Recent insights into vitiligo pathognenesis highlight impact of various factors like environmental factors, genetic factors, cellular stress and autoimmune factors. In vitiligo patients abnormal response of innate immune system is observed. The latest research shows that the IFN-γ/CXCL10 axis plays a special role in the pathogenesis of vitiligo. Interferon γ (IFN-γ) can be produced by autoreactive CD8 + T cells. Receptors for interferon gamma (IFN-γR) are located on the surface of keratinocytes. After binding IFN-γ to its receptor (IFN-γR) there is an activation of the JAK-STAT pathway. That causes the release of the chemokines like CXCL9 and CXCL10. Patients with vitiligo have a higher serum concentration of CXCL10 chemokine compared to healthy people. CXCR3 receptors for the CXCL10 chemokine are located on autoreactive CD8+ lymphocytes. The CXCL10 chemokine binds to its receptor CXCR3. That leads to the migration of autoreactive T cells to the epidermis and destruction of melanocytes. Furthermore, changes in cytokine secretion by T helper cells Th1, Th2, Th17 and regulatory T cells (Treg) may contribute to disease progression. In vitiligo is observed elevated levels of IL-2, IL-6, IL-17 and decreased level of IL-4. Current treatment methods are not satisfying and mainly based on the use of off-label drugs. Better understandig etiology of vitiligo enable searching for new effective treatment methods. To minimize systemic side effects, topical drug forms are searching. The effectiveness of new combined therapies is also being studied, including topical treatment with phototherapy, surgical methods with phototherapy, general therapy with surgical methods, etc. New potential therapies, especially with JAK/STAT inhibitors, may provide new perspectives for the treatment of vitiligo.
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spelling doaj.art-a890b177aed34275a6dee22902266b312022-12-22T00:05:23ZpolPolish Pharmaceutical SocietyFarmacja Polska0014-82612020-07-0176632433210.32383/farmpol/125553125553New perspectives in vitiligo treatmentAlicja Konieczna0Andrzej Winnicki1Jerzy Krysiński2Katedra Technologii Postaci Leku, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu, PolskaKatedra Technologii Postaci Leku, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu, PolskaKatedra Technologii Postaci Leku, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu, PolskaVitiligo is a chronic depigmentation disease. It is characterized by damage or destruction of melanocytes (melanin-producing cells). The desease affects about 2% of population. The pathogenesis is complex and not fully understood. Recent insights into vitiligo pathognenesis highlight impact of various factors like environmental factors, genetic factors, cellular stress and autoimmune factors. In vitiligo patients abnormal response of innate immune system is observed. The latest research shows that the IFN-γ/CXCL10 axis plays a special role in the pathogenesis of vitiligo. Interferon γ (IFN-γ) can be produced by autoreactive CD8 + T cells. Receptors for interferon gamma (IFN-γR) are located on the surface of keratinocytes. After binding IFN-γ to its receptor (IFN-γR) there is an activation of the JAK-STAT pathway. That causes the release of the chemokines like CXCL9 and CXCL10. Patients with vitiligo have a higher serum concentration of CXCL10 chemokine compared to healthy people. CXCR3 receptors for the CXCL10 chemokine are located on autoreactive CD8+ lymphocytes. The CXCL10 chemokine binds to its receptor CXCR3. That leads to the migration of autoreactive T cells to the epidermis and destruction of melanocytes. Furthermore, changes in cytokine secretion by T helper cells Th1, Th2, Th17 and regulatory T cells (Treg) may contribute to disease progression. In vitiligo is observed elevated levels of IL-2, IL-6, IL-17 and decreased level of IL-4. Current treatment methods are not satisfying and mainly based on the use of off-label drugs. Better understandig etiology of vitiligo enable searching for new effective treatment methods. To minimize systemic side effects, topical drug forms are searching. The effectiveness of new combined therapies is also being studied, including topical treatment with phototherapy, surgical methods with phototherapy, general therapy with surgical methods, etc. New potential therapies, especially with JAK/STAT inhibitors, may provide new perspectives for the treatment of vitiligo.https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2020%2F6%2F04_SZ_Bielactwo_n.pdfpathogenesistreatmentvitiligo
spellingShingle Alicja Konieczna
Andrzej Winnicki
Jerzy Krysiński
New perspectives in vitiligo treatment
Farmacja Polska
pathogenesis
treatment
vitiligo
title New perspectives in vitiligo treatment
title_full New perspectives in vitiligo treatment
title_fullStr New perspectives in vitiligo treatment
title_full_unstemmed New perspectives in vitiligo treatment
title_short New perspectives in vitiligo treatment
title_sort new perspectives in vitiligo treatment
topic pathogenesis
treatment
vitiligo
url https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2020%2F6%2F04_SZ_Bielactwo_n.pdf
work_keys_str_mv AT alicjakonieczna newperspectivesinvitiligotreatment
AT andrzejwinnicki newperspectivesinvitiligotreatment
AT jerzykrysinski newperspectivesinvitiligotreatment