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Melanoma Inhibitory Activity (MIA) is an effective therapeutic target for recalcitrant non-segmental vitiligo, in combination with oral antioxidant medications and UVA or sun exposure.

Vitiligo is characterized by acquired autoimmune depigmentation of the skin. Studies based on an animal model have suggested the involvement of melanoma inhibitory activity (MIA) protein in vitiligo pathogenesis. MIA protein mediates the detachment of melanocytes from the extracellular matrix (ECM) proteins, leading to the formation of depigmented macules. An oligopeptide-based topical formulation has been introduced in the market with claims it can inhibit the activity of MIA proteins to treat vitiligo.

This case report, published in Medicine, assessed the efficacy of a MIA-containing topical formulation in a 50-year-old patient with a 10-year history of non-segmental vitiligo that is recalcitrant to ultraviolet exposure and other treatments. The investigators utilized the topical preparation with MIA-inhibitory peptides on particular areas of the body including the sides of the trunk and the face. The other areas of the body were left untreated, serving as controls. These included the legs and arms of the patient. The patient then received sun exposure or underwent UVA sessions to stimulate melanocyte replication during treatment.

The authors observed recovery in the repigmentation of the treated areas, with 50% improvement after 3 months and 80% improvement in these regions after 9 months of treatment. The patient did not report any systemic or local adverse effects. The investigators observed no changes in the control regions of the body.

In summary, melanocytorrhagy associated with MIA protein is a novel pathogenic mechanism of vitiligo, serving as a newer therapeutic approach for the treatment of vitiligo. A recent topical formulation with MIA-inhibitor technology has been developed for treating white macules in vitiligo. This therapeutic approach is effective for treating and mediating repigmentation in recalcitrant and non-segmental vitiligo, combined with UVA or sun exposure and the administration of oral antioxidants. It is further recommended that future clinical trials should establish the therapeutic safety and efficacy of the topical formulation with MIA-inhibitory peptides.

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Hernandez Navarro, S., Segura Tejedor, J., Bajona Roig, M., Luisetto, R., Fedrigo, M., Castellani, C., Angelini, A., Alaibac, M., & Bordignon, M. (2022). Efficacy of a topical formulation containing MIA (Melanoma Inhibitory Activity) – Inhibitory peptides in a case of recalcitrant vitiligo in combination with UV exposure. Medicine (Baltimore), 101(46), e31833. https://doi.org/10.1097/md.0000000000031833

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