Vitiligo therapy: restoring immune privilege?

The therapeutic hypothesis proposed by Speeckaert and van Geel in this issue (1) is based on the dramatic effects of the new drugs targeting immune privilege checkpoints (PD1/PDL, CTLA4) in current advanced melanoma therapy as major inductors of vitiligo changes in the skin. Such striking clinical manifestations cannot be classified as mere side effects without considering possible consequences for spontaneously occurring vitiligo.”

[1]  R. Speeckaert,et al.  Targeting CTLA‐4, PD‐L1 and IDO to modulate immune responses in vitiligo , 2017, Experimental dermatology.

[2]  A. Taïeb,et al.  New insights into immune mechanisms of vitiligo. , 2016, Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia.

[3]  R. Ballotti,et al.  Transcriptional Analysis of Vitiligo Skin Reveals the Alteration of WNT Pathway: A Promising Target for Repigmenting Vitiligo Patients. , 2015, The Journal of investigative dermatology.

[4]  E. Steingrímsson,et al.  Altered E-Cadherin Levels and Distribution in Melanocytes Precede Clinical Manifestations of Vitiligo. , 2015, The Journal of investigative dermatology.

[5]  V. Sharma,et al.  Alteration in regulatory T cells and programmed cell death 1‐expressing regulatory T cells in active generalized vitiligo and their clinical correlation , 2015, The British journal of dermatology.

[6]  K. Ezzedine,et al.  Type I interferon signature in the initiation of the immune response in vitiligo , 2014, Pigment cell & melanoma research.

[7]  J. Alcocer-Varela,et al.  CTLA-4 and autoimmunity: new insights into the dual regulator of tolerance. , 2013, Autoimmunity reviews.

[8]  N. J. Gibbons,et al.  Blunted epidermal L‐tryptophan metabolism in vitiligo affects immune response and ROS scavenging by Fenton chemistry, part 2: epidermal H2O2/ONOO–‐mediated stress in vitiligo hampers indoleamine 2,3‐dioxygenase and aryl hydrocarbon receptor‐mediated immune response signaling , 2012, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[9]  R. Spritz.  Six decades of vitiligo genetics: Genomewide studies provide insights into autoimmune pathogenesis , 2011, The Journal of investigative dermatology.

[10]  Deevya L. Narayanan,et al.  Review: Ultraviolet radiation and skin cancer , 2010, International journal of dermatology.

[11]  J. Soria,et al.  Association of Vitiligo With Tumor Response in Patients With Metastatic Melanoma Treated With Pembrolizumab. , 2016, JAMA dermatology.