[开放获取]    白癜风靶向药物临床应用进展及前景

doi:10.35541/cjd.20230509

中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (1): 12-16.doi: 10.35541/cjd.20230509

[开放获取] 白癜风靶向药物临床应用进展及前景

李舒丽李春英

空军军医大学西京皮肤医院，西安 710032

收稿日期:2023-09-04 修回日期:2023-11-16 发布日期:2024-01-05
通讯作者: 李春英 E-mail:lichying@fmmu.edu.cn
基金资助:
国家自然科学基金（82222059、82173416）

Clinical application of targeted drugs in vitiligo: progress and prospects

Li Shuli, Li Chunying

Department of Dermatology, Xijing Hospital, Air Force Medical University, Xi′an 710032, China

Received:2023-09-04 Revised:2023-11-16 Published:2024-01-05
Contact: Li Chunying E-mail:lichying@fmmu.edu.cn
Supported by:
National Natural Science Foundation of China（82222059、82173416）

摘要/Abstract

摘要： 【摘要】近年针对白癜风的发病机制研究取得了较大进展，涌现了较多新的治疗方法和药物。γ干扰素激活的Janus激酶（JAK）信号和黑色素细胞再生信号通路是目前白癜风治疗研究中最受关注的靶点。本文总结了当前针对这些通路的新药物在白癜风治疗中的效果和经验，JAK抑制剂是目前最有前景的新型药物，且联合光疗可提高疗效。

关键词: 白癜风, Janus激酶类, 酶抑制剂, 托法替布, 辛伐他汀, α促黑色素细胞激素

Abstract: 【Abstract】 In recent years, great progress has been made in the research on the pathogenesis of vitiligo, and many new treatment methods and drugs have emerged. Interferon-γ-activated Janus kinase （JAK） signaling and melanocyte regeneration signaling pathways are the most concerned targets in the research on the treatment of vitiligo. This article summarizes the efficacy of current new drugs targeting these pathways and the experience in applying these drugs in the treatment of vitiligo. JAK inhibitors are currently the most promising new drugs for the treatment of vitiligo, and their efficacy can be improved in combination with phototherapy.

Key words: Vitiligo, Janus kinases, Enzyme inhibitors, Tofacitinib, Simvastatin, Alpha-melanocyte stimulating hormone

李舒丽李春英. [开放获取] 白癜风靶向药物临床应用进展及前景[J]. 中华皮肤科杂志, 2024,57(1):12-16. doi:10.35541/cjd.20230509

Li Shuli, Li Chunying. Clinical application of targeted drugs in vitiligo: progress and prospects[J]. Chinese Journal of Dermatology, 2024, 57(1): 12-16.doi:10.35541/cjd.20230509

