Zhu Jing, Luo Lingling, Guo Youming, Wei Tianqi, Huang Xin, Xiao Xuemin, Li Chengrang
Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, No.12 Jiangwangmiao, Xuanwu District, Nanjing, 210042, Jiangsu, China.
Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, China.
Arch Dermatol Res. 2024 Dec 20;317(1):143. doi: 10.1007/s00403-024-03658-x.
Vitiligo is the most frequently diagnosed depigmentation disease, affecting nearly 0.5-2% of individuals worldwide. This disorder is characterized by melanocyte loss, which results in skin and hair depigmentation. Psychological problems are common in patients, especially in those with the involvement of the face and hands. Several studies have recently focused on the use of JAK inhibitors for vitiligo treatment. However, studies on the selective JAK1 inhibitor upadacitinib for vitiligo treatment are limited. This study aimed to assess the efficacy and safety of upadacitinib in the treatment of vitiligo. This retrospective case series included five patients diagnosed with non-segmental vitiligo who were treated with upadacitinib for 4 months or longer. Disease severity was assessed using the Vitiligo Area Scoring Index (VASI). Five patients took 15 mg of upadacitinib orally for 4 consecutive months, and all achieved repigmentation. The plasma collected from the peripheral blood of the four patients showed that the CXCL9 level dropped after upadacitinib treatment. However, the CXCL10 level did not change significantly using enzyme-linked immunosorbent assay (ELISA). Flow cytometry revealed that the ratio of CD4 + CD3+/CD8 + CD3 + T cells in the blood samples tended to decrease through the treatment. And the Th1-like Tregs (CD4 + Foxp3 + IFN-γ + Tregs) were also downregulated in the peripheral blood. In conclusion, the JAK1 inhibitor upadacitinib was found to be effective and safe for treating non-segmental vitiligo.
白癜风是最常被诊断出的色素脱失性疾病，全球近0.5%-2%的人受其影响。这种疾病的特征是黑素细胞缺失，导致皮肤和毛发色素脱失。心理问题在患者中很常见，尤其是那些面部和手部受累的患者。最近有几项研究聚焦于使用JAK抑制剂治疗白癜风。然而，关于选择性JAK1抑制剂乌帕替尼治疗白癜风的研究有限。本研究旨在评估乌帕替尼治疗白癜风的疗效和安全性。这项回顾性病例系列研究纳入了5例被诊断为非节段性白癜风且接受乌帕替尼治疗4个月或更长时间的患者。使用白癜风面积评分指数（VASI）评估疾病严重程度。5例患者连续4个月口服15毫克乌帕替尼，均实现了色素再生。对4例患者外周血采集的血浆检测显示，乌帕替尼治疗后CXCL9水平下降。然而，使用酶联免疫吸附测定（ELISA）法检测发现CXCL10水平没有显著变化。流式细胞术显示，通过治疗，血样中CD4+CD3+/CD8+CD3+T细胞的比例呈下降趋势。并且外周血中Th1样调节性T细胞（CD4+Foxp3+IFN-γ+Tregs）也下调。总之，发现JAK1抑制剂乌帕替尼治疗非节段性白癜风有效且安全。
