The regenerative potential of autologous stem and somatic cells in vitiligo

Vitiligo is a human pigmentary disorder characterized by autoimmune destruction of mature melanocytes in the skin. In addition to studies on the inflammatory component of the disease, current treatments tend to involve stimulation of local melanocyte stem cells or transplantation of functional melanocytes from uninjured areas, however, in some cases of extensive depigmentation, only a few healthy cells can be obtained. This review discusses examples in the literature of the use of different sources of autologous stem and somatic cells in order to obtain melanocyte progenitors or mature melanocytes, and compares the strategy of stem cell differentiation with that of somatic cell reprogramming. More specifically, this review illustrates the capability of stem cells to differentiate from dental pulp, bone marrow, and adipose tissue; the reprogramming of pluripotent cells and the transdifferentiation of fibroblasts and keratinocytes. Each of these approaches is capable of producing fully functional melanocytes, but all have advantages and disadvantages. Finally, the relevance for potential clinical application is discussed, along with the risks associated with each strategy and the major current barriers to their use.