Liu Yang, Liu Ziqi, Li Dan, He Xuanxuan, Xiang Leihong, Li Bin, Zhang Chengfeng
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Shanghai Institute of Immunology, Shanghai Jiao Tong University, Shanghai, China.
Br J Dermatol. 2025 Apr 28;192(5):796-806. doi: 10.1093/bjd/ljae472.
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.
白癜风是一种自身免疫性皮肤病，其攻击产生色素的黑素细胞并导致色素脱失。这种毁容性疾病经常影响身体的可见部位，因此会造成沉重的心理负担并降低生活质量。尽管它仍然难以治疗，但对其免疫发病机制的日益深入了解极大地塑造了白癜风的治疗模式。随着自身反应性细胞毒性T细胞的影响得到广泛解释，越来越多的证据表明调节性T细胞（Tregs）在白癜风免疫微环境中的独特作用。我们系统地综述了白癜风患者中Treg缺乏、不稳定、活力降低和功能障碍的情况，并结合了自身免疫背景下Treg功能调节的新发现，包括代谢改变、翻译后修饰以及与其他免疫细胞的相互作用。我们进一步总结了白癜风实践和研究中经典和先进的针对Treg的治疗方法。在此，我们分享白癜风中Tregs的最新知识，为基于Treg的新型治疗策略提供见解。
