Interaction between genetic, immunological, and environmental factors in the development of vitiligo
Keywords:
AUTOINMUNIDAD; FACTORES DE RIESGO; GENÉTICA; SUSCEPTIBILIDAD A ENFERMEDADES; VITÍLIGO. , AUTOIMMUNITY; RISK FACTORS; GENETICS; DISEASE SUSCEPTIBILITY; VITILIGO., AUTOIMUNIDADE; FATORES DE RISCO; GENÉTICA; SUSCETIBILIDADE A DOENÇAS; VITILIGO.Abstract
Introduction: vitiligo is the most common depigmenting disorder and represents a complex cutaneous disease with significant clinical, immunological, and psychosocial repercussions, whose origin is clearly multifactorial.
Objective: to describe the interaction of genetic, immunological, and environmental factors involved in the pathogenesis and progression of vitiligo.
Methods: a bibliographic review was conducted in international databases such as Medline, Embase, PubMed, Cochrane, and DARE, including studies published between 2019 and 2024. Selection criteria were applied to identify and select relevant sources for subsequent analysis.
Development: the literature demonstrates a strong genetic basis associated with genes related to innate and adaptive immunity, as well as melanocyte-specific genes that act as autoantigens. Multiple autoimmune comorbidities are described, with particular emphasis on thyroid diseases, alopecia areata, and psoriasis. Associations with hepatitis C, metabolic syndrome, and mild cardiovascular alterations are also identified. Environmental factors, such as exposure to phenols, smoking, certain medications, and inadequate diet, influence the development of intestinal dysbiosis and oxidative stress. The psychosocial impact is significant, with high prevalences of anxiety, depression, and neuropsychiatric disorders, especially in cases of early onset.
Conclusions: vitiligo results from a complex interaction between genetic predisposition, immune dysfunction, and environmental factors. Its clinical management should be comprehensive, taking into account systemic comorbidities and psychological support, which may optimize early diagnosis and guide more personalized therapeutic strategies.
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