Recent Progress and Future Directions: The Nano-Drug Delivery System for the Treatment of Vitiligo

Figures & data

Figure 1 Illustration of the pathogenesis of vitiligo.

Figure 2 A scheme of the nano-drug delivery systems for vitiligo therapy.

Table 1 Treatment Approaches for Vitiligo

Treatment Approaches		Indications	Defects/Side Effects
Topical corticosteroids	Betamethasone dipropionate, clobetasol dipropionate, mometasone furoate	Localized vitiligo, both on adults and children.	Skin atrophy, telangectasias, folliculitis, acneic lesions, hypertrichosis and striae distensae.
Topical immunomodulators	Tacrolimus, pimecrolimus	Adult patients, as a substitution option of corticosteroids.	Photosensitivity, burning sensation, erythema, pruritus, flushing; increased risk of cutaneous and noncutaneous lymphomas.
Antioxidants	Vitamin C, vitamin E, superoxide dismutase, polypodium leucotomos	In association with all kinds of treatment options.	No obvious side effects reported while treatment effect is not obvious.
Phototherapy	NB-UVB, PUVA	Generalized vitiligo both in adults and children. Usually combine with additional drugs.	Hyperpigmentation, erythema, burning and blistering, increased risk of skin cancer.
Other treatments	Surgical therapies, depigmentation, cosmetic approaches, etc.

Figure 3 Existing nano-drug delivery system for vitiligo therapy.

Table 2 Nano-Drug Delivery System for Vitiligo Therapy

Formulation	Drug/Therapeutic Agent	Outcome	Ref
Liposomes	8-Methoxypsoralen	The release and permeation–accumulation of 8-MOP is increased in vitro	[^Citation59]
Deformable liposomes	Baicalin and berberine	Stimulated melanin production and tyrosinase activity. Showed remarkable antioxidant and photoprotective capabilities	[^Citation60]
Deformable liposomes	Resveratrol and psoralen	Higher penetration rate, significantly stimulated melanin and tyrosinase activity, potential antioxidant activity, promoted pigmentation and restoration of redox balance by free radical scavenging activity.	[^Citation61]
Cationic niosomes	Human tyrosinase plasmid in mouse melanoma cells by Tat peptide	Enhanced the expression of human tyrosinase gene and melanin production with relatively low cytotoxicity; improved the stability of the plasmid loaded in the niosomes.	[^Citation62]
Cationic niosomes	Tyrosinase plasmid pMEL34	The expressed tyrosinase activities were four times higher than the free plasmid and the plasmid loaded in nonelastic niosomes. Exhibit potential as a gene topical delivery system for vitiligo.	[^Citation63]
Microemulsion-based gel	Clobetasol propionate	Showed better retention in the skin and less irritation potential, permeated and retained into skin layers; significantly enhanced skin permeation and accumulation; patients treated with MBC showed faster repigmentation	[^Citation64,Citation65]
Nanosized ethosomes-based hydrogel	8-Methoxypsoralen	Significantly increased skin permeation and accumulation in the epidermal and dermal layers. Showed insignificant phototoxicity and erythema compared with the conventional cream.	[^Citation66]
Nanoparticles	Palladium and platinum	Is able to active AHR and NRF2 in human keratinocytes	[^Citation67]
Nanoparticles	Polydopamine	The melanin-like nanoparticles were endocytosed by human epidermal keratinocytes and mimicked the behavior of natural melanosomes.	[^Citation68]

Table 3 Brief Introduction of Novel Liposomal Systems

Carriers	First Described	Typical Compositions	Characteristics and Advantages Compared to Conventional Liposomes
Invasomes	A. Fahr et al in 2003.^Citation92	Phosphatidylcholine, ethanol, terpenes.	Enhance transdermal absorption of both aqueous and lipid-soluble drugs.
Ethosomes	E.Touitou et al in 1996^Citation96	Phospholipids, high proportion of ethanol (20–45%)	Smaller particle size; fusion with skin lipids and increase the penetration of ethosomes.
Niosomes	RM.Handjanivila et al in 1979^Citation96	Non-ionic surfactants and cholesterol.	A greater bioavailability; more stable than liposomes in oxidizing environment.
Transfersomes	G. Ceve et al in 1992.^Citation97	Phosphatidylcholine, surfactants (sodium cholate, Tween 80, Tween 60, Span 80, etc.)	Greatly improve the deformability and elasticity of the carriers; migrate into deeper skin layers.

Figure 4 Schematic diagram of the role of MC1R in melanin synthesis and secretion.

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