{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:03:56Z","timestamp":1793034236590,"version":"4.5.0"},"reference-count":202,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["PNRR-MCNT2-2023-12377707"],"award-info":[{"award-number":["PNRR-MCNT2-2023-12377707"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Vitiligo is a chronic autoimmune disease characterized by the destruction of epidermal melanocyte, resulting in well-demarcated white patches on the skin. Despite the established use of corticosteroids and calcineurin inhibitors and the recent introduction of Janus kinase (JAK) inhibitors, a breakthrough targeted therapy that interrupts the IFN-\u03b3 signaling pathway, stable repigmentation remains a major clinical challenge, necessitating deeper investigation into its pathogenesis. Among the factors contributing to vitiligo, including genetic predisposition and autoimmunity, oxidative stress is a central driver of melanocyte damage and the subsequent autoimmune response. Chronic oxidative disequilibrium (high ROS level and impaired mitochondrial activity) and reduced antioxidant capacity (Nrf2\/ARE pathway and catalase deficiency) function as triggering factors upstream of most other pathogenic pathways. Consequently, targeting oxidative stress, either as a monotherapy or in synergy with emerging targeted treatments, remains a pivotal area of therapeutic interest even in the current era of targeted therapies. Still, a significant gap remains the lack of standardized oxidative biomarkers to monitor disease activity and therapeutic response. Identifying these indicators is essential for personalized clinical management in vitiligo. This review examines how chronic oxidative disequilibrium and a reduced antioxidant capacity initiate and sustain the autoimmune cascade, leading to disease onset and progression.<\/jats:p>","DOI":"10.3390\/biom16040612","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:57:21Z","timestamp":1776758241000},"page":"612","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Targeting Oxidative Stress to Treat Vitiligo: Clinical and Molecular Evidence"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2096-6748","authenticated-orcid":false,"given":"Noemi","family":"Aprile","sequence":"first","affiliation":[{"name":"UOSVD Dermatology and Allergology, Hospital Vito Fazzi, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9329-8348","authenticated-orcid":false,"given":"Simona","family":"Scano","sequence":"additional","affiliation":[{"name":"Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3883-5500","authenticated-orcid":false,"given":"Barbara","family":"Bellei","sequence":"additional","affiliation":[{"name":"Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7222-9056","authenticated-orcid":false,"given":"Alberto","family":"Marini","sequence":"additional","affiliation":[{"name":"Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Filoni","sequence":"additional","affiliation":[{"name":"UOSVD Dermatology and Allergology, Hospital Vito Fazzi, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"240","DOI":"10.4103\/ijdvl.IJDVL_409_18","article-title":"A cross-sectional study of spontaneous repigmentation in vitiligo","volume":"86","author":"Taneja","year":"2020","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/wrr.12798","article-title":"Lesional skin in vitiligo exhibits delayed in vivo reepithelialization compared to the nonlesional skin","volume":"28","author":"Gupta","year":"2020","journal-title":"Wound Repair. Regen."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1159\/000288166","article-title":"Epidermal permeability barrier recovery is delayed in vitiligo-involved sites","volume":"23","author":"Liu","year":"2010","journal-title":"Skin Pharmacol. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"eabn9299","DOI":"10.1126\/sciadv.abn9299","article-title":"Altered epidermal proliferation, differentiation, and lipid composition: Novel key elements in the vitiligo puzzle","volume":"8","author":"Kovacs","year":"2022","journal-title":"Sci. Adv."},{"key":"ref_5","first-page":"e2023312S","article-title":"Clinical Features of Vitiligo and Social Impact on Quality of Life","volume":"13","author":"Seneschal","year":"2023","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2573143","DOI":"10.1080\/07853890.2025.2573143","article-title":"Global prevalence of autoimmune diseases in turner syndrome: A systematic review and meta-analysis","volume":"57","author":"Hwang","year":"2025","journal-title":"Ann. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1111\/j.1755-148X.2012.00997.x","article-title":"Revised classification\/nomenclature of vitiligo and related issues: The Vitiligo Global Issues Consensus Conference","volume":"25","author":"Ezzedine","year":"2012","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1016\/j.jaad.2019.06.022","article-title":"The association between vitiligo and diabetes mellitus: A systematic review and meta-analysis","volume":"81","author":"Chang","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Hu, Z., and Wang, T. (2023). Beyond skin white spots: Vitiligo and associated comorbidities. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1072837"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/s41572-025-00670-x","article-title":"Vitiligo","volume":"11","author":"Seneschal","year":"2025","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/pcmr.12949","article-title":"An update on Vitiligo pathogenesis","volume":"34","author":"Seneschal","year":"2021","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chang, W., and Ko, C. (2023). The Role of Oxidative Stress in Vitiligo: An Update on Its Pathogenesis and Therapeutic Implications. Cells, 12.","DOI":"10.3390\/cells12060936"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bellei, B., Pitisci, A., Ottaviani, M., Ludovici, M., Cota, C., Luzi, F., Dell\u2019Anna, M.L., and Picardo, M. (2013). Vitiligo: A possible model of degenerative diseases. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0059782"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/exd.13868","article-title":"Involvement of non-melanocytic skin cells in vitiligo","volume":"28","author":"Bastonini","year":"2019","journal-title":"Exp. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/jcp.22027","article-title":"Membrane lipid defects are responsible for the generation of reactive oxygen species in peripheral blood mononuclear cells from vitiligo patients","volume":"223","author":"Ottaviani","year":"2010","journal-title":"J. Cell. Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e71699","DOI":"10.1002\/hsr2.71699","article-title":"Evaluation of Oxidative Stress in Red Blood Cells From Vitiligo Patients and Its Correlation With Disease Severity and Activity: A Cohort Case-Control Study","volume":"9","author":"Saleh","year":"2026","journal-title":"Health Sci. