Baricitinib is Effective in Treating Progressing Vitiligo in vivo and in vitro

Jie Dong; Xuan Huang; Li-Ping Ma; Fei Qi; Si-Nian Wang; Zi-Qin Zhang; Shi-Nan Wei; Ling Gao; Fang Liu

doi:10.1177/15593258221105370

Baricitinib is Effective in Treating Progressing Vitiligo in vivo and in vitro

Dose Response. 2022 May 31;20(2):15593258221105370. doi: 10.1177/15593258221105370. eCollection 2022 Apr-Jun.

Authors

Jie Dong¹, Xuan Huang², Li-Ping Ma³, Fei Qi¹, Si-Nian Wang⁴, Zi-Qin Zhang⁴, Shi-Nan Wei⁴, Ling Gao³, Fang Liu¹

Affiliations

¹ Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
² Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
³ China CDC Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China.
⁴ PLA Rocket Force Characteristic Medical Center, Beijing, China.

Abstract

Objective: To evaluate the clinical efficacy and safety of baricitinib, a Janus kinase (JAK) inhibitor, in treating patient with progressing vitiligo, and to further explore the regulation of baricitinib on melanocytes (MCs) in vitro.

Methods: Four patients with progressing vitiligo were treated with oral baricitinib for a total of 12 weeks. MCs were cultured in vitro and irradiated by high-dose ultraviolet B (UVB, 150mJ/cm²) to make an MC damaged model (MC-Ds). Baricitinib was added at a final concentration of 25 μM. Dopamine staining and NaOH method were used to measure the tyrosinase activity and melanin level, respectively, real-time quantitative polymerase chain reaction (RT-qPCR) was used to measure the mRNA levels of tyrosinase (TYR), tyrosinase-related protein-1 (TRP-1).

Results: Significant re-pigmentation was observed in the week 12 without obvious side effects. Depigmentation occurred in 2 patients at the 3-month follow-up. Laboratory research found that higher doses of UVB irradiation (150mJ/cm²) could decrease melanin content of MCs, baricitinib (25 μM) could significantly promote tyrosinase activity, melanin content, and TYR, TRP-1 gene expression of MC-Ds.

Conclusion: Our preliminary study showed that baricitinib was effective and safe in treating progressing vitiligo. Baricitinib could promote tyrosinase activity, melanin content and TYR, TRP1 gene expression of MC-Ds in vitro.

Keywords: baricitinib; janus kinase inhibitor; melanocyte; ultraviolet; vitiligo.