A Systematic Review of Case Series and Clinical Trials Investigating Regenerative Medicine for the Treatment of Vitiligo.

Abstract

Aims and objectives: The aim of this study is to examine the efficacy and safety of various regenerative medicine treatments, such as cell therapy, platelet-rich plasma (PRP), plasma-poor platelet (PPP), plasma-rich fibrin (PRF), mesenchymal stem cells, stromal vascular fraction (SVF), exosomes, adipose-derived stem cells (ADSC), and stem cell-conditioned media (SC-CM), for treating vitiligo.

Method: We conducted a thorough search of major databases such as PubMed, Scopus, and Web of Science, and selected 48 articles based on specific criteria. We used EndNote X8 and Google Sheets to review and extract data from the articles. After analyzing the studies, we categorized them accordingly.

Results: This systematic review analyzed 48 articles involving 2186 patients with vitiligo to assess the effectiveness of regenerative medicine treatments. Key findings revealed that methods such as autologous non-cultured melanocyte-keratinocyte transplantation and platelet-rich plasma (PRP) injection exhibited significant repigmentation, particularly when combined with modalities like NB-UVB phototherapy and laser treatments. Notably, the autologous melanocyte-keratinocyte transplantation achieved over 50% repigmentation within 9 months, while PRP demonstrated an average repigmentation of 58.7%, especially effective with CO₂ laser treatment. Hair follicle-derived cell transplantation also showed impressive response rates, achieving good to excellent results in up to 93.8% of patients. Side effects were noted in 21 of 28 studies, primarily involving pain, with no serious adverse events reported. The risk of bias assessment indicated that 37.21% of studies were low risk, while 48.84% had high risks overall. These findings suggest that while regenerative medicine holds promise for vitiligo treatment, further clinical trials are necessary to explore additional methods like stromal vascular fraction and exosomes.

Conclusion: We have concluded that regenerative medicine plays an effective role in the treatment of vitiligo lesions. Furthermore, this treatment method is safe and does not cause serious complications. It can be used alone or in combination with other methods for treating vitiligo. To advance the treatment of vitiligo, we recommend conducting clinical trials on the unexplored branches of regenerative medicine.