首页 > 白癜风百科 > 白癜风常识> 英语文献:医生和科学家现在已经确定了导致白癜风的关键途径




热门问题:白癜风是遗传性疾病吗?Is vitiligo genetically transmitted disease?

Update Insert: After leaving my initial “yes” reply which is a bit different as it happened in my late 40’s, and was another auto-immune condition for me on my cheecks only, I also mentioned a Clinical Trial I had read of an “already existing medication” having astonishing results for Vitiligo. I was going to edit as I run long. But I read everyone else’s replies first. I saw how many people suffered, and did not see anyone with knowledge of good news on the horizon.


After reading the hopeless acceptance, awful people treating sufferers like subhumans (ggrrh!) I erased the rust of my personal story and am just pasting several trials of new medications that are working so you can see and have hope as results are real and they are here. One of two has pictures. I will try to paste a third, but must run. I will return and add more, and find the drug used I read about first, as I recall the results were instants or pretty darned close.


For the people (which seem mainly woman?) I have seen with this condition affect their arms, their face… And people with more natural pigmentation of course have higher contrast thus more idiots staring at them…I still see their beauty and cohesive look as many people must. However, I have read some heartbreaking accounts about their life experiences first-hand. The depression, hiding, shame, idiots, cruelty. It was much worse than I every imagined. You are loved. Your Vitiligo is not offensive. The spots on my cheeks: Yes idiots see them as make-up does not totally cover and same idiots end up sticking fingertips in my face in those spots “Hey you duh a’aint got color duhhh” Me: Jack=== get your grubby e-coli infested hands and fingers off my face. We all know you don’t wipe properly. So my suffering is .0005% to yours. It sounds like 7 years old was a common time to be afflicted. I was in my 40’s. And yes, people as a majority: children and adults are cruel, cruel idiots.


Yale dermatologists successfully restore skin color in vitiligo patients


By Ziba Kashef


january 31, 2018


Building on prior research that examined the use of an arthritis medication to treat vitiligo, a team of Yale dermatologists has successfully applied a novel combination therapy — the medication and light — to restore skin color in patients.


The study, led by associate professor of dermatology Brett King, M.D., was published in JAMA Dermatology on January 31, 2018.

该由皮肤病学副Brett King医学领导,于2018年1月31日发表在《医学会皮肤病杂志》上。

King and his colleagues reported two cases of patients with significant loss of skin color from vitiligo, a chronic autoimmune disease that destroys skin pigment, leaving white splotches where there had been color. For King’s patients, standard treatments, such as steroid creams and light treatment, had failed to restore pigmentation. To address these difficult cases, the research team combined the medication, tofacitinib, with narrow band ultraviolet B light therapy. In recent experiments, King and Dr. John Harris, a dermatologist at University of Massachusetts-Worcester, had shown that tofacitinib keeps the immune system from attacking the skin cells that manufacture melanin pigment (color), and light stimulates pigment-making cells to restore color to the skin.

金和他的同事报告了两例因白癜风(一种破坏皮肤色素的慢性自身免疫性疾病,在有颜色的地方留下白色斑点)而导致皮肤颜色丧失的患者。对于King's患者,标准治疗,如类固醇乳膏和轻度治疗,未能恢复色素沉着。为了解决这些困难的病例,团队将药物托法替尼与窄波段紫外线B光相结合。在近的实验中,麻州大学伍斯特的皮肤科医生King和John Harris已经证明,托福替尼可以防止免疫系统攻击制造黑色素(肤色)的皮肤细胞,并且光刺激色素使细胞恢复皮肤颜色。

After a few months of the combination therapy, there was remarkable improvement, report the researchers: One patient saw near-total restoration of skin color on her face, neck, chest, forearms, and shins. The other patient experienced similar success.


Left to right: Dr. King’s vitiligo patient at the beginning of treatment, and at three and six months later.


While more research is needed, the study highlights another advance by the Yale team in treating this and other stigmatizing skin conditions. “These findings will define treatment of vitiligo in the future,” King said.


