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It has been shown that perilesional melanocytes have a lower ratio of Bcl-2/Bax than control melanocytes, suggesting that melanocytes from patients with vitiligo are more susceptible to apoptosis activation due to altered Bcl-2 and Bax expression and that the balance between pro-apoptotic and anti-apoptotic proteins in vitiligo melanocytes is shifted towards apoptosis [44]

Moreover, this metabolic plasticity extends to mitochondrial adaptation, where certain aggressive subpopulations (e.g., metastatic cells) maintain flexible oxidative capacity to survive microenvironmental stresses, demonstrating the multifaceted role of metabolic rewiring in tumor progression [10]

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Toxicol Appl Pharm