July 23--It's at best a cosmetic disability; at worst a skin ailment that can make a person suffer in sunlight. Some 30-50 million people in India live with vitiligo, white patches on the skin that are badly understood as a disease and unfairly treated as a social stigma.
In a step that not only throws light on the underlying biology of the disease but marks the initial logical step towards its treatment, a team of scientists from Indian research institutes, Ram Manohar Lohia Hospital in Delhi and L'oreal Research in France, have shown how a particular pathway, triggered by cosmetic agents such as curcumin (from turmeric) and santalol (from sandalwood) are responsible for the disequilibrium in the skin.
The findings have been published in the Thursday's issue of the Journal of Investigative Dermatology.
"The result looks very good. I can say this is the first step towards a rational design of drug for vitiligo," said G. Padmanabhan, former director of the Indian Institute of Science, who, as the department of biotechnology's (DBT) distinguished biotechnologist is aware of this work.
Oxidative stress--or physiologically more than normal levels of oxygen in the body--is responsible for many diseases; vitiligo is understood to be one of them.
Using curcumin, the active ingredient in turmeric, and santalol, the main constituent of sandalwood oil, on skin patches, researchers showed that these agents increased the oxidative stress on the skin and result in vitiligo.
Though it's too early to say if these compounds are linked to the high incidence of vitiligo in India where both turmeric and sandalwood are popular as tpical skin applications, a correlation can't be ruled out.
"If we were to extrapolate, these (turmeric and sandalwood) could be possible triggers for vitiligo," said Rajesh S. Gokhale, one of the lead authors of the study and director of the Institute of Genomics and Integrative Biology in Delhi.
In order to build their case, Gokhale and his team are readying a set of research findings for publication which together show new dimensions of the disease, including its genetics.
"So far it is primarily taken to be an autoimmune disease (where the body's own immune system destroys melanocytes or pigment-producing cells). So drugs are given to kill T-cells (rogue cells) and doctors use ultraviolet light to induce melanin, but this proves counterproductive in many cases," said Gokhale.
With the research underway, Gokhale says his group will soon be able to classify vitiligo. It's often misunderstood as one disease, but is actually multiple diseases with a single phenotype (physical manifestation); it's a network of events, researchers say. Encouraged by the state of local research, Gokhale said "it's a clear cut case of a (health) problem than can be cracked within five to 10 years."
For Padmanabhan, this is promising as well as challenging. "The good thing is that unlike earlier days when we chased the industry, now they are coming to us (academics); but India still doesn't have the capability to produce a new molecule drug and take it to the international market."
The research so far has been funded by DBT and now is even supported by the Council for Scientific and Industrial Research.
Funding isn't an issue, but creating awareness is. For his part, Gokhale thinks vitiligo could benefit from having "brand ambassadors", especially from the industry.
"After all, if people like Sachin Tendulkar take up a cause, the rest of the country ensures that it gets resolved."
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