Immunology of Vitiligo

Hann, Seung Kyung

Abstract

Vitiligo is frequently associated with autoimmune diseases, such as multiple glandular insuffi ciencies and thyroid diseases. In addition, various circulating antiorgan antibodies are found in patients with vitiligo. This raises the possibility that vitiligo might also be an antibody associated au toimmune disease. Variou. alterations in peripheral mononuclear cells, especially T-cells and T-cell subsets have been desiribed in patients with vitiligo. The discovery of circulating antimelanocyte antibodies in patients with vitiligo demonstrateci that vitiligo may be associted with alterations in the specific immunity to melanocytes. These vit iligo antibodies, which are more common in patients with vitiligo than in normal individuals, react with cell surface pigment cell antigens with MWs of approximately 150, 90, 75, 40-45, and 35 kDa, and can kill rnelanocytes in vitro. It has been suggested tiat melanocytes are much more sensitive to toxic or immune mediatece injury that other cutaneou; cell types, thus explaining their apparently selective destruction in vitiligo despite the rather bro d specificity of these vitiligo antibodies. However vitiligo autoantibodies are not found in all vitilio patients. Some of t,hem are present in patients without vitiligo. Tak ing into account the common occurrence of circulation autoantibodies irrelevant to the pathogene sis of the cutaneous hypomelanosis in vitiligo patients, the pathogenetic role of these vitiligo anti bodies has not yet been demonstrated, and the possibility that they represent an impertineni epiphenomenon in vitiligo cannot be ruled out.