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"8416763","DOI":"10.1155\/2017\/8416763","article-title":"Oxidative Stress: Harms and Benefits for Human Health","volume":"2017","author":"Pizzino","year":"2017","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Papaccio, F., Arino, A.D., Caputo, S., and Bellei, B. (2022). Focus on the Contribution of Oxidative Stress in Skin Aging. Antioxidants, 11.","DOI":"10.3390\/antiox11061121"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"7370642","DOI":"10.1155\/2016\/7370642","article-title":"Ultraviolet Radiation-Induced Skin Aging: The Role of DNA Damage and Oxidative Stress in Epidermal Stem Cell Damage Mediated Skin Aging","volume":"2016","author":"Panich","year":"2016","journal-title":"Stem Cells Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11010-020-03901-9","article-title":"Role of Nrf2 in cell senescence regulation","volume":"476","author":"Yuan","year":"2021","journal-title":"Mol. Cell. Biochem."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1080\/10715760600917151","article-title":"Oxygen free radicals in cell senescence: Are they signal transducers?","volume":"40","author":"Passos","year":"2006","journal-title":"Free Radic. Res."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Tirichen, H., Yaigoub, H., Xu, W., Wu, C., Li, R., and Li, Y. (2021). Mitochondrial Reactive Oxygen Species and Their Contribution in Chronic Kidney Disease Progression Through Oxidative Stress. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.627837"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/j.1600-0625.2007.00675.x","article-title":"Regulation of melanogenesis--controversies and new concepts","volume":"17","author":"Schallreuter","year":"2008","journal-title":"Exp. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Tanaka, H., Yamashita, Y., Umezawa, K., Hirobe, T., Ito, S., and Wakamatsu, K. (2018). The Pro-Oxidant Activity of Pheomelanin is Significantly Enhanced by UVA Irradiation: Benzothiazole Moieties Are More Reactive than Benzothiazine Moieties. Int. J. Mol. Sci., 19.","DOI":"10.20944\/preprints201809.0091.v1"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1755-148X.2010.00673.x","article-title":"MC1R stimulation by alpha-MSH induces catalase and promotes its re-distribution to the cell periphery and dendrites","volume":"23","author":"Maresca","year":"2010","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/j.1755-148X.2007.00432.x","article-title":"Correlation between melanogenic and catalase activity in in vitro human melanocytes: A synergic strategy against oxidative stress","volume":"21","author":"Maresca","year":"2008","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Krishnamurthy, H.K., Pereira, M., Rajavelu, I., Jayaraman, V., Krishna, K., Wang, T., Bei, K., and Rajasekaran, J.J. (2024). Oxidative stress: Fundamentals and advances in quantification techniques. Front. Chem., 12.","DOI":"10.3389\/fchem.2024.1470458"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s11033-024-09771-4","article-title":"Regulation of Keap1-Nrf2 signaling in health and diseases","volume":"51","author":"Xiao","year":"2024","journal-title":"Mol. Biol. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/s41577-020-00478-8","article-title":"Redox regulation of immunometabolism","volume":"21","author":"Muri","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e70013","DOI":"10.1002\/biof.70013","article-title":"The role of NRF2 transcription factor in inflammatory skin diseases","volume":"51","author":"Salman","year":"2025","journal-title":"Biofactors"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8796735","DOI":"10.1155\/2022\/8796735","article-title":"The Promising Role of Chemokines in Vitiligo: From Oxidative Stress to the Autoimmune Response","volume":"2022","author":"He","year":"2022","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Cui, Y., and Man, X. (2023). Biology of melanocytes in mammals. Front. Cell Dev. Biol., 11.","DOI":"10.3389\/fcell.2023.1309557"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1056\/NEJMoa061592","article-title":"NALP1 in vitiligo-associated multiple autoimmune disease","volume":"356","author":"Jin","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1056\/NEJMoa0908547","article-title":"Variant of TYR and autoimmunity susceptibility loci in generalized vitiligo","volume":"362","author":"Jin","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/ng.2272","article-title":"Genome-wide association analyses identify 13 new susceptibility loci for generalized vitiligo","volume":"44","author":"Jin","year":"2012","journal-title":"Nat. Genet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1038\/ng.3680","article-title":"Genome-wide association studies of autoimmune vitiligo identify 23 new risk loci and highlight key pathways and regulatory variants","volume":"48","author":"Jin","year":"2016","journal-title":"Nat. Genet."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1016\/j.ajhg.2024.09.007","article-title":"Inverse relationship between polygenic risk burden and age of onset of autoimmune vitiligo","volume":"111","author":"Roberts","year":"2024","journal-title":"Am. J. Hum. Genet."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ymgme.2005.07.023","article-title":"Decreased phenylalanine uptake and turnover in patients with vitiligo","volume":"86","author":"Schallreuter","year":"2005","journal-title":"Mol. Genet. Metab."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/BF02505037","article-title":"Increased monoamine oxidase A activity in the epidermis of patients with vitiligo","volume":"288","author":"Schallreuter","year":"1996","journal-title":"Arch. Dermatol. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/BF03260057","article-title":"Catalase enzyme mutations and their association with diseases","volume":"8","author":"Goth","year":"2004","journal-title":"Mol. Diagn."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"153","DOI":"10.14712\/fb2014060040153","article-title":"Human catalase, its polymorphisms, regulation and changes of its activity in different diseases","volume":"60","author":"Kodydkova","year":"2014","journal-title":"Folia Biol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1034\/j.1600-0749.2002.00057.x","article-title":"Genetic association of the catalase gene (CAT) with vitiligo susceptibility","volume":"15","author":"Casp","year":"2002","journal-title":"Pigment Cell Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1111\/bjd.15681","article-title":"The catalase gene promoter and 5\u2032-untranslated region variants lead to altered gene expression and enzyme activity in vitiligo","volume":"177","author":"Mansuri","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Saif, G.A.B., Alshammary, A.F., and Ali Khan, I. (2023). Evaluation of CAT Variants A-89T, C389T, and C419T in Patients with Vitiligo in the Saudi Population. Medicina, 59.","DOI":"10.3390\/medicina59040708"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"619","DOI":"10.23736\/S0392-0488.17.05488-8","article-title":"Vitiligo susceptibility and catalase gene polymorphisms in Sicilian population","volume":"153","author":"Caputo","year":"2018","journal-title":"G. Ital. Dermatol. Venereol."},{"key":"ref_46","first-page":"173","article-title":"No association between catalase (CAT) gene polymorphisms and susceptibility to vitiligo in a Turkish population","volume":"164","author":"Akbas","year":"2013","journal-title":"Clin. Ter."