Other Yale authors are Sa Rang Kim, Henry Heaton, and Lucy Y. Liu. King has served on advisory boards or is a consultant for Celgene, Eli Lilly and Company, Concert Pharmaceuticals Inc., and Pfizer Inc.

耶鲁大学的其他作家还有金萨朗、亨利·希顿和露西·Y·刘。King曾在咨询任职,或是Celgene、礼来公司、Concert Pharmaceuticals Inc.和辉瑞公司的。

2. New Treatment Could Be 'Breakthrough' for Vitiligo


By Serena Gordon


HealthDay Reporter


MONDAY, Feb. 5, 2018 (HealthDay News) -- Doctors have discovered a combination of treatments that can return color to skin that has been lightened by vitiligo -- the skin disease that turned Michael Jackson's skin white.


The new therapy includes the oral medication Xeljanz (tofacitinib) -- a drug already approved for use in rheumatoid arthritis patients that dampens the body's immune response -- and ultraviolet-B light therapy.


The combination has only been used on two vitiligo patients, but according to a study author, the results have been dramatic.


Experts add, however, that the findings need to be duplicated in studies with larger groups of people.


The treatment produces "results that are impossible to achieve with common therapies," said Dr. Brett King, an associate professor of dermatology at Yale University School of Medicine.


"I think this is a breakthrough in vitiligo treatment," he added.


One of King's vitiligo patients, Shahanaj Akter, agreed.

国王的白癜风患者之一沙哈纳吉·阿克特(Shahanaj Akter)表示同意。

"My skin is so much better. I can use make-up and it blends nicely. I am so excited," she said.


Akter, 34, first noticed a white patch of skin above her eyebrow on her normally brown skin while she was pregnant in her 20s. That patch grew bigger and bigger, and then white patches showed up on her hands and neck.


Vitiligo is a skin condition that causes white patches of skin to appear on various parts of the face and body, according to the Vitiligo Research Foundation (VRF). The disorder can also cause hair to lose its pigment and turn white. The condition can affect people of any race, but is more noticeable in people with darker skin and hair.


General vitiligo is believed to be an autoimmune condition, which means the immune system mistakenly attacks pigment-producing cells (melanocytes).


The condition affects up to 2 percent of the world's population, according to the VRF.


Vitiligo is not contagious. But King said people are often concerned when they see people with vitiligo on their hands. He said patients have told him that cashiers sometimes ask them to put money or credit cards down on the counter so they don't have to touch their hands.


"Vitiligo affects the way the world interacts with you. It can be frustrating and embarrassing, and for some, it leads to clinical depression and anxiety," King said.


Akter was living in her native country of Bangladesh when her condition first began, and vitiligo carries even more of a stigma there. Some people said unkind things to her.


"I cried a lot. I wanted to be my color again," she said.


To that end, Akter tried treatment after treatment in Bangladesh and then in the United States. Some therapies caused intolerable side effects, and none brought the results she was hoping for.


"It was terrible. I tried so many things," she said.


That's when King suggested she try the new combination therapy.


At the time of treatment, Akter had white patches on about three-quarters of her face. She also had patches on her neck, chest, forearms, hands and shins. She was given 5 milligrams of tofacitinib twice daily, and full body UV-B light therapy twice weekly.


After three months, Akter's face was almost completely free of white patches. About 75 percent of her neck, chest, forearms and shins were re-pigmented with color. Her hands had only minimal freckling.


How does this treatment work?


Dr. Seemal Desai, a clinical assistant professor of dermatology at the University of Texas Southwestern Medical Center in Dallas, explained it this way: "The immune system is attacking the melanocytes, so they go into hiding. Tofacitinib tells them it's OK to come out of hiding, and the UV light brings them out of hibernation."

达拉斯德克萨斯大学西南医学中心皮肤科助理Seemal Desai解释道:“免疫系统正在攻击黑素细胞,所以它们躲藏起来。Tofacitinib告诉他们,躲藏起来是可以的,紫外线会使它们冬眠。”

King and his colleagues also reported on a white man in his 50s who had long-standing vitiligo. He had previously received treatment to remove all pigment so he would be uniformly white. But he still had patches of whiter skin on 90 percent of his face. He also had patches on his torso and arms.


