In addition, a variety of cytokines secreted by T helper cell subsets- Th1 (IFN-γ, TNF-α, IL-2) and Th2 (IL-4, IL-10, IL-13) not only exacerbate autoimmune responses but also perpetuate the vicious cycle of immune dysfunction, ultimately leading to the clinical manifestations of vitiligo [33]. Here, TNF is linked to vitiligo.