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Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo

Tumour necrosis factor (TNF)‐α, a proinflammatory cytokine central to many autoimmune diseases, has been implicated in the depigmentation process in vitiligo. We review its role in vitiligo by exploring its pro‐ and anti‐inflammatory properties and examine the effects of blocking its actions with TN...

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Autores principales: Webb, K.C., Tung, R., Winterfield, L.S., Gottlieb, A.B., Eby, J.M., Henning, S.W., Le Poole, I.C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583813/
https://www.ncbi.nlm.nih.gov/pubmed/26149498
http://dx.doi.org/10.1111/bjd.14016
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author Webb, K.C.
Tung, R.
Winterfield, L.S.
Gottlieb, A.B.
Eby, J.M.
Henning, S.W.
Le Poole, I.C.
author_facet Webb, K.C.
Tung, R.
Winterfield, L.S.
Gottlieb, A.B.
Eby, J.M.
Henning, S.W.
Le Poole, I.C.
author_sort Webb, K.C.
collection PubMed
description Tumour necrosis factor (TNF)‐α, a proinflammatory cytokine central to many autoimmune diseases, has been implicated in the depigmentation process in vitiligo. We review its role in vitiligo by exploring its pro‐ and anti‐inflammatory properties and examine the effects of blocking its actions with TNF‐α antagonist therapeutics in reports available in the literature. We found that TNF‐α inhibition halts disease progression in patients with progressive vitiligo but that, paradoxically, treatment can be associated with de novo vitiligo development in some patients when used for other autoimmune conditions, particularly when using adalimumab and infliximab. These studies reinforce the importance of stating appropriate outcomes measures, as most pilot trials propose to measure repigmentation, whereas halting depigmentation is commonly overlooked as a measure of success. We conclude that TNF‐α inhibition has proven useful for patients with progressive vitiligo, where TNF‐α inhibition is able to quash cytotoxic T‐cell‐mediated melanocyte destruction. However, a lingering concern for initiating de novo disease will likely prevent more widespread application of TNF inhibitors to treat vitiligo.
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spelling pubmed-45838132016-09-01 Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo Webb, K.C. Tung, R. Winterfield, L.S. Gottlieb, A.B. Eby, J.M. Henning, S.W. Le Poole, I.C. Br J Dermatol Review Article Tumour necrosis factor (TNF)‐α, a proinflammatory cytokine central to many autoimmune diseases, has been implicated in the depigmentation process in vitiligo. We review its role in vitiligo by exploring its pro‐ and anti‐inflammatory properties and examine the effects of blocking its actions with TNF‐α antagonist therapeutics in reports available in the literature. We found that TNF‐α inhibition halts disease progression in patients with progressive vitiligo but that, paradoxically, treatment can be associated with de novo vitiligo development in some patients when used for other autoimmune conditions, particularly when using adalimumab and infliximab. These studies reinforce the importance of stating appropriate outcomes measures, as most pilot trials propose to measure repigmentation, whereas halting depigmentation is commonly overlooked as a measure of success. We conclude that TNF‐α inhibition has proven useful for patients with progressive vitiligo, where TNF‐α inhibition is able to quash cytotoxic T‐cell‐mediated melanocyte destruction. However, a lingering concern for initiating de novo disease will likely prevent more widespread application of TNF inhibitors to treat vitiligo. John Wiley and Sons Inc. 2015-08-25 2015-09 /pmc/articles/PMC4583813/ /pubmed/26149498 http://dx.doi.org/10.1111/bjd.14016 Text en © 2015 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Article
Webb, K.C.
Tung, R.
Winterfield, L.S.
Gottlieb, A.B.
Eby, J.M.
Henning, S.W.
Le Poole, I.C.
Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
title Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
title_full Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
title_fullStr Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
title_full_unstemmed Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
title_short Tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
title_sort tumour necrosis factor‐α inhibition can stabilize disease in progressive vitiligo
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583813/
https://www.ncbi.nlm.nih.gov/pubmed/26149498
http://dx.doi.org/10.1111/bjd.14016
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