参考文献 27

［1］	Craiglow BG, King BA. Tofacitinib citrate for the treatment of vitiligo: a pathogenesis⁃directed therapy［J］. JAMA Dermatol, 2015,151（10）:1110⁃1112. doi: 10.1001/jamadermatol.2015.1520.
［2］	Liu LY, Strassner JP, Refat MA, et al. Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure［J］. J Am Acad Dermatol, 2017,77（4）:675⁃682.e1. doi: 10.1016/j.jaad.2017.05.043.
［3］	Kim SR, Heaton H, Liu LY, et al. Rapid repigmentation of vitiligo using tofacitinib plus low⁃dose, narrowband UV⁃B phototherapy［J］. JAMA Dermatol, 2018,154（3）:370⁃371. doi: 10.1001/jamadermatol.2017.5778.
［4］	Fang WC, Chiu SH, Lin SY, et al. Evaluation of low⁃dose tofacitinib combining narrowband UVB therapy for treating vitiligo patients who had failed previous therapy: a pilot study［J］. Photodermatol Photoimmunol Photomed, 2021,37（4）:345⁃347. doi: 10.1111/phpp.12661.
［5］	Gianfaldoni S, Tchernev G, Wollina U, et al. Micro ⁃ focused phototherapy associated to Janus kinase inhibitor: a promising valid therapeutic option for patients with localized vitiligo［J］. Open Access Maced J Med Sci, 2018,6（1）:46⁃48. doi: 10.3889/oamjms.2018.042.
［6］	Fang WC, Lin SY, Huang SM, et al. Low⁃dose tofacitinib with 308⁃nm excimer therapy successfully induced repigmentation in patients with refractory vitiligo［J］. Clin Exp Dermatol, 2022,47（4）:782⁃783. doi: 10.1111/ced.15070.
［7］	Song H, Hu Z, Zhang S, et al. Effectiveness and safety of tofacitinib combined with narrowband ultraviolet B phototherapy for patients with refractory vitiligo in real⁃world clinical practice［J］. Dermatol Ther, 2022,35（11）:e15821. doi: 10.1111/dth. 15821.
［8］	Xu Z, Xing X, Xuan Y, et al. Progressive nonsegmental vitiligo successfully treated with oral tofacitinib and narrow⁃band UVB: a case report of 2⁃year follow⁃up［J］. Photodermatol Photoimmunol Photomed, 2023,39（6）:663⁃666. doi: 10.1111/phpp.12900.
［9］	Mobasher P, Guerra R, Li SJ, et al. Open⁃label pilot study of tofacitinib 2% for the treatment of refractory vitiligo［J］. Br J Dermatol, 2020,182（4）:1047⁃1049. doi: 10.1111/bjd.18606.
［10］	McKesey J, Pandya AG. A pilot study of 2% tofacitinib cream with narrowband ultraviolet B for the treatment of facial vitiligo［J］. J Am Acad Dermatol, 2019,81（2）:646⁃648. doi: 10.1016/j.jaad.2019.04.032.
［11］	Harris JE, Rashighi M, Nguyen N, et al. Rapid skin repigmentation on oral ruxolitinib in a patient with coexistent vitiligo and alopecia areata （AA）［J］. J Am Acad Dermatol, 2016,74（2）:370⁃371. doi: 10.1016/j.jaad.2015.09.073.
［12］	Rothstein B, Joshipura D, Saraiya A, et al. Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib［J］. J Am Acad Dermatol, 2017,76（6）:1054⁃1060.e1. doi: 10.1016/j.jaad. 2017.02.049.
［13］	Joshipura D, Alomran A, Zancanaro P, et al. Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib: a 32⁃week open⁃label extension study with optional narrow⁃band ultraviolet B［J］. J Am Acad Dermatol, 2018,78（6）:1205⁃1207.e1. doi: 10.1016/j.jaad.2018.02.023.
［14］	Rosmarin D, Pandya AG, Lebwohl M, et al. Ruxolitinib cream for treatment of vitiligo: a randomised, controlled, phase 2 trial［J］. Lancet, 2020,396（10244）:110⁃120. doi: 10.1016/S0140⁃6736（20）30609⁃7.
［15］	Rosmarin D, Passeron T, Pandya AG, et al. Two phase 3, randomized, controlled trials of ruxolitinib cream for vitiligo［J］. N Engl J Med, 2022,387（16）:1445⁃1455. doi: 10.1056/NEJMoa 2118828.
［16］	Mumford BP, Gibson A, Chong AH. Repigmentation of vitiligo with oral baricitinib［J］. Australas J Dermatol, 2020,61（4）:374⁃376. doi: 10.1111/ajd.13348.
［17］	Li X, Sun Y, Du J, et al. Excellent repigmentation of generalized vitiligo with oral baricitinib combined with NB⁃UVB phototherapy［J］. Clin Cosmet Investig Dermatol, 2023,16:635⁃638. doi: 10.2147/CCID.S396430.
［18］	Pan T, Mu Y, Shi X, et al. Concurrent vitiligo and atopic dermatitis successfully treated with upadacitinib: a case report［J］. J Dermatolog Treat, 2023,34（1）:2200873. doi: 10.1080/09546634.2023.2200873.
［19］	Su X, Luo R, Ruan S, et al. Efficacy and tolerability of oral upadacitinib monotherapy in patients with recalcitrant vitiligo［J］. J Am Acad Dermatol, 2023:S0190⁃9622（23）02410⁃02416. doi: 10.1016/j.jaad.2023.07.1016.
［20］	Ezzedine K, Peeva E, Yamaguchi Y, et al. Efficacy and safety of oral ritlecitinib for the treatment of active nonsegmental vitiligo: a randomized phase 2b clinical trial［J］. J Am Acad Dermatol, 2023,88（2）:395⁃403. doi: 10.1016/j.jaad.2022.11.005.
［21］	Noël M, Gagné C, Bergeron J, et al. Positive pleiotropic effects of HMG⁃CoA reductase inhibitor on vitiligo［J］. Lipids Health Dis, 2004,3:7. doi: 10.1186/1476⁃511X⁃3⁃7.
［22］	Vanderweil SG, Amano S, Ko WC, et al. A double⁃blind, placebo⁃controlled, phase⁃Ⅱ clinical trial to evaluate oral simvastatin as a treatment for vitiligo［J］. J Am Acad Dermatol, 2017,76（1）:150⁃151.e3. doi: 10.1016/j.jaad.2016.06.015.
［23］	Nguyen S, Chuah SY, Fontas E, et al. Atorvastatin in combination with narrowband UV⁃B in adult patients with active vitiligo: a randomized clinical trial［J］. JAMA Dermatol, 2018,154（6）:725⁃726. doi: 10.1001/jamadermatol.2017.6401.
［24］	Niezgoda A, Winnicki A, Kosmalski T, et al. The evaluation of vitiligous lesions repigmentation after the administration of atorvastatin calcium salt and simvastatin⁃acid sodium salt in patients with active vitiligo （EVRAAS）, a pilot study: study protocol for a randomized controlled trial［J］. Trials, 2019,20（1）:78. doi: 10.1186/s13063⁃018⁃3168⁃4.
［25］	Grimes PE, Hamzavi I, Lebwohl M, et al. The efficacy of afamelanotide and narrowband UV⁃B phototherapy for repigmen⁃tation of vitiligo［J］. JAMA Dermatol, 2013,149（1）:68⁃73. doi: 10.1001/2013.jamadermatol.386.
［26］	Lim HW, Grimes PE, Agbai O, et al. Afamelanotide and narrowband UV⁃B phototherapy for the treatment of vitiligo: a randomized multicenter trial［J］. JAMA Dermatol, 2015,151（1）:42⁃50. doi: 10.1001/jamadermatol.2014.1875.
［27］	Toh J, Chuah SY, Jhingan A, et al. Afamelanotide implants and narrow⁃band ultraviolet B phototherapy for the treatment of nonsegmental vitiligo in Asians［J］. J Am Acad Dermatol, 2020,82（6）:1517⁃1519. doi: 10.1016/j.jaad.2020.01.035.

