Vitiligo, From Physiopathology to Emerging Treatments: A Review
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REVIEW
Vitiligo, From Physiopathology to Emerging Treatments: A Review Laure Migayron . Katia Boniface . Julien Seneschal
Received: July 31, 2020 Ó The Author(s) 2020
ABSTRACT Vitiligo is a chronic inflammatory skin disease leading to the loss of epidermal melanocytes. To date, treatment options for vitiligo patients are limited, lack sustained efficacy, and are mainly based on off-label use of immunosuppressive agents, such as systemic or topical steroids or topical calcineurin inhibitors, in association with the use of ultraviolet light. However, recent insights into the understanding of the immune pathogenesis of the disease have led to the identification of several therapeutic targets and the development of targeted therapies that are now being tested in clinical trials. In this review, based on the physiopathology of the disease, we summarize emerging targets that could be developed for the treatment of vitiligo Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12928409. L. Migayron K. Boniface J. Seneschal (&) University of Bordeaux, INSERM, BMGIC, U1035, 33000 Bordeaux, France e-mail: [email protected]
and discuss recent and ongoing developments of drugs for the management of the disease.
Keywords: Cytokines; Disease progression; Emerging treatments; JAK; Maintenance therapy; Melanocyte; Regeneration; Resident memory; T cells; Vitiligo Key Summary Points A better understanding of the immune pathogenesis of vitiligo has led to the identification and development of targeted therapies. Targeting innate immune pathways through the inhibition of danger signals, such as HSP70, represents an interesting approach for the treatment of vitiligo. Resident memory T cells are involved in the recurrence of vitiligo and could be targeted by blocking interleukin-15.
L. Migayron R&D Department, SILAB, Brive-la-Gaillarde, France
Trials involving JAK inhibitors, which inhibit the effects of several proinflammatory cytokines, have shown promising results in vitiligo.
J. Seneschal Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin disorders, Hospital Saint-Andre´, Bordeaux, France
Promoting the regeneration of melanocytes and preventing their loss will still be an important step to consider in treating vitiligo.
Dermatol Ther (Heidelb)
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. To view digital features for this article go to https://doi. org/10.6084/m9.figshare.12928409.
INTRODUCTION Vitiligo is a common chronic inflammatory skin depigmenting disorder with a worldwide prevalence of 0.5–1% [1]. The occurrence of white patches results from a loss of epidermal melanocytes [2]. While vitiligo does not affect life expectancy, the color dissimilarity has a serious impact on patients’ quality of life and mental well-being, with patients often enduring stigmatization and social isolation, as well as being more subject to psychiatric morbidities [3,
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