Vitiligo and its multifactorial autoimmune pathogenesis: facing the present and future
DOI:
https://doi.org/10.29176/2590843X.1748Keywords:
Vitiligo, causality, autoimmunity, genetics, immunology, CD8-Positive T-Lymphocytes, T-Lymphocytes, Regulatory, IFN-γ, Janus Kinase 1, Janus Kinase 2, receptors, CXCR3, Janus Kinase InhibitorsAbstract
Introduction: the pathogenesis of vitiligo is multifactorial; its diagnosis is mainly clinical and in selected cases is supported by histopathological studies that show the absence of melanocytes. The fundamental aspects of vitiligo are presented with emphasis on immunopathological events.
Materials and methods: narrative review. The Pubmed and Google Scholar search engines were used, with terms "vitiligo", "vitiligo aetiology", "immunopathogenesis of vitiligo", "vitiligo history". 45 articles were selected, including Colombian literature.
Results and discussion: vitiligo is a disease as old as humanity. Until today, a clear causal phenomenon has not been established, but rather a set of events related to its origin and perpetuation. Thanks to decades of research, some genetic and environmental influences on melanocytes have been revealed, which lead to a greater susceptibility to oxidative damage and a decrease in their intercellular adhesion. In response to different noxa, innate and adaptive immunity are activated, leading to destruction of the melanocyte mediated by cytotoxic CD8 + T cells. Participation of IFN-γ, the JAK/STAT pathway, especially JAK-1 and JAK-2, and the CXCR3B chemokine receptor are highlighted.
Conclusions: multiple biological phenomena converge in the etiopathogenesis of vitiligo; the result is the activation of CD8+ T lymphocytes, responsible for the destruction of melanocytes. The understanding of immunopathogenic pathways opens the door for the use of target therapies such as JAK inhibitors and CXCR3B inhibitors.
Author Biographies
Santiago Beuth Ruiz, Universidad de Antioquia; Medellín, Colombia.
Residente de primer año de Dermatología, Universidad de Antioquia; Medellín, Colombia.
Margarita Maria Velasquez-Lopera, Universidad de Antioquia, Medellín, Colombia
Médica Dermatóloga, Doctor en Ciencias Básicas Biomédicas, énfasis en Inmunología. Profesora Universidad de Antioquia, Medellín, Colombia.
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