【摘要】 既往研究多认为自身免疫紊乱是白癜风的主要发病机制，近年来多维组学研究进一步提示，代谢重编程(metabolic reprogramming)可能在黑素细胞损伤及免疫激活中发挥重要作用。氧化还原稳态失衡可削弱黑素细胞抗氧化防御；脂质代谢紊乱不仅可通过谷胱甘肽过氧化物酶4(GPX4)/长链酰基辅酶A合成酶4(ACSL4)失衡诱导铁死亡，其相关脂肪因子还可能参与系统性代谢异常与免疫杀伤过程；线粒体功能障碍与能量代谢异常，如过氧化物酶体增殖物激活受体γ辅激活因子1α(PGC-1α)无效代偿、沉默信息调节因子家族(sirtuins)表观调控网络障碍等，可重塑皮损微环境，并可通过介导低氧诱导因子1α(HIF-1α)等靶点增强CD8~+T细胞的免疫黏附，而氨基酸及一碳代谢通路相关基因变异，如酪氨酸酶(TYR)和亚甲基四氢叶酸还原酶(MTHFR)基因多态性，可影响黑素合成，也可能促进新自身抗原产生。本文梳理了代谢相关基因在白癜风发病机制中的研究进展，为进一步揭示白癜风的发病机制奠定基础，并有望为白癜风早期生物标志物筛查及靶向代谢重塑治疗提供新的临床转化视角。更多还原

【Abstract】 Autoimmune dysregulation has long been considered as the major pathogenic mechanism of vitiligo. In recent years, multi-omics studies have further suggested that metabolic reprogramming initiates and drives melanocyte damage and immune activation. Imbalanced redox homeostasis may weaken the antioxidant defense of melanocytes. Lipid metabolism disorders may not only induce ferroptosis through an imbalance between glutathione peroxidase 4(GPX4) and acyl-CoA synthetase long-chain family member 4(ACSL4), but also involve related adipokines in systemic metabolic syndrome and immune-mediated cytotoxicity. Mitochondrial dysfunction and abnormal energy metabolism, such as ineffective compensation of peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α) and dysregulation of the epigenetic regulatory network of the sirtuin family, may reshape the lesional microenvironment and enhance the immune adhesion of CD8~+T cells through targets such as hypoxia-inducible factor-1 alpha(HIF-1α). In addition, genetic variations in amino acid and one-carbon metabolism pathways, such as polymorphisms in tyrosinase(TYR) and methylenetetrahydrofolate reductase(MTHFR), may affect melanin synthesis and promote the generation of neoantigens. This article reviews recent advances in the research on metabolism-related genes in the pathogenesis of vitiligo, providing a basis for further elucidating the pathogenic mechanisms of vitiligo and offering new translational perspectives for early biomarker screening and targeted metabolic remodeling therapy.更多还原