To synthesize evidence on Treg biology and immunoregulatory functions in vitiligo, emphasizing their critical role in disease pathology and differences between peripheral blood and lesional skin.
Key Findings:
Reduced Treg frequency and impaired suppressive capacity in peripheral blood of vitiligo patients, indicating systemic dysregulation.
Marked decrease of tissue-resident and antigen-specific Treg subsets in lesional skin, suggesting localized immune failure.
Proinflammatory microenvironment in skin further compromises Treg function, exacerbating disease severity.
Dysregulation leads to insufficient suppression of autoreactive CD8+ T cells and persistent melanocyte destruction, highlighting the need for targeted interventions.
Therapies like NB-UVB, JAK inhibitors, and low-dose IL-2 show promise in restoring immune balance, warranting further investigation.
Interpretation:
The findings highlight the critical role of Treg in maintaining immune tolerance in vitiligo and suggest that both systemic and local Treg dysfunction contribute to disease pathology.
Limitations:
The review primarily synthesizes existing literature without presenting new experimental data, which may limit the depth of insights.
Potential biases in the studies reviewed, such as selection bias and publication bias, may affect the conclusions drawn.
Conclusion:
Understanding Treg dysregulation in vitiligo can inform the development of targeted therapies and improve patient outcomes, emphasizing the need for continued research in this area.
