Rashighi Mehdi, Harris John E
Department of Dermatology, University of Massachusetts Medical School, Worcester, MA 01605, USA; Department of Dermatology, Tehran University of Medical Sciences, 415 Taleqani Avenue, Tehran 1416613675, Iran.
Department of Dermatology, University of Massachusetts Medical School, Worcester, MA 01605, USA.
Dermatol Clin. 2017 Apr;35(2):257-265. doi: 10.1016/j.det.2016.11.014.
The pathogenesis of vitiligo involves interplay between intrinsic and extrinsic melanocyte defects, innate immune inflammation, and T-cell-mediated melanocyte destruction. The goal of treatment is to not only halt disease progression but also promote repigmentation through melanocyte regeneration, proliferation, and migration. Treatment strategies that address all aspects of disease pathogenesis and repigmentation are likely to have greatest efficacy, a strategy that may require combination therapies. Current treatments generally involve nontargeted suppression of autoimmunity, whereas emerging treatments are likely to use a more targeted approach based on in-depth understanding of disease pathogenesis, which may provide higher efficacy with a good safety profile.
白癜风的发病机制涉及内在和外在黑素细胞缺陷、先天性免疫炎症以及T细胞介导的黑素细胞破坏之间的相互作用。治疗的目标不仅是阻止疾病进展，还通过黑素细胞再生、增殖和迁移促进色素再生。针对疾病发病机制和色素再生各个方面的治疗策略可能具有最大疗效，这一策略可能需要联合治疗。目前的治疗通常涉及非靶向性自身免疫抑制，而新兴治疗可能基于对疾病发病机制的深入理解采用更具靶向性的方法，这可能提供更高疗效且安全性良好。
