Students wearing Michael Jackson masks, at an awareness programme on vitiligo, in Chennai.
The current decade will probably be known as the decade of the gut, given the incredible number of significant biological connections we are making between the gut and human well being. However, this is not about the gut per se; this is about the role of gut-friendly bacteria in the process of re-pigmentation, particularly in persons with vitiligo.
Vitiligo is a chronic auto immune disorder where the body’s defence system begins to attack the pigment-producing cells and causes de-pigmented white patches on the skin. While usually the condition can be only cosmetic, these patches on the skin can be stigmatising for the patient, particularly if they are present on the face or arms, and thus obvious to others. New research from Northwestern University from a pre-clinical trial in mice has shown that a natural compound derived from gut-friendly bacteria significantly slows down the progression of vitiligo and may restore pigmentation. The findings, if substantiated through rigorous double blind random control clinical trials, could offer hope to millions affected by the autoimmune disease.
It is estimated that vitiligo affects 0.5% to 2% of the global population and is linked to other health challenges, including for some persons, higher risks of cardiovascular disease, psychological distress, and endocrine disorders. The prevalence of vitiligo in India has been invariably reported between 0.25% and 4% of dermatology outpatients across studies from India, and up to 8.8% in Gujarat and Rajasthan, as per a paper in the Indian Dermatology Online Journal. Studies and observations have recorded an erosion of self confidence among those with vitiligo, resulting in an impact on the mental health of the individual.
“The results in our model were astonishing,” says I. Caroline Le Poole, professor of dermatology and microbiology-immunology at Northwestern University Feinberg School of Medicine. “We found that administering a microbial compound weekly to vitiligo-prone mice significantly suppressed disease progression. It made a spectacular difference in an aggressive model of the disease.” The results of the study were recently published in the Journal of Investigative Dermatology.
“We are trying to understand the pigment cell and how it works. Vitiligo patches can be a big deal for patients, particularly during adolescence and youth,” Dr. Le Poole explains in a video call. While acknowledging the renewed global interest in what microbiomes can do for health, she adds that she was interested first in the effect of the gut microbiome on antibody-mediated auto immune disease, here in the development of vitiligo patches.
Dr. Le Poole and her colleagues administered a microbial product weekly to vitiligo-prone mice over an 18-week period. By the end, pigment loss on the mice’s backs was reduced by 74%. The product reduced killer T cells that attack the skin’s pigment and increased protective regulatory T cells, which are typically scarce in vitiligo patients. “This simple microbial compound could work as a standalone therapy or in synergy with existing treatments,” Dr. Le Poole says.
However, she adds that it is necessary to intervene as early as possible and that the effects might not be as dramatic or efficient in advanced disease. There are typically two peaks in persons with vitiligo — in adolescence, and then, again, during the 40s and 50s. Dr. Le Poole adds that the disease has been found to be more severe in people with darker skin tones, as found in the Indian population. Naturally, the visibility of the discoloration in people with darker skin can also amplify stigma and emotional distress. “Patients often feel powerless as they watch their disease progress, unsure how they will look next month. For many, stabilising the disease would be life changing,” she explains.
The next challenge would be to adapt the microbial product for human use. “Weekly injections could work, but we need to explore simpler options, like a food additive or ointment,” according to Dr. Le Poole. “We also need to understand how long the effects last and the best timing for treatment.” She adds that the same microbial compound injected in mice could potentially treat other autoimmune conditions, particularly those involving killer T cells in the skin. The next step would be to collaborate with scientists from several institutions to refine the compound, understand its mechanisms, and determine whether it works alongside existing treatments for auto-immune disease.”
Published – March 07, 2025 06:30 am IST