The treatment of vitiligo has been one of the difficulties of dermatological diseases, the disease usually develops rapidly but is difficult to treat. When patients have vitiligo, their appearance is damaged, which leads to a great impact on social, work, and even marriage and life. Although the treatment of vitiligo is currently a difficult problem, it is also a hot spot, and many medical workers and scientific researchers are working hard to find better and more effective treatment methods. The autologous melanocyte in vitro culture transplantation is a new method explored through the hard work of researchers in recent years.
Early stage vitiligo develops rapidly (called progressive stage) and usually requires medication or ultraviolet treatment to control the expansion of the disease, when the body’s immunity is abnormal and melanocytes are easily destroyed and transplantation therapy cannot be used. And when the condition is stable, the white spots no longer expand (called stable stage), but the effect of using drugs or ultraviolet treatment is very slow or ineffective, then you can choose transplantation therapy. At this time the body immunity is relatively stable, the survival rate of transplanted melanocytes is higher, and most doctors believe that the longer the stabilization period, the better the transplantation effect will be.
The melanocyte transplantation for vitiligo is not a new method, in the 1980s, the method has been used for clinical patients, mainly including several transplantation methods: epidermal transplantation, microporous transplantation, skin slice transplantation, etc. The most widely used is epidermis transplantation, the principle of this method is to use the epidermis separator in the patient’s normal skin (usually the abdomen) to send out several small blisters, the wall of the blisters is the epidermis layer of the skin, containing melanocytes, and then the wall of the blisters sent out will be cut off and attached to the white spot area where the epidermis is removed, melanocytes will be planted in the transplant, so that the white spot re-colored. Epidermal grafts are widely used because they are effective and have few side effects, and the blisters are so thin that most of them do not leave scars. However, the problem is that such a piece of epidermis is only one square centimeter in size and the area that can be treated is also only one square centimeter in size. If the white spot is small, a few pieces of epidermis can cover the white spot, but if the white spot is large, it is not possible to provide enough epidermis at the normal skin. In addition, there must be gaps between the skin pieces to ensure maximum cell viability, so many of them will have a “pebble”-like appearance after recovery, i.e., there will be white gaps between the skin pieces and uneven pigmentation.
The invention of the autologous melanocyte in vitro culture transplantation method has solved the above problem. Since the 1990s, scientists have been working on the in vitro culture of melanocytes. Cultivation of cells isolated from the human body in vitro is usually difficult, leaving the human environment and requiring more nutrient-rich conditions outside the body to maintain normal cell growth. If melanocytes can be successfully cultured in vitro and allowed to expand, a large number of melanocytes can be cultured for transplantation in the leukoplakic area by taking only a few skin fragments from the patient’s normal skin. This kind of transplantation is different from epidermal transplantation, the melanocyte content of the epidermal slice directly used for transplantation is tiny, while the melanocyte quantity cultured in vitro is huge, which can transplant large area of vitiligo, and the recoloration after transplantation is faster and evenly pigmented. The technology has matured and normal melanocytes can be successfully cultured in vitro. The doctor does not use all the cells for transplantation, but can leave a small number of cells to be cultured in vitro, so that the cells can be transplanted again after they have grown well again.
As one of the surgical treatments, autologous melanocyte transplantation in vitro culture, like other surgical procedures, is indicated for patients for whom non-surgical treatments (including medications and ultraviolet therapy) have failed. In addition there are some risks and precautions: 1. Some vitiligo patients have poor melanocyte viability due to their special physique, which makes it difficult to culture successfully in vitro, such patients cannot undergo autologous melanocyte in vitro culture transplantation. The actual fact is that you can find a lot of people who are not able to get a good deal on this kind of things. 2, the successful in vitro culture melanocytes may not be able to fully survive in the white spot area. The epidermal environment of vitiligo patients’ white spot area is abnormal, if the skin environment is still unfavorable for the growth of melanocytes when transplanted, the melanocytes on the transplant will still die, resulting in no pigmentation after surgery. The most important thing is that you will be able to get the most out of the newest and most popular brand. If the patient’s condition enters the progressive stage again after surgery, the transplanted melanocytes may be damaged and die again, resulting in the recurrence of the white spots.
The most advanced vitiligo treatment technology, the autologous melanocyte in vitro culture transplantation method requires high laboratory conditions, cell culture technology and cell transplantation technology are more complex, the operator needs to undergo strict training and assessment, currently only a few large public hospitals in China can carry out. The cost of culturing melanocytes is expensive because of the high requirements of in vitro melanocytes for growth conditions, and the complexity of various operating techniques, the cost of this method is relatively high at present.