After three months of treatment on his face, he had about 50 percent re-pigmentation. After six months, he had about 75 percent re-pigmentation of his face. King was surprised at how effective the treatment was because the man had previously undergone chemical destruction of the pigment cells.


Desai said the findings "look promising, and that new treatment options are great."


But, he added, this study needs to be replicated in a larger group of people.


And he noted that right now, people will likely have a hard time getting reimbursed for tofacitinib because it's not approved for treating vitiligo. He didn't know exact costs but said the drug is quite expensive. Estimates put the drug's price tag at roughly $2,000 a month.


Both King and Desai said the drug seems to be well tolerated. King said he doesn't know how long people would need to take the drug, but suspects some would be on it long-term, possibly for life.


Details of the cases were published online Jan. 31 in a research letter in the journal JAMA Dermatology.


WebMD News from HealthDay


SourcesCopyright © 2013-2018 HealthDay. All rights reserved.


3. "Speaking of Vitiligo..."


Afamelanotide tested as a new treatment for vitiligo


Posted On: Sunday, September 21, 2014Posted By: John E. Harris


A report was recently published describing a study to test the ability of afamelanotide to improve the response of vitiligo patients to narrow band ultraviolet light B (nbUVB) phototherapy. In short, the treatment worked. I was not personally involved in conducting the study, but I know the study authors personally, and they are great doctors who are well-known vitiligo specialists.


The successful treatment of vitiligo requires suppression of the autoimmune response, followed by regrowth of melanocytes back into the white skin to produce pigment and reverse the white spots. Afamelanotide, produced by Clinuvel, is a synthetic, simplified form of alpha-melanocyte stimulating hormone (a-MSH), which is a natural hormone produced in the skin that stimulates melanocytes to grow and produce melanin pigment. Narrow band UVB suppresses the autoimmune response in the skin and stimulates the melanocyte to start regrowing into the white skin. The authors reasoned that adding afamelanotide to nbUVB treatment would speed up the process of repigmentation by stimulating the melanocytes to regrow and produce melanin faster.


Patients who entered the study were randomized into either nbUVB treatment 2-3 times per week alone, or combined treatment with nbUVB and afamelanotide. Those in the combined treatment group started with 1 month of nbUVB and then received an implant that contained 16 mg of afamelanotide deep in their skin, just above their hip, and nbUVB treatment was continued. The drug diffused out into the entire body, providing a stimulus for all of the melanocytes in the patient’s skin. A new implant was inserted every month for 3 more months, and the amount of repigmentation of the white spots was measured.


The results show that subjects who received afamelanotide in addition to nbUVB therapy regained their pigment faster and to a greater extent than the ones who only received nbUVB therapy. The pigment came back on average 20 days sooner with the afamelanotide, and more pigment returned as well. It worked best for those with darker skin. There were some side effects of the treatment – all of the subjects that received afamelanotide developed darker skin, and 2 of the subjects quit the study because of this. Nausea was reported in 18% and fatigue in 11% of those who were treated with the drug. Some are concerned about the effect of afamelanotide on moles and an increased risk for melanoma, although there was no evidence of changing moles in this study, and there is no evidence of increased risk of melanoma to date.


It is currently not known whether using a larger dose of afamelanotide, using it more frequently, or using it for a longer period of time would produce even better results. The authors didn’t test whether afamelanotide would work on its own, without nbUVB. More studies will be required to determine this, but this certainly looks like a good start!




JAN 25, 2018








What’s the latest in vitiligo research and treatments? Living Dappled had the chance to find out in its first episode of “Ask the Experts” featuring Dr. John Harris, Director of the University of Massachusetts Vitiligo Clinic and Research Center.

