Although vitiligo is often called an autoimmune disease, this has never been confirmed with any certainty. In fact, the cause of vitiligo is not yet known: various factors appear to play a role, including oxidative stress, heredity, hormonal and environmental factors, diet, immune system and seasonality. Dr Bordignon’s studies confirm that the main cause of vitiligo lies beyond the immune system and precisely in the action of a protein known as MIA (Melanoma Inhibitory Activity), present in the skin of adult and child patients suffering from vitiligo. It is produced by the melanocyte itself, although the reason for this is not yet known. The role of genetic predisposition to the development of vitiligo, which is expressed at a certain point in life, appears to be clear: in adults, it often occurs after a particularly stressful period, which triggers the biological mechanism to produce the protein.

With Dr Bordignon’s studies, published in the most prestigious scientific publications around the world, it has been confirmed that the MIA protein is always present in the skin of patients suffering from vitiligo: it acts by undermining the adhesiveness of melanocytes, namely the cells that produce melanin, the natural pigment of our skin. So, what causes the white patch? The MIA protein produced by melanocytes turns against the same, acting like scissors, causing the breakage of the adhesion molecules between the melanocytes (so-called integrins) and the basal membrane (the structure that separates the epidermis, where melanocytes reside, from the dermis). This causes the complete detachment of the pigmented cells, which leave the affected part of the skin, depriving it entirely of melanin and thus creating white patches. Skin exfoliation does the rest: the parts of the skin with vitiligo are in fact those that are rubbed the most.

All this happens, however, without the body’s immune sentinels being activated: the white skin patches do not entail itching, burning or other symptoms but merely produce a difference in colour compared to the surrounding healthy skin. In fact, the skin is perfectly healthy. This is why Dr Bordignon’s studies have been focused on new research.

Since the biological mechanisms that trigger the MIA protein are still unclear, it is difficult to discuss prevention generically. However, a healthy and balanced lifestyle and the ability to manage stress can make a difference.