Medically reviewed by Dr. John Harris, dermatologist and Director of the UMass Vitiligo Clinic and Research Center.
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.
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.
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.
With more clinical trials coming, doctors and scientists are looking to patients with vitiligo to get involved to help test the drugs. Patients can find out about clinical trials at https://clinicaltrials.gov/ or sign up to receive news and information directly from Dr. Harris at https://www.umassmed.edu/vitiligo/about/subscribe/.
Watch the full interview below:
Erika Page is the Founder and Editor of Living Dappled. After getting vitiligo at the age of seven, she lost 100% of her pigment to the condition and today lives with universal vitiligo.