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.0906-6705.2006.00423.x","article-title":"Association study between catalase gene polymorphisms and the susceptibility to vitiligo in Korean population","volume":"15","author":"Park","year":"2006","journal-title":"Exp. Dermatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1038\/jid.2010.192","article-title":"Promoter variant in the catalase gene is associated with vitiligo in Chinese people","volume":"130","author":"Liu","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.freeradbiomed.2013.08.189","article-title":"Involvement of superoxide dismutase isoenzymes and their genetic variants in progression of and higher susceptibility to vitiligo","volume":"65","author":"Laddha","year":"2013","journal-title":"Free Radic. Biol. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.gene.2012.04.011","article-title":"Relationships between single nucleotide polymorphisms of antioxidant enzymes and disease","volume":"501","author":"Crawford","year":"2012","journal-title":"Gene"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/00008571-200303000-00004","article-title":"The Ala16Val genetic dimorphism modulates the import of human manganese superoxide dismutase into rat liver mitochondria","volume":"13","author":"Sutton","year":"2003","journal-title":"Pharmacogenetics"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1111\/exd.13007","article-title":"Genetic variations (Arg5Pro and Leu6Pro) modulate the structure and activity of GPX1 and genetic risk for vitiligo","volume":"25","author":"Mansuri","year":"2016","journal-title":"Exp. Dermatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1089\/ars.2009.2976","article-title":"Dysfunction of glutathione S-transferase leads to excess 4-hydroxy-2-nonenal and H(2)O(2) and impaired cytokine pattern in cultured keratinocytes and blood of vitiligo patients","volume":"13","author":"Kostyuk","year":"2010","journal-title":"Antioxid. Redox Signal."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1038\/bjc.1995.332","article-title":"Phenotype of glutathione S-transferase Mu (GSTM1) and susceptibility to malignant melanoma. MMM group. Multidisciplinary Malignant Melanoma Group","volume":"72","author":"Lafuente","year":"1995","journal-title":"Br. J. Cancer"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1111\/j.1755-148X.2011.00872.x","article-title":"Glutathione S-transferase M1\/T1 gene polymorphisms and vitiligo in a Mediterranean population","volume":"24","author":"Guarneri","year":"2011","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.lfs.2007.05.006","article-title":"Association of glutathione S-transferase gene polymorphisms (GSTM1 and GSTT1) of vitiligo in Korean population","volume":"81","author":"Uhm","year":"2007","journal-title":"Life Sci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2646","DOI":"10.1038\/jid.2009.143","article-title":"Genetic polymorphisms of glutathione S-transferase and risk of vitiligo in the Chinese population","volume":"129","author":"Liu","year":"2009","journal-title":"J. Investig. Dermatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1365-2230.2012.04413.x","article-title":"Glutathione S-transferase M1 and T1 genetic polymorphism in Egyptian patients with nonsegmental vitiligo","volume":"38","author":"Bassiouny","year":"2013","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1590\/abd1806-4841.20185796","article-title":"A study of the association of glutathione S-transferase M1\/T1 polymorphisms with susceptibility to vitiligo in Egyptian patients","volume":"93","author":"Aly","year":"2018","journal-title":"An. Bras. Dermatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1111\/ijd.13761","article-title":"Aryl hydrocarbon receptor (AhR) transcription is decreased in skin of vitiligo patients","volume":"56","author":"Rekik","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"13542","DOI":"10.1038\/srep13542","article-title":"AHR promoter variant modulates its transcription and downstream effectors by allele-specific AHR-SP1 interaction functioning as a genetic marker for vitiligo","volume":"5","author":"Wang","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.jid.2025.07.027","article-title":"Downregulated Aryl Hydrocarbon Receptor Expression Is Linked with Increased IFN-gamma Production and Impaired Immune Checkpoint Upregulation in Vitiligo","volume":"146","author":"Belpaire","year":"2026","journal-title":"J. Investig. Dermatol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s00403-024-03405-2","article-title":"The role of aryl hydrocarbon receptor agonists in the treatment of vitiligo","volume":"316","author":"Bitterman","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1111\/j.1365-2133.2011.10798.x","article-title":"The association of functional polymorphisms in the aryl hydrocarbon receptor (AHR) gene with the risk of vitiligo in Han Chinese populations","volume":"166","author":"Wang","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Furue, M., and Tsuji, G. (2019). Chloracne and Hyperpigmentation Caused by Exposure to Hazardous Aryl Hydrocarbon Receptor Ligands. Int. J. Environ. Res. Public. Health, 16.","DOI":"10.3390\/ijerph16234864"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1111\/jcmm.12874","article-title":"Genetic polymorphism of the Nrf2 promoter region is associated with vitiligo risk in Han Chinese populations","volume":"20","author":"Song","year":"2016","journal-title":"J. Cell. Mol. Med."},{"key":"ref_67","first-page":"14","article-title":"Nuclear Factor Erythroid-2-related Factor 2 Gene Polymorphisms in Vitiligo","volume":"14","author":"Sorour","year":"2021","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e14024","DOI":"10.1111\/ijcp.14024","article-title":"The relationship between non-segmental Vitiligo, HLA genotype and oxidative stress","volume":"75","author":"Hayran","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1400370","DOI":"10.1080\/20013078.2017.1400370","article-title":"Biological roles and potential applications of immune cell-derived extracellular vesicles","volume":"6","author":"Wen","year":"2017","journal-title":"J. Extracell. Vesicles"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1600-065X.2011.01040.x","article-title":"Innate and adaptive immune responses to cell death","volume":"243","author":"Rock","year":"2011","journal-title":"Immunol. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"102664","DOI":"10.1016\/j.autrev.2020.102664","article-title":"New insight into the role of exosomes in vitiligo","volume":"19","author":"Wong","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Li, S., Dai, W., Wang, S., Kang, P., Ye, Z., Han, P., Zeng, K., and Li, C. (2021). Clinical Significance of Serum Oxidative Stress Markers to Assess Disease Activity and Severity in Patients With Non-Segmental Vitiligo. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.739413"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Kassab, A., Khalij, Y., Ayed, Y., Dar-Odeh, N., Kokandi, A.A., Denguezli, M., and Youssef, M. (2023). Serum Inflammatory and Oxidative Stress Markers in Patients with Vitiligo. J. Clin. Med., 12.","DOI":"10.3390\/jcm12185861"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Masood, M., Lane, B., Maghfour, J., Ceresnie, M., Mokhtari, M., Bardhi, R., Kohli, I., Ozog, D., and Mohammad, T.F. (2026). The efficacy of tranexamic acid in prevention and treatment of post-inflammatory hyperpigmentation: A pilot study. Clin. Exp. Dermatol., ahead of print.","DOI":"10.1093\/ced\/llag082"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1007\/s00403-009-0964-4","article-title":"Circulatory levels of antioxidants and lipid peroxidation in Indian patients with generalized and localized vitiligo","volume":"301","author":"Khan","year":"2009","journal-title":"Arch. Dermatol. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/jocd.13499","article-title":"Does oxidative stress correlate with disease activity and severity in vitiligo? An analytical study","volume":"20","author":"Mathachan","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1046\/j.0022-202x.2001.01459.x","article-title":"Mitochondrial impairment in peripheral blood mononuclear cells during the active phase of vitiligo","volume":"117","author":"Maresca","year":"2001","journal-title":"J. Investig. Dermatol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Caputo, S., Papaccio, F., Marrapodi, R., Lopez, G., Iacovelli, P., Pacifico, A., Migliano, E., Cota, C., Di Nardo, A., and Picardo, M. (2025). Defective Intracellular Insulin\/IGF-1 Signaling Elucidates the Link Between Metabolic Defect and Autoimmunity in Vitiligo. Cells, 14.","DOI":"10.3390\/cells14080565"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"13663","DOI":"10.1038\/s41598-017-13961-5","article-title":"Energetic mitochondrial failing in vitiligo and possible rescue by cardiolipin","volume":"7","author":"Ottaviani","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1002\/1529-0131(200201)46:1<175::AID-ART10015>3.0.CO;2-H","article-title":"Mitochondrial hyperpolarization and ATP depletion in patients with systemic lupus erythematosus","volume":"46","author":"Gergely","year":"2002","journal-title":"Arthritis Rheumatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"10835","DOI":"10.1038\/s41598-017-11056-9","article-title":"T cells display mitochondria hyperpolarization in human type 1 diabetes","volume":"7","author":"Chen","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.trsl.2010.04.001","article-title":"Altered mitochondrial membrane potential, mass, and morphology in the mononuclear cells of humans with type 2 diabetes","volume":"156","author":"Widlansky","year":"2010","journal-title":"Transl. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.7150\/thno.30398","article-title":"SIRT3-Dependent Mitochondrial Dynamics Remodeling Contributes to Oxidative Stress-Induced Melanocyte Degeneration in Vitiligo","volume":"9","author":"Yi","year":"2019","journal-title":"Theranostics"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"3401570","DOI":"10.1155\/2016\/3401570","article-title":"Dysfunction of Autophagy: A Possible Mechanism Involved in the Pathogenesis of Vitiligo by Breaking the Redox Balance of Melanocytes","volume":"2016","author":"Qiao","year":"2016","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"42394","DOI":"10.1038\/srep42394","article-title":"Dysregulated autophagy increased melanocyte sensitivity to H(2)O(2)-induced oxidative stress in vitiligo","volume":"7","author":"He","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.freeradbiomed.2025.08.027","article-title":"FUNDC1-dependent mitochondrial-ER membranes mediate mitochondrial dysfunction and melanocyte damage under oxidative stress","volume":"240","author":"Ma","year":"2025","journal-title":"Free Radic. Biol. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.molcel.2022.03.025","article-title":"Reshaping endoplasmic reticulum quality control through the unfolded protein response","volume":"82","author":"Wiseman","year":"2022","journal-title":"Mol. Cell"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"24881","DOI":"10.1074\/jbc.M004454200","article-title":"Ligand-independent dimerization activates the stress response kinases IRE1 and PERK in the lumen of the endoplasmic reticulum","volume":"275","author":"Liu","year":"2000","journal-title":"J. Biol. Chem."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"27013","DOI":"10.1016\/S0021-9258(19)61473-0","article-title":"Activation of ATF6 and an ATF6 DNA binding site by the endoplasmic reticulum stress response","volume":"275","author":"Wang","year":"2000","journal-title":"J. Biol. Chem."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1038\/ni.1857","article-title":"TLR activation of the transcription factor XBP1 regulates innate immune responses in macrophages","volume":"11","author":"Martinon","year":"2010","journal-title":"Nat. Immunol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1038\/ni.2808","article-title":"The unfolded-protein-response sensor IRE-1alpha regulates the function of CD8alpha+ dendritic cells","volume":"15","author":"Osorio","year":"2014","journal-title":"Nat. Immunol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"10161","DOI":"10.1128\/MCB.24.23.10161-10168.2004","article-title":"Translational repression mediates activation of nuclear factor kappa B by phosphorylated translation initiation factor 2","volume":"24","author":"Deng","year":"2004","journal-title":"Mol. Cell. Biol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1038\/s41598-020-59237-3","article-title":"Endoplasmic reticulum stress promotes inflammation-mediated proteolytic activity at the ocular surface","volume":"10","author":"Woodward","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"151881","DOI":"10.1016\/j.imbio.2019.11.016","article-title":"Endoplasmic reticulum stress in autoimmune diseases","volume":"225","author":"Liu","year":"2020","journal-title":"Immunobiology"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.semcdb.2020.04.006","article-title":"Endoplasmic Reticulum Protein Quality Control in beta Cells","volume":"103","author":"Shrestha","year":"2020","journal-title":"Semin. Cell Dev. Biol."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Kucharska-Lusina, A., Skrzypek, M., Tokarczyk, A., Dragan, G., and Majsterek, I. (2025). Endoplasmic Reticulum-Dependent Apoptotic Response to Cellular Stress in Patients with Rheumatoid Arthritis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26062489"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"101914","DOI":"10.1016\/j.arr.2023.101914","article-title":"The endoplasmic reticulum stress and unfolded protein response in Alzheimer\u2019s disease: A calcium dyshomeostasis perspective","volume":"87","author":"Lim","year":"2023","journal-title":"Ageing Res. Rev."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/pcmr.13006","article-title":"The impaired unfolded protein-premelanosome protein and transient receptor potential channels-autophagy axes in apoptotic melanocytes in vitiligo","volume":"35","author":"Xie","year":"2022","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jdermsci.2025.01.001","article-title":"Unfolded protein response modulates Tyrosinase levels and melanin production during melanogenesis","volume":"117","author":"Yamazaki","year":"2025","journal-title":"J. Dermatol. Sci."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"2753","DOI":"10.1097\/CM9.0000000000003802","article-title":"Protein aggregation in neurodegenerative diseases","volume":"138","author":"Wang","year":"2025","journal-title":"Chin. Med. J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/1523-1747.ep12480976","article-title":"Structural aberration of the rough endoplasmic reticulum and melanosome compartmentalization in long-term cultures of melanocytes from vitiligo patients","volume":"97","author":"Boissy","year":"1991","journal-title":"J. Investig. Dermatol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1089\/ars.2007.1782","article-title":"Endoplasmic reticulum stress and oxidative stress: A vicious cycle or a double-edged sword?","volume":"9","author":"Malhotra","year":"2007","journal-title":"Antioxid. Redox Signal."