Differential Impact of Environmental Factors on Systemic and Localized Autoimmunity

May 2023 in “ Frontiers in immunology ”

Hanane Touil, Kristin Mounts, Philip L. De Jager

Alopecia Areata Vitamin D dietary interventions autoimmunity obesity AA diet autoimmune diseases

From the encyclopedia

Alopecia Areata →

autoimmune disorder causing patchy hair loss

Vitamin D →

vitamin you should probably be taking for general health might also help your hair a little

Studysummary This review discusses how environmental factors like lifestyle, nutrition, and vitamin deficiencies may influence autoimmune diseases such as MS, SLE, and AA, highlighting associations with vitamin D levels and dietary interventions, but notes a lack of conclusive evidence for their roles in disease pathogenesis.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This review examines the role of environmental factors such as lifestyle, nutrition, and vitamin deficiencies in the development and progression of autoimmune diseases, specifically Multiple Sclerosis (MS), Systemic Lupus Erythematosus (SLE), and Alopecia Areata (AA). It highlights the common association of low Vitamin D levels with these conditions, particularly its correlation with disease activity in MS and AA, while noting the less clear relationship in SLE. The review also discusses other vitamins, overall diet, and lifestyle impacts on these diseases. For instance, dietary interventions in MS patients have shown improvements in clinical outcomes and quality of life, and certain diets and supplements have been linked to lower incidence and improved symptoms in MS, SLE, and AA. Conversely, obesity is associated with a higher incidence of MS and organ damage in SLE. The review underscores the complex interaction between environmental factors and genetic susceptibility in autoimmunity and suggests that understanding these relationships could lead to therapeutic interventions.

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research Efficacy of a Mixed Preparation Containing Piperine, Capsaicin, and Curcumin in the Treatment of Alopecia Areata

4 citations , March 2022 in “Journal of cosmetic dermatology”

This study concluded that a mixed preparation of piperine, capsaicin, and curcumin is effective for treating alopecia areata but is not superior to minoxidil over a short-term period.

research Dietary Habits in Japanese Patients with Alopecia Areata

5 citations , October 2021 in “Clinical, cosmetic and investigational dermatology”

In this study, Japanese patients with alopecia areata were found to have higher BMI and retinol intake, with retinol intake predicting severity of hair loss.

research Alopecia Areata: An Update on Etiopathogenesis, Diagnosis, and Management

290 citations , August 2021 in “Clinical Reviews in Allergy & Immunology”

JAK inhibitors show promise for treating alopecia areata, but more research is needed.

research Treatment of Pediatric Alopecia Areata: A Systematic Review

48 citations , April 2021 in “Journal of the American Academy of Dermatology”

This study found that topical