Vitiligo immunopathogenesis: Insight of immune components and prospects of emerging immunotherapies

Vitiligo is an acquired depigmenting disease characterized by the loss of pigmentation from the skin due to selective killing of pigment forming cells (melanocytes) by cytotoxic T cells (CD8+ T cells). The pathogenesis of vitiligo has broad spectrum ranging from genetic, biochemical and immunological factors. Based on these multifactorial aetiologies several hypotheses have been suggested with substantial evidence. Recent advances in the understanding of immunopathogenesis of the disease have opened new avenues that may be translated into effective treatment strategies. There is requirement of new immunomolecular targets aiming to reinstate the skin homeostasis by maintaining the fine tuning with immune parameters and melanocyte microenvironment of the skin. The present review will address the recent advances in the pathogenesis of generalized vitiligo (GV) giving emphasis on memory T cells, regulatory T cells (Tregs), cytokines and chemokines with prospects of promising immunotherapies.