白癜风和治疗的进展是什么?住在麻州大学的白癜风诊所和中心John Harris的集“活”。

Hosted on Living Dappled’s Facebook, the live interview highlighted five things to know about vitiligo research and treatments in 2018. A scientist and dermatologist, Dr. Harris called in from his office in the Worcester, Massachusetts research center and even gave a surprise tour at the end of the interview.

在Living Dappled的Facebook上,这场现场采访了2018年白癜风和治疗需要了解的五件事。身为科学家和皮肤科医生的哈里斯从位于马萨诸塞州伍斯特中心的办公室打来电话,甚至在采访结束时进行了一次喜之旅。

Find out what we learned from Dr. Harris below and view the video below to catch the full interview.


#1 Research In Vitiligo Has Been Going On For Over 2,000 Years


Over 2,000 years ago, patients in India were told to chew bavachee seeds and sit out in the sun. The seeds contained psoralen, a chemical used in a modern treatments for vitiligo. So while 2,000 years ago, people knew about vitiligo and were interested in treating it, it took another couple thousand years to for doctors and scientists to find out how it works and make treatment more efficient. The modern era of research started about 70 years ago when a couple of doctors and researchers took psoralen as a chemical and gave it to patients as a topical solution on the skin or as a pill and then gave them UVA light therapy – otherwise known as PUVA. First developed back in the fifties and sixties, PUVA has been replaced with UVB because PUVA has been shown to increase the risk of skin cancer and UVB works just as well or better, but doesn’t appear to increase the skin cancer risk.


Today, the pace has picked up and even more research is happening in large part due to an increased availability of tools and interest from pharmaceutical companies. Vitiligo specialty clinics are located all over the world with four or five in the United States. And vitiligo scientists and dermatologists are collaborating globally through organizations like the Global Vitiligo Foundation and conferences to combine efforts towards ultimately finding a cure.


#2 Vitiligo Was Only Recently Recognized As An Autoimmune Disease


Until recently, there was a lot of debate surrounding vitiligo as an autoimmune disease. In vitiligo, the melanocytes (pigment cells) are abnormal and attract the immune system, which ends up killing them. Unfortunately, the immune cells are attacking normal cells that aren’t causing problems. Although vitiligo is an autoimmune disease, there’s a lot more to the disease and investigations are continuing. It’s important to recognize that it’s autoimmune disease because there are a lot of treatments being developed that alter and modify the immune system, which means they could work for vitiligo. Building a foundation on these existing treatments that can intervene early and cut off the immune attack can save time on research and ultimately bring patients treatments sooner.


#3 Research Can Be Categorized In Three Key Ways – And They All Matter


Research in vitiligo is broken down into three types. Basic research is a term used to describe research that happens with cells in a dish or on animal models, including mice. Translational research is done with humans and involves taking blood and skin samples for analysis. The final type is clinical research, which involves giving patients medicine to test new drugs or understand how vitiligo changes in people over time.


All three types of research are essential to fully understanding a disease. The University of Massachusetts Vitiligo Clinic and Research Center does all three types, integrating them to understand the big picture of vitiligo. Particularly, they’ve had success with translational research as more than 100 of their patients have been generous in donating blood and skin samples.


#4 The Key Pathway Responsible For Vitiligo Has Been Identified – And That’s Good News


Imagine going to bed at night and needing to turn off the lights in your room. Ideally, you would reach over and use the lamp next to your bed instead of going to the basement and shutting down the circuit breaker for the whole house. In the same way, you don’t want to shut down your entire immune system just to make your vitiligo better.


The good news is that doctors and scientists have now identified the key pathway responsible for vitiligo, which allows them to shut off the lights in your entire room – to continue with the metaphor – and the next wave of drugs will do that. The next step is to figure out how to turn off your lights with your single lamp switch – the most effective, safe way to treat vitiligo because it would have fewer side effects.


#5 New Clinical Trials For Vitiligo Have Already Started And More Are Coming


In the past 70 years, there have been only a couple clinical trials but the good news is that new trials are already underway and more are coming. Currently, the company Incyte is testing a new topical cream through a multicenter trial that will last two years.



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