Sahu Nandita, Jain Parag, Sahu Deepika, Kaur Kulvinder, Nagori Kushagra
Department of Pharmacology, Rungta College of Pharmaceutical Sciences and Research, Bhilai, Chhattisgarh 490024, India.
Department of Pharmacology, Rungta College of Pharmaceutical Sciences and Research, Bhilai, Chhattisgarh 490024, India.
Int J Pharm. 2025 Feb 10;670:125106. doi: 10.1016/j.ijpharm.2024.125106. Epub 2024 Dec 22.
Vitiligo is a complex dermatological disorder involving the loss of melanocytes, with resultant patches of depigmentation. It affects 1% of the world population, affecting patients' mental health and quality of life. With all the improvement seen, conventional treatment methods-steroids, phototherapy, and immunomodulators-come with the limitations of being less effective, having more side effects, and low compliance. Advances in novel drug delivery systems now provide promising alternatives for better therapy. The general view of the pathophysiology of vitiligo is provided in this manuscript, mainly on oxidative stress, autoimmune mechanisms, and melanocyte apoptosis as chief factors. New approaches towards treatment, especially drug delivery systems based on nanotechnology, such as liposomes, polymeric nanoparticles, and hydrogels are discussed. These systems can facilitate the improvement of stability, penetration, and targeted delivery of drugs, thus reducing systemic exposure to adverse effects. There is also a potential improvement in microneedles, transdermal patches, and gene therapy like CRISPR-Cas9 to correct pigmentation by correcting the underlying factors at the cellular and molecular level. Other novel therapies include Janus Kinase (JAK) inhibitors and cell-based approaches, among them melanocyte-keratinocyte transplantation, which may have the potential to give sustained repigmentation. The article also deals with the role of phytoconstituents, like curcumin, quercetin, and ginkgo biloba, with antioxidant, anti-inflammatory, and immunomodulatory properties, thus it can be a natural adjuvant to conventional treatment. The multidisciplinary approach may be necessary in the incorporation of pharmacological advances along with new delivery systems into an enhancement strategy of treatments of vitiligo. This approach corrects some of the traditional weaknesses and taps emerging technologies for an even better treatment approach, patient oriented. Follow-up studies should then be directed toward clinical trials for the substantiation of such observations and treatment regimens for more universal applications.
白癜风是一种复杂的皮肤病，涉及黑素细胞的丧失，导致色素脱失斑。它影响着全球1%的人口，对患者的心理健康和生活质量造成影响。尽管已有诸多进展，但传统治疗方法——类固醇、光疗和免疫调节剂——存在疗效欠佳、副作用较多和依从性低等局限性。新型药物递送系统的进展为更好的治疗提供了有前景的替代方案。本文阐述了白癜风病理生理学的一般观点，主要聚焦于氧化应激、自身免疫机制和黑素细胞凋亡等主要因素。文中讨论了治疗的新方法，尤其是基于纳米技术的药物递送系统，如脂质体、聚合物纳米颗粒和水凝胶。这些系统有助于提高药物的稳定性、渗透性和靶向递送，从而减少全身暴露于不良反应。微针、透皮贴剂以及像CRISPR-Cas9这样通过在细胞和分子水平纠正潜在因素来矫正色素沉着的基因疗法也有潜在的改进。其他新型疗法包括 Janus激酶（JAK）抑制剂和基于细胞的方法，其中黑素细胞 - 角质形成细胞移植可能有实现持续色素再生的潜力。文章还探讨了具有抗氧化、抗炎和免疫调节特性的植物成分，如姜黄素、槲皮素和银杏叶的作用，因此它们可以作为传统治疗的天然辅助剂。在将药理学进展与新的递送系统纳入白癜风治疗增强策略中时，多学科方法可能是必要的。这种方法纠正了一些传统的弱点，并利用新兴技术实现更以患者为导向的更好治疗方法。后续研究应朝着临床试验方向进行，以证实此类观察结果，并制定更广泛应用的治疗方案。
