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Exclusion criteria included non-RCT designs, studies involving premenopausal women or other populations, and studies not reporting relevant outcomes (Supplementary Table 2)

In mice, daily injections of oxaloacetate for 2 weeks increased the number of mitochondria in brain cells

Knockdown of prosaposin in CaCo-2 cells also decreases cellular CoQ 10 content, causing a decrease in ATP formation and glucose consumption [156]

GPR120 signaling inhibits NF-B and NLRP3 inflammasome activation while promoting a shift toward an anti-inflammatory M2 macrophage phenotype [93]

Consequently, oxidative stress acts not only as an initial trigger in vitiligo but also as a catalyst that, by generating autoantigens and inflammatory cytokines, perpetuates autoimmune responses and drives disease progression 17,46