Disease activity and treatment response biomarkers in vitiligo: a scoping review of multi-omic studies

Vitiligo is an autoimmune cutaneous disease characterized by focal or generalized depigmentation due to loss of melanocytes. As more molecularly targeted therapies gain FDA approval or achieve positive late-stage clinical trials results, an opportunity exists to summarize the current state of the art in vitiligo biomarker and omics studies. Vitiligo is an unpredictable disease, with the clinical course varying from patient to patient. Leveraging the wide range of available multi-omic data may help identify biomarkers that can assist with prognostication (e.g., active vs. stable disease) and treatment selection. This review aims to summarize the literature on non-segmental vitiligo molecular biology, including genetics, transcriptomics, miRNA biology, proteomics, lipidomics, and metabolomics, with an eye towards identifying potential candidate biomarkers for future clinical development. Utilizing an evidence rating tool for critical appraisal of selected biomarkers, several candidate biomarkers are highlighted for their association with disease activity or treatment response, including serum measurements of CXCL10, CXCL9, IL-17, miR-25, IFN- γ, IL-6, and MIF.