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.1038\/jid.2012.181","article-title":"Vitiligo-inducing phenols activate the unfolded protein response in melanocytes resulting in upregulation of IL6 and IL8","volume":"132","author":"Toosi","year":"2012","journal-title":"J. Investig. Dermatol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"5693572","DOI":"10.1155\/2020\/5693572","article-title":"Increased Serum Levels of IFN-gamma, IL-1beta, and IL-6 in Patients with Alopecia Areata and Nonsegmental Vitiligo","volume":"2020","author":"Tomaszewska","year":"2020","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1080\/08820139.2020.1813756","article-title":"Investigation of the Role of Interleukin 6 in Vitiligo Pathogenesis","volume":"51","author":"Singh","year":"2022","journal-title":"Immunol. Investig."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"2490","DOI":"10.1161\/01.ATV.0000242903.41158.a1","article-title":"The unfolded protein response is an important regulator of inflammatory genes in endothelial cells","volume":"26","author":"Gargalovic","year":"2006","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Ren, Y., Yang, S., Xu, S., Gao, M., Huang, W., Gao, T., Fang, Q., Quan, C., Zhang, C., and Sun, L. (2009). Genetic variation of promoter sequence modulates XBP1 expression and genetic risk for vitiligo. PLoS Genet., 5.","DOI":"10.1371\/journal.pgen.1000523"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.jid.2016.12.028","article-title":"Misbalanced CXCL12 and CCL5 Chemotactic Signals in Vitiligo Onset and Progression","volume":"137","author":"Rezk","year":"2017","journal-title":"J. Investig. Dermatol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jaci.2016.10.013","article-title":"Oxidative stress drives CD8(+) T-cell skin trafficking in patients with vitiligo through CXCL16 upregulation by activating the unfolded protein response in keratinocytes","volume":"140","author":"Li","year":"2017","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/j.jid.2024.01.007","article-title":"Membranal Expression of Calreticulin Induced by Unfolded Protein Response in Melanocytes: A Mechanism Underlying Oxidative Stress-Induced Autoimmunity in Vitiligo","volume":"144","author":"Song","year":"2024","journal-title":"J. Investig. Dermatol."},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Liu, Y., Wang, Y., Zhou, J., Li, H., Liu, C., Zhong, B., Liu, J., Liu, L., Zhang, L., and Sun, L. (2025). Restoring metabolic flexibility: Targeting organelle interaction networks in the pathogenesis and therapy of MASLD. Front. Cell Dev. Biol., 13.","DOI":"10.3389\/fcell.2025.1718799"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"368","DOI":"10.5152\/j.aott.2025.25541","article-title":"Improving subtalar arthrodesis with a skin-matched patient-specific surgical guide: A comparative cadaveric study","volume":"59","author":"Karaismailoglu","year":"2025","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0925-4439(93)90082-C","article-title":"Subcellular fractionation of cultured normal human melanocytes: New insights into the relationship of melanosomes with lysosomes and peroxisomes","volume":"1181","author":"Smit","year":"1993","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"103017","DOI":"10.1016\/j.ceca.2025.103017","article-title":"Calcium acts as a critical determinant of mitochondria-nuclear networking driven retrograde signaling","volume":"127","author":"Ahuja","year":"2025","journal-title":"Cell Calcium"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.prp.2016.12.019","article-title":"Reduced immunohistochemical expression of adhesion molecules in vitiligo skin biopsies","volume":"213","author":"Jung","year":"2017","journal-title":"Pathol. Res. Pract."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1038\/jid.2015.25","article-title":"Altered E-Cadherin Levels and Distribution in Melanocytes Precede Clinical Manifestations of Vitiligo","volume":"135","author":"Wagner","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1089\/dna.2023.0188","article-title":"The Role of Regulatory Cell Death in Vitiligo","volume":"43","author":"Liu","year":"2024","journal-title":"DNA Cell Biol."},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Marrapodi, R., Marini, A., and Bellei, B. (2025). Dysregulated Intracellular Signaling in the Pathogenesis of Vitiligo: An Update on Emerging Therapeutic Strategies. Biomedicines, 13.","DOI":"10.3390\/biomedicines13092177"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.freeradbiomed.2018.08.022","article-title":"TRPM2 mediates mitochondria-dependent apoptosis of melanocytes under oxidative stress","volume":"126","author":"Kang","year":"2018","journal-title":"Free Radic. Biol. Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"100981","DOI":"10.1016\/j.arr.2019.100981","article-title":"Premature cell senescence in human skin: Dual face in chronic acquired pigmentary disorders","volume":"57","author":"Bellei","year":"2020","journal-title":"Ageing Res. Rev."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"111779","DOI":"10.1016\/j.mad.2023.111779","article-title":"Acceleration of melanocyte senescence by the proinflammatory cytokines IFNgamma and TNFalpha impairs the repigmentation response of vitiligo patients to narrowband ultraviolet B (NBUVB) phototherapy","volume":"211","author":"Dong","year":"2023","journal-title":"Mech. Ageing Dev."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s00403-016-1713-0","article-title":"Senescence in the lesional fibroblasts of non-segmental vitiligo patients","volume":"309","author":"Rani","year":"2017","journal-title":"Arch. Dermatol. Res."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"116515","DOI":"10.1016\/j.intimp.2026.116515","article-title":"Stress-immune-Repigmentation niche in vitiligo: Mechanistic integration and therapeutic implications","volume":"177","author":"Han","year":"2026","journal-title":"Int Immunopharmacol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"157123","DOI":"10.1016\/j.cyto.2026.157123","article-title":"Oxidative stress activates HIF-1alpha to mediate the secretion of CXCL9 and CXCL10 in keratinocytes and trigger the abnormal immune response in vitiligo","volume":"200","author":"Chen","year":"2026","journal-title":"Cytokine"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"469","DOI":"10.2147\/CCID.S210106","article-title":"Role of Janus kinase 1 and signal transducer and activator of transcription 3 in vitiligo","volume":"12","author":"Samaka","year":"2019","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/1203475420972340","article-title":"Cutaneous JAK Expression in Vitiligo","volume":"25","author":"Tawfik","year":"2021","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1038\/s41598-025-86134-4","article-title":"Integrative genetics and multiomics analysis reveal mechanisms and therapeutic targets in vitiligo highlighting JAK STAT pathway regulation of CTSS","volume":"15","author":"Dong","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.jid.2016.09.016","article-title":"Keratinocyte-Derived Chemokines Orchestrate T-Cell Positioning in the Epidermis during Vitiligo and May Serve as Biomarkers of Disease","volume":"137","author":"Richmond","year":"2017","journal-title":"J. Investig. Dermatol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"126719","DOI":"10.1016\/j.ijpharm.2026.126719","article-title":"Tofacitinib citrate nanoemulgel induced repigmentation in vitiligo: Assessment of oxidative stress, protein, immunohistochemistry, and mRNA expressions","volume":"694","author":"Veerabomma","year":"2026","journal-title":"Int. J. Pharm."