【白斑症的新希望🧬】：當免疫系統「聽錯指令」時，我們如何精準的「導正」它？

很榮幸受邀到高雄榮總，與皮膚科同道們分享白斑症的最新研究與治療觀點。

近年來研究發現，干擾素γ（IFN-γ）是白斑免疫攻擊的關鍵角色之一。它會誤導免疫系統攻擊黑色素細胞，造成色素脫失。

有趣的是，我們前年的發表的研究中發現，即使在缺乏免疫細胞的情況下，只要 IFN-γ 的濃度升高，黑色素細胞仍會因為氧化壓力增加而死亡。而白斑症患者的皮膚病灶IFN-γ 的濃度明顯高於非病灶以及正常人。

這種細胞死亡與傳統機轉不同，我們鑑定為 ferroptosis，由脂質過氧化引發，是白斑發病機轉中被低估的一塊。

因這個機制主要透過 JAK-STAT路徑傳導，因此美國FDA已核准一款 JAK抑制劑外用藥膏，用於> 12歲以上非分節型白斑患者。我們也正積極追蹤這個藥物在實際困難型白斑治療中的效果。

我們持續努力，希望在治療白斑的路上，找到更多突破的可能，讓每位患者都多一點選擇、多一點希望。

黃昭瑜醫師研究論文連結： Ng CY et al. J Dermatol Sci. 2023 Jun;110(3):78-88.)

🧬 [New Hope for Vitiligo]: When the immune system “misfires,” how can we precisely “reset” its course?

It was an honor to be invited to Kaohsiung Veterans General Hospital to share the latest research and treatment perspectives on vitiligo with dermatology colleagues nationwide.

Studies have recently identified interferon-gamma (IFN-γ) as a key player in the autoimmune response behind vitiligo. IFN-γ misguides the immune system to attack melanocytes, leading to pigment loss.

Interestingly, in our study published two years ago, we found that even in the absence of immune cells, elevated levels of IFN-γ alone can induce oxidative stress, ultimately causing melanocyte death. IFN-γ is highly expressed in lesional skin and nonlesional skin of vitiligo compare to healthy controls.

This type of cell death differs from classical pathways, we identified it as ferroptosis, a lipid peroxidation-driven process that may be an under-recognized contributor to vitiligo pathogenesis.

Since this mechanism is mediated via the JAK-STAT signaling pathway, the U.S. FDA approved a topical JAK inhibitor cream for patients 12 and older with non-segmental vitiligo.

At the Vitiligo & Pigment Center (VIPC) at Chang Gung Memorial Hospital, we are currently analyzing the real-world outcomes of this medication, especially in treatment-resistant vitiligo.

We’re continuing to work hard, hoping to discover breakthroughs in the treatment of vitiligo—

so that every patient may have more options, and a little more hope.

Publication : Ng CY et al. J Dermatol Sci. 2023 Jun;110(3):78-88.）