Recent trends in the treatment of vitiligo using novel drug delivery system

Abstract

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.

Keywords: CRISPR-Cas9; Clinical therapy; Drug delivery; Melanocytes; Nanotechnology; Vitilogo.