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Additionally, the high levels of LA, low pH, hypoxia, and reactive oxygen species (ROS) prevalent in the TME can impair T cells and natural killer cells while polarizing tumor-associated macrophages into a pro-tumoral M2-like phenotype, collectively facilitating immune evasion [20]

This comprehensive metabolic shift results in enhanced lipid utilization (lower cellular fat accumulation) and an efficient use of nutrients, echoing the metabolic effects of calorie restriction or exercise at the cellular scale

You may also have symptoms of other autoimmune diseases along with vitiligo, such as: A goiter or enlarged thyroid glands Anemia or low levels of healthy red blood cells Extreme weight and muscle loss Premature grey hair Patchy hair loss Weakness Vitiligo Types There are five types of vitiligo

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