Comprehensive Overview of Cytokine Interplay in Vitiligo: A Decade of Meta-Analyses Systematically Reviewed

Abstract

(1) Background: Vitiligo is an autoimmune skin disorder characterized by melanocyte destruction. Despite metabolic disturbances and oxidative stress also playing a key role in its pathogenesis, accumulating evidence highlights a prominent role for cytokine dysregulation. (2) Methods: A systematic search was conducted to identify meta-analyses published in the last decade that investigated cytokine involvement in vitiligo. (3) Results: Based on predefined inclusion criteria, nine meta-analyses were retrieved and reviewed. The findings confirm a central role for interferon-gamma (IFN-γ) in vitiligo pathogenesis, although recent meta-analyses suggest that IFN-γ gene polymorphisms are more broadly associated with autoimmunity rather than being vitiligo-specific. Elevated interleukin-17 (IL-17) levels have been consistently reported in vitiligo patients, supporting its contribution to immune-mediated melanocyte destruction. Regulatory T cell dysfunction appears to play a crucial role in disease progression. Additionally, TNF-α-308 G/A polymorphism has been linked to a genetic susceptibility to vitiligo, particularly in specific populations, reinforcing the role of TNF-α in immune dysregulation. Lastly, chemokines involved in immune cell recruitment to melanocytes further illustrate the complex inflammatory network underlying the disease. (4) Conclusions: This systematic review consolidates evidence from a decade of meta-analyses, underscoring the significance of cytokine dysregulation in vitiligo and highlighting potential therapeutic targets.