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1158\/1078-0432.CCR-12-3603","article-title":"Molecular pathways: Interleukin-15 signaling in health and in cancer","volume":"20","author":"Mishra","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.freeradbiomed.2019.05.011","article-title":"Oxidative stress-induced IL-15 trans-presentation in keratinocytes contributes to CD8(+) T cells activation via JAK-STAT pathway in vitiligo","volume":"139","author":"Chen","year":"2019","journal-title":"Free Radic. Biol. Med."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"155432","DOI":"10.1016\/j.cyto.2021.155432","article-title":"Tumor Necrosis Factor-alpha affects melanocyte survival and melanin synthesis via multiple pathways in vitiligo","volume":"140","author":"Singh","year":"2021","journal-title":"Cytokine"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s00403-016-1675-2","article-title":"IL-33 circulating serum levels are increased in patients with non-segmental generalized vitiligo","volume":"308","author":"Vaccaro","year":"2016","journal-title":"Arch. Dermatol. Res."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.12659\/MSM.914898","article-title":"Perspectives of New Advances in the Pathogenesis of Vitiligo: From Oxidative Stress to Autoimmunity","volume":"25","author":"Wang","year":"2019","journal-title":"Med. Sci. Monit."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0140-6736(14)60763-7","article-title":"Vitiligo","volume":"386","author":"Ezzedine","year":"2015","journal-title":"Lancet"},{"key":"ref_136","doi-asserted-by":"crossref","unstructured":"Traks, T., Keermann, M., Karelson, M., Ratsep, R., Reimann, E., Silm, H., Vasar, E., Koks, S., and Kingo, K. (2015). Polymorphisms in Toll-like receptor genes are associated with vitiligo. Front. Genet., 6.","DOI":"10.3389\/fgene.2015.00278"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/exd.12103","article-title":"Vitiligo: Interplay between oxidative stress and immune system","volume":"22","author":"Laddha","year":"2013","journal-title":"Exp. Dermatol."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.cyto.2016.12.014","article-title":"Increased systemic and epidermal levels of IL-17A and IL-1beta promotes progression of non-segmental vitiligo","volume":"91","author":"Bhardwaj","year":"2017","journal-title":"Cytokine"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/jocd.12517","article-title":"Cytokine profile (IL-2, IL-6, IL-17, IL-22, and TNF-alpha) in vitiligo-New insight into pathogenesis of disease","volume":"18","author":"Sushama","year":"2019","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s00011-025-02035-2","article-title":"The IL-6 autocrine loop promoting IFN-gamma-induced fibroblast senescence is involved in psychological stress-mediated exacerbation of vitiligo","volume":"74","author":"Cao","year":"2025","journal-title":"Inflamm. Res."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"4899","DOI":"10.1096\/fj.201701242RR","article-title":"IL-17 induces cellular stress microenvironment of melanocytes to promote autophagic cell apoptosis in vitiligo","volume":"32","author":"Zhou","year":"2018","journal-title":"FASEB J."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1152\/physrev.00023.2017","article-title":"The KEAP1-NRF2 System: A Thiol-Based Sensor-Effector Apparatus for Maintaining Redox Homeostasis","volume":"98","author":"Yamamoto","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/pcmr.12208","article-title":"Preferential secretion of inducible HSP70 by vitiligo melanocytes under stress","volume":"27","author":"Mosenson","year":"2014","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1038\/jid.2008.45","article-title":"HSP70i accelerates depigmentation in a mouse model of autoimmune vitiligo","volume":"128","author":"Denman","year":"2008","journal-title":"J. Investig. Dermatol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"2531","DOI":"10.1016\/j.jid.2018.06.186","article-title":"HSP70i(Q435A)-Encoding DNA Repigments Vitiligo Lesions in Sinclair Swine","volume":"138","author":"Henning","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1755-148X.2011.00916.x","article-title":"HSP70i is a critical component of the immune response leading to vitiligo","volume":"25","author":"Mosenson","year":"2012","journal-title":"Pigment. Cell Melanoma Res."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/exd.12183","article-title":"A central role for inducible heat-shock protein 70 in autoimmune vitiligo","volume":"22","author":"Mosenson","year":"2013","journal-title":"Exp. Dermatol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1111\/bjd.15550","article-title":"Heat shock protein 70 potentiates interferon alpha production by plasmacytoid dendritic cells: Relevance for cutaneous lupus and vitiligo pathogenesis","volume":"177","author":"Jacquemin","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"eabd8995","DOI":"10.1126\/scitranslmed.abd8995","article-title":"scRNA-seq of human vitiligo reveals complex networks of subclinical immune activation and a role for CCR5 in T(reg) function","volume":"13","author":"Gellatly","year":"2021","journal-title":"Sci. Transl. Med."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1046\/j.1365-4362.2002.01463.x","article-title":"Rapid initiation of repigmentation in vitiligo with Dead Sea climatotherapy in combination with pseudocatalase (PC-KUS)","volume":"41","author":"Schallreuter","year":"2002","journal-title":"Int. J. Dermatol."},{"key":"ref_151","first-page":"10","article-title":"Treatment of vitiligo with narrow-band UVB and topical gel containing catalase and superoxide dismutase","volume":"15","author":"Kostovic","year":"2007","journal-title":"Acta Dermatovenerol. Croat."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1111\/j.1365-2133.2009.09252.x","article-title":"A randomized, double-blinded, placebo-controlled trial of pseudocatalase cream and narrowband ultraviolet B in the treatment of vitiligo","volume":"161","author":"Wittal","year":"2009","journal-title":"Br. J. Dermatol."},{"key":"ref_153","first-page":"7","article-title":"Comparative study between excimer light and topical antioxidant versus excimer light alone for treatment of vitiligo","volume":"18","author":"Soliman","year":"2016","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/09546634.2020.1729952","article-title":"Comparison of the efficacy of Tacrolimus 0.1% ointment and Tacrolimus 0.1% plus topical pseudocatalase\/superoxide dismutase gel in children with limited vitiligo: A randomized controlled trial","volume":"33","author":"Alshiyab","year":"2022","journal-title":"J. Dermatolog. Treat."