Vitiligo is an autoimmune skin disease that targets pigment-producing melanocytes and results in depigmentation. This disfiguring condition frequently affects visible areas of the body and therefore causes a heavy psychological burden and a decreased quality of life. Although it remains intractable, the ever-growing understanding of its immunopathogenesis has dramatically shaped the treatment paradigm for vitiligo. With the impact of autoreactive cytotoxic T cells explained extensively, accumulating evidence suggests the unique role of regulatory T cells (Tregs) in the immune microenvironment of vitiligo. We systematically reviewed Treg deficiency, instability, reduced vitality and dysfunction in people with vitiligo, combined with novel findings regarding Treg function modulation in autoimmune backgrounds, including metabolic alteration, post-translational modifications and interaction with other immune cells. We further summarized classic and advanced Treg-targeted therapeutics in vitiligo practice and research. Herein, we share up-to-date knowledge of Tregs in vitiligo, providing insights into novel Treg-based therapeutic strategies.
Vitiligo is a skin condition where the immune system wrongly attacks the cells that make the skin's colour (called melanin). This causes patches of skin to lose pigment and appear white. Vitiligo can affect a person’s psychological wellbeing due to its visible effects. Our study focused on understanding the role of a type of immune cell called ‘regulatory T cells’ (or ‘Tregs’) in vitiligo. Tregs help regulate the immune system. They are often dysfunctional and unstable in people with vitiligo. Our review reveals that Tregs may not function well in these cases. We also looked at how Tregs are affected by changes in metabolism, changes in proteins and how they work with other immune cells. Our findings suggest that enhancing the function of Tregs could lead to promising new treatments for vitiligo. This may improve outcomes for people in the future. More research is crucial to explore this and develop treatments that harness the potential of Tregs.
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