[1]	中国研究型医院学会皮肤科学专业委员会中国医师协会皮肤科医师分会. [开放获取] 白癜风光疗指南（2025版）[J]. 中华皮肤科杂志, 2025, 58(3): 197-208.
[2]	李明李妍李邻峰. Janus激酶抑制剂在中重度特应性皮炎中的应用进展[J]. 中华皮肤科杂志, 2025, 0(3): 20220342-e0220342.
[3]	李翔倩张建中周城. 系统小分子药物和生物制剂治疗斑秃的临床研究进展[J]. 中华皮肤科杂志, 2025, 0(3): 20240247-e20240247.
[4]	李倩雯廖志锴乐悦段博林耿朦朦雷铁池. 抗氧化剂Tempol抑制氧化应激状态下免疫诱导白癜风小鼠尾部皮肤色素脱失[J]. 中华皮肤科杂志, 2025, 58(2): 126-131.
[5]	宋璞刘宇郭森李舒丽刘玲李春英. 肥大细胞来源的趋化因子配体5影响氧化应激状态下白癜风CD8⁺ T细胞的迁移[J]. 中华皮肤科杂志, 2025, 0(2): 20230513-e20230513.
[6]	周妙妮盛安琪傅丽芳金嵘许文尉晓冬许爱娥. 茶多酚抗氧化凝胶联合窄谱中波紫外线治疗白癜风疗效及安全性的单中心随机对照试验[J]. 中华皮肤科杂志, 2025, 0(2): 20240421-e20240421.
[7]	罗莉张博娜吴畏汤文静李岳华刘晓莉马雅楠李翠翠齐梦岩孙妮石琼. [开放获取] 308 nm准分子激光与308 nm准分子光治疗194例儿童白癜风的疗效及安全性回顾分析[J]. 中华皮肤科杂志, 2024, 57(8): 721-727.
[8]	陈佳希易秀莉李春英李舒丽. 叶酸对体外培养的黑色素细胞氧化应激损伤的保护作用研究[J]. 中华皮肤科杂志, 2024, 57(6): 547-552.
[9]	张迪敏曹成周妙妮盛安琪林福全许爱娥. 复方倍他米松注射液联合治疗后进展期非节段型白癜风稳定率及影响因素分析[J]. 中华皮肤科杂志, 2024, 57(4): 350-354.
[10]	袁立燕余晓玲王晓华杨斌. [开放获取] TYK2抑制剂治疗斑块状银屑病的作用机制和临床研究进展[J]. 中华皮肤科杂志, 2024, 0(3): 20220740-e0220740.
[11]	戴叶芹宋秀祖. 毛囊及毛囊细胞移植在白癜风治疗中的应用进展[J]. 中华皮肤科杂志, 2024, 0(3): 20230274-e0230274.
[12]	刘绿野张峻岭. 铁死亡在常见皮肤病中的研究进展[J]. 中华皮肤科杂志, 2024, 0(3): 20220783-e20220783.
[13]	高金平张学军. 巴瑞替尼在皮肤科的临床应用进展[J]. 中华皮肤科杂志, 2024, 0(3): 20230528-e20230528.
[14]	张钰得王红娟康晓静. 干细胞治疗白癜风的基础及临床研究进展[J]. 中华皮肤科杂志, 2024, 0(3): 20240127-e20240127.
[15]	孙玮蔚陈健儒李舒丽高天文李春英. 白癜风小鼠模型抑郁样行为的观察[J]. 中华皮肤科杂志, 2024, 57(2): 147-154.

[开放获取] 白癜风靶向药物临床应用进展及前景

Clinical application of targeted drugs in vitiligo: progress and prospects

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 27

相关文章 15

Metrics

本文评价

推荐阅读 10