Epidermal Growth Factor Receptor/Mitogen-Activated Kinase Inhibitor Treatment Induces a Distinct Inflammatory Hair Follicle Response That Includes Collapse of Immune Privilege

    David Rutkowski, Rachel Scholey, John Davies, Derek Pye, Fiona Blackhall, Richard B. Warren, Francisco Jiménez, C.E.M. Griffiths, Ralf Paus
    TLDR EGFRi/MEKi treatments cause hair follicles to lose some immune protection, leading to inflammation.
    The study investigates the effects of epidermal growth factor receptor inhibitors (EGFRi) and mitogen-activated kinase inhibitors (MEKi) on hair follicles (HFs), particularly focusing on the immune privilege (IP) of the follicles. In a sample of 9 patients with chronic EGFRi treatment and 5 patients with acute treatment, researchers found that EGFRi/MEKi treatments lead to a partial collapse of HF IP, characterized by increased expression of major histocompatibility complex (MHC) molecules and decreased transforming growth factor-β1. This immune response includes CD8+ T-cell infiltration and increased transcription of inflammatory chemokines and interleukins. The findings suggest that managing EGFRi/MEKi-induced folliculitis should involve strategies to protect HF IP and inhibit interleukin-33 (IL-33).
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