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1111\/jdv.17331","article-title":"Oral gliadin-protected superoxide dismutase in addition to phototherapy for treating non-segmental vitiligo: A 24-week prospective randomized placebo-controlled study","volume":"35","author":"Fontas","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_156","unstructured":"Hameed, M.F., Abu-Raghif, A.R., Farhood, I.G., and Ali, N.M. (2016). The effectiveness of systemic co-enzyme Q10 in vitiligo. Iraqi J. Med. Sci., 11, Available online: https:\/\/doaj.org\/article\/873c57db546e4b9ea3645763f1d84d5d."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"2483808","DOI":"10.1080\/09546634.2025.2483808","article-title":"The efficacy of combined phototherapy with topical therapy in vitiligo: A network meta-analysis","volume":"36","author":"Luo","year":"2025","journal-title":"J. Dermatolog. Treat."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"7881717","DOI":"10.1155\/2022\/7881717","article-title":"Implications of Oxidative Stress in the Pathogenesis and Treatment of Hyperpigmentation Disorders","volume":"2022","author":"Xing","year":"2022","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.1365-2230.2007.02514.x","article-title":"Antioxidants and narrow band-UVB in the treatment of vitiligo: A double-blind placebo controlled trial","volume":"32","author":"Mastrofrancesco","year":"2007","journal-title":"Clin Exp. Dermatol."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/dth.12172","article-title":"Evaluation of an oral supplement containing Phyllanthus emblica fruit extracts, vitamin E, and carotenoids in vitiligo treatment","volume":"28","author":"Colucci","year":"2015","journal-title":"Dermatol. Ther."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/ijd.14510","article-title":"Treatment responses in patients with vitiligo to very potent topical corticosteroids combined with vitaminotherapy in Madagascar","volume":"58","author":"Sendrasoa","year":"2019","journal-title":"Int. J. Dermatol."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/jocd.14436","article-title":"Role of nutritional supplements in selected dermatological disorders: A review","volume":"21","author":"Sardana","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_163","doi-asserted-by":"crossref","unstructured":"Yaghoobi, R., Omidian, M., and Bagherani, N. (2011). Original article title: \u201cComparison of therapeutic efficacy of topical corticosteroid and oral zinc sulfate-topical corticosteroid combination in the treatment of vitiligo patients: A clinical trial\u201d. BMC Dermatol., 11.","DOI":"10.1186\/1471-5945-11-7"},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"e2022140","DOI":"10.5826\/dpc.1204a140","article-title":"Serum Copper and Zinc Levels Among Iranian Vitiligo Patients","volume":"12","author":"Khoshdel","year":"2022","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"23700","DOI":"10.1038\/s41598-024-61982-8","article-title":"Zinc, copper, and selenium levels in vitiligo: A systematic review and meta-analysis","volume":"14","author":"Anam","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_166","doi-asserted-by":"crossref","unstructured":"Ye, Z., Chen, J., Du, P., Ni, Q., Li, B., Zhang, Z., Wang, Q., Cui, T., Yi, X., and Li, C. (2022). Metabolomics Signature and Potential Application of Serum Polyunsaturated Fatty Acids Metabolism in Patients With Vitiligo. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.839167"},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3109\/14764172.2015.1114646","article-title":"Triple-combination treatment with oral alpha-lipoic acid, betamethasone injection, and NB-UVB for non-segmental progressive vitiligo","volume":"18","author":"Li","year":"2016","journal-title":"J. Cosmet. Laser Ther."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.7150\/ijms.51545","article-title":"Regulatory effects of Lactobacillus plantarum-GMNL6 on human skin health by improving skin microbiome","volume":"18","author":"Tsai","year":"2021","journal-title":"Int. J. Med. Sci."},{"key":"ref_169","doi-asserted-by":"crossref","unstructured":"Zhao, W., Peng, C., Sakandar, H.A., Kwok, L., and Zhang, W. (2021). Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.643420"},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"5193","DOI":"10.1111\/jcmm.14393","article-title":"Ginkgo biloba extract protects human melanocytes from H(2) O(2) -induced oxidative stress by activating Nrf2","volume":"23","author":"Zhang","year":"2019","journal-title":"J. Cell. Mol. Med."},{"key":"ref_171","doi-asserted-by":"crossref","unstructured":"Szczurko, O., Shear, N., Taddio, A., and Boon, H. (2011). Ginkgo biloba for the treatment of vitilgo vulgaris: An open label pilot clinical trial. BMC Complement. Altern. Med., 11.","DOI":"10.1186\/1472-6882-11-21"},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1046\/j.1365-2230.2003.01207.x","article-title":"Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo","volume":"28","author":"Parsad","year":"2003","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"e14776","DOI":"10.1111\/dth.14776","article-title":"NB-UVB plus oral Polypodium leucotomos extract display higher efficacy than NB-UVB alone in patients with vitiligo","volume":"34","author":"Pacifico","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/j.1468-3083.2006.02132.x","article-title":"Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: A randomized double-blind placebo-controlled study","volume":"21","author":"Bos","year":"2007","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"e12949","DOI":"10.1111\/dth.12949","article-title":"Effectiveness of topical Nigella sativa for vitiligo treatment","volume":"32","author":"Sarac","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_176","doi-asserted-by":"crossref","unstructured":"Calzari, P., Vaienti, S., and Nazzaro, G. (2023). Uses of Polypodium leucotomos Extract in Oncodermatology. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020673"},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1089\/ars.2009.2779","article-title":"The involvement of Smac\/DIABLO, p53, NF-kB, and MAPK pathways in apoptosis of keratinocytes from perilesional vitiligo skin: Protective effects of curcumin and capsaicin","volume":"13","author":"Becatti","year":"2010","journal-title":"Antioxid. Redox Signal."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"150871","DOI":"10.1016\/j.bbrc.2024.150871","article-title":"Network pharmacology, molecular docking and experimental study on the mechanism of Curcumin\u2019s anti-ferroptosis in melanocytes","volume":"736","author":"Liu","year":"2024","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1089\/pho.2009.2637","article-title":"Tetrahydrocurcuminoid cream plus targeted narrowband UVB phototherapy for vitiligo: A preliminary randomized controlled study","volume":"28","author":"Asawanonda","year":"2010","journal-title":"Photomed. Laser Surg."},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1111\/jcmm.17711","article-title":"Kaempferol promotes melanogenesis and reduces oxidative stress in PIG1 normal human skin melanocytes","volume":"27","author":"Xie","year":"2023","journal-title":"J. Cell. Mol. Med."