Ouwerkerk, Wouter, Narayan, Vidhya S., Chielie, Saskia, van Uden, Nathalie O.P., Schneider, Martin-Alexander, Gaulis, Swann, Kjellerup, Rasmus Boye, Loesche, Christian, Hanser, Malika, McNamara, Elizabeth, Bekkenk, Marcel W., Wolkerstorfer, Albert and Luiten, Rosalie M. (2025) Immune and biological changes during treatment in patients with non-segmental vitiligo and their relation to repigmentation. Journal of Investigative Dermatology. ISSN ISSN 0022-202X

Abstract

Background: The treatment of non-segmental vitiligo (NSV) remains a challenge and is poorly understood. The aim of this study was to evaluate protein differences in lesional and non-lesional skin and changes of cellular and proteomic markers early in treatment in lesional skin and blood in relation to clinical response.
Methods and Results: This prospective exploratory study was conducted in 30 NSV patients, 11 starting with standard-of-care topical therapy and 19 in combination with narrowband (NB)-UVB phototherapy. We identified 53 proteins that differed significantly between blister fluid from lesional and non-lesional skin, prior to treatment. After 3-months of treatment, CD3+, CD8+ T and TRM (CD69+CD103-) cell populations decreased in skin biopsies, together with changes in 47 blister fluid proteins. Percentages of cTfh17, CD336+Nkbright, type 1 regulatory T (Tr1) and Interleukin-10-secreting Tr1 cells decreased in blood. Decrease in TRM (blister fluid), Tr1 and Interleukin-10-secreting Tr1 (blood), and Fatty Acid-Binding Protein 4 (FABP4; blister fluid), were associated with repigmentation, measured with the Vitiligo Extent Score at baseline and 6-months.
Conclusion: Differences in lesional and non-lesional skin prior to treatment, do not reflect changes in lesional skin early in therapy nor associations with clinical repigmentation response. We found that a decrease of FABP4 protein and TRM cells in skin and IL10 secreting Tr1 cells in blood were significantly associated with the repigmentation response to treatment of vitiligo.

Item Type:	Article
Date Deposited:	03 Dec 2025 00:45
Last Modified:	03 Dec 2025 00:45
URI:	https://oak.novartis.com/id/eprint/56656