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Vitiligo: what’s new in the psycho-neuro-endocrine-immune connection and related treatments

Vitiligo: Was gibt es Neues im Psycho-Neuro- Endokrino-Immunologischen Zusammenhang und bei verwandten Therapien?

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Summary

Vitiligo is an acquired depigmentary skin disorder of unknown origin characterized by well-demarcated, white macules of varying size and distribution. Despite relevant new research and progresses, why melanocytes disappear to induce the characteristic achromic lesions of vitiligo is not fully understood. In spite of recent findings implicating genetic, immune and oxidative stress factors, the exact pathogenesis of vitiligo remains obscure. An innovative concept based on a functional cross-talk between the nervous and immune system is emerging. Neuropeptides released from peripheral nerve endings could synergize with new cytokines to adversely affect melanocyte function and viability. Evidence is increasing regarding the role of neuropeptides in the pathogenesis of vitiligo and a new winning approach to vitiligo therapy based on neuropeptides regulation is at the horizon.

Zusammenfassung

Die Vitiligo ist eine erworbene pigmentäre Hauterkrankung unbekannter ätiologie, welche von gut abgegrenzten weißen Hautflecken unterschiedlicher Größe und Verteilung gekennzeichnet ist. Ungeachtet neuer, relevanter Forschungen und Erkenntnisfortschritte ist der Grund für das Abnehmen von Melanozyten und die Induktion der charakteristischen pigmentarmen Läsionen der Vitiligo nicht hinreichend geklärt. Trotz rezenter Erkenntnisse im Bezug auf genetische, immunologische und oxidative Stressfaktoren ist die genaue Pathogenese der Vitiligo unklar. Im Entstehen begriffen ist ein innovatives Konzept, das auf die gegenseitige funktionelle Beeinflussung zwischen dem Nerven- und Immunsystem aufbaut. So könnten von peripheren Nervenenden ausgehende Neuropeptide mit neuen Zytokinen synergieren und sich negativ auf die melanozytische Funktions- und Entwicklungsfähigkeit auswirken. Die wachsende Evidenz im Hinblick auf die Bedeutung von Neuropeptiden bei der Pathogenese der Vitiligo geht mit einem neuen, gewinnbringenden Ansatz in der Vitiligotherapie auf der Basis der Neuropeptidenregulation einher.

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The authors declare any affiliation or significant financial involvement in any organizations or entity with a direct financial interest in the subject matter or materials discussed in the manuscript on this page.

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Authors and Affiliations

  1. University of Rome “G. Marconi”, Rome, Italy

    Torello Lotti MD

  2. University of Florence, Florence, Italy

    Matteo Zanardelli

  3. Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy

    Angelo Massimiliano D’Erme MD

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  1. Torello Lotti MD
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  3. Angelo Massimiliano D’Erme MD
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Correspondence to Torello Lotti MD.

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Lotti, T., Zanardelli, M. & D’Erme, A. Vitiligo: what’s new in the psycho-neuro-endocrine-immune connection and related treatments. Wien Med Wochenschr 164, 278–285 (2014). https://doi.org/10.1007/s10354-014-0288-7

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