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Also, Apo M/S1P may activate PI3K/Akt pathway by S1PR1 and S1PR3 to irritate eNOS expression and NO generation, lessening monocytes adhesion to ECs 95,96

These peptide hormones mediate their biological actions through five different but closely related G-protein coupled melanocortin receptors (MC1-R to MC5-R) that are distributed in many tissues and involved in the regulation of important physiological functions including skin pigmentation, steroidogenesis, energy homeostasis, sexual function, and exocrine secretion (Yang, 2011)

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At the same time, increased MC1R expression on melanocytes membrane in the nonlesional skin of vitiligo patients matching to controls may represent an attempt to restore normal pigmentation [81,82]