},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"e35533","DOI":"10.1097\/MD.0000000000035533","article-title":"Efficacy and safety of compound glycyrrhizin in combination with conventional therapy in treatment of vitiligo: A systematic review and meta-analysis of randomized controlled trials","volume":"102","author":"Jian","year":"2023","journal-title":"Medicine"},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1016\/j.jaad.2020.01.035","article-title":"Afamelanotide implants and narrow-band ultraviolet B phototherapy for the treatment of nonsegmental vitiligo in Asians","volume":"82","author":"Toh","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_183","doi-asserted-by":"crossref","unstructured":"Bellei, B., Papaccio, F., and Picardo, M. (2022). Regenerative Medicine-Based Treatment for Vitiligo: An Overview. Biomedicines, 10.","DOI":"10.3390\/biomedicines10112744"},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"18298","DOI":"10.1038\/s41598-021-97296-2","article-title":"CXCL9 as a key biomarker of vitiligo activity and prediction of the success of cultured melanocyte transplantation","volume":"11","author":"Lin","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_185","doi-asserted-by":"crossref","first-page":"10015","DOI":"10.1038\/s41598-017-10710-6","article-title":"Maximizing non-enzymatic methods for harvesting adipose-derived stem from lipoaspirate: Technical considerations and clinical implications for regenerative surgery","volume":"7","author":"Bellei","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_186","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/s13287-019-1364-0","article-title":"Differentiation of adipose-derived stem cells to functional CD105(neg) CD73(low) melanocyte precursors guided by defined culture condition","volume":"10","author":"Zavala","year":"2019","journal-title":"Stem Cell Res. Ther."},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1186\/s40001-025-03062-9","article-title":"Peripheral blood mesenchymal stem cells repair oxidative damage and apoptosis in an H(2)O(2)-induced vitiligo oxidative stress in vitro model via the IL-10-mediated PI3K\/AKT pathway","volume":"30","author":"Yang","year":"2025","journal-title":"Eur. J. Med. Res."},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/s13287-018-0956-4","article-title":"Adipose tissue-derived extracellular fraction characterization: Biological and clinical considerations in regenerative medicine","volume":"9","author":"Bellei","year":"2018","journal-title":"Stem Cell Res. Ther."},{"key":"ref_189","doi-asserted-by":"crossref","unstructured":"Li, L., Ngo, H.T.T., Hwang, E., Wei, X., Liu, Y., Liu, J., and Yi, T. (2019). Conditioned Medium from Human Adipose-Derived Mesenchymal Stem Cell Culture Prevents UVB-Induced Skin Aging in Human Keratinocytes and Dermal Fibroblasts. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21010049"},{"key":"ref_190","doi-asserted-by":"crossref","first-page":"101766","DOI":"10.1016\/j.trim.2022.101766","article-title":"Vitiligo: An immune disease and its emerging mesenchymal stem cell therapy paradigm","volume":"76","author":"Zhang","year":"2023","journal-title":"Transpl. Immunol."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"16","DOI":"10.2340\/00015555-1174","article-title":"Co-culture of melanocytes with adipose-derived stem cells as a potential substitute for co-culture with keratinocytes","volume":"92","author":"Kim","year":"2012","journal-title":"Acta Derm. Venereol."},{"key":"ref_192","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3892\/mmr.2021.12522","article-title":"Repigmentation by combined narrow-band ultraviolet B\/adipose-derived stem cell transplantation in the mouse model: Role of Nrf2\/HO-1-mediated Ca(2+) homeostasis","volume":"25","author":"Bian","year":"2022","journal-title":"Mol. Med. Rep."},{"key":"ref_193","doi-asserted-by":"crossref","first-page":"328","DOI":"10.4062\/biomolther.2014.065","article-title":"Adipose-derived stem cells improve efficacy of melanocyte transplantation in animal skin","volume":"22","author":"Lim","year":"2014","journal-title":"Biomol. Ther."},{"key":"ref_194","doi-asserted-by":"crossref","unstructured":"Vladulescu, D., Scurtu, L.G., Simionescu, A.A., Scurtu, F., Popescu, M.I., and Simionescu, O. (2023). Platelet-Rich Plasma (PRP) in Dermatology: Cellular and Molecular Mechanisms of Action. Biomedicines, 12.","DOI":"10.3390\/biomedicines12010007"},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/JD9.0000000000000171","article-title":"Progress in the Use of Platelet-Rich Plasma to Treat Vitiligo and Melasma","volume":"4","author":"Ding","year":"2021","journal-title":"Int. J. Dermatol. Venereol."},{"key":"ref_196","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4103\/0974-2077.150734","article-title":"Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author\u2019s Perspective","volume":"7","author":"Dhurat","year":"2014","journal-title":"J. Cutan. Aesthet. Surg."},{"key":"ref_197","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.reth.2025.08.005","article-title":"Exosomes derived from platelet-rich plasma promote hair regeneration by regulating the SIRT1\/FoxO3a pathway to alleviate oxidative stress","volume":"30","author":"Yang","year":"2025","journal-title":"Regen. Ther."},{"key":"ref_198","doi-asserted-by":"crossref","unstructured":"Li, Y., Cheng, B., and Tian, J. (2025). Platelet-rich plasma may accelerate diabetic wound healing by modulating epithelial\/endothelial-mesenchymal transition through inhibiting reactive oxygen species-mediated oxidative stress. Front. Bioeng. Biotechnol., 13.","DOI":"10.3389\/fbioe.2025.1623780"},{"key":"ref_199","doi-asserted-by":"crossref","first-page":"e12929","DOI":"10.1111\/phpp.12929","article-title":"Narrowband ultraviolet B phototherapy combined with intralesional injection of either latanoprost or platelet-rich plasma for stable nonsegmental vitiligo","volume":"40","author":"Fawzy","year":"2024","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_200","doi-asserted-by":"crossref","first-page":"2826","DOI":"10.1111\/jocd.14582","article-title":"Comparison between 308-nm excimer light alone versus 308-nm excimer light and platelet-rich plasma in the treatment for localized vitiligo","volume":"21","author":"Elsaadany","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_201","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/iwj.13524","article-title":"Current art of combination therapy with autologous platelet-rich plasma for stable vitiligo: A meta-analysis","volume":"18","author":"Chen","year":"2021","journal-title":"Int. Wound J."},{"key":"ref_202","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.arthro.2014.02.020","article-title":"Characterization and comparison of 5 platelet-rich plasma preparations in a single-donor model","volume":"30","author":"Magalon","year":"2014","journal-title":"Arthroscopy"}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/4\/612\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:19:30Z","timestamp":1776917970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/4\/612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":202,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["biom16040612"],"URL":"https:\/\/doi.org\/10.3390\/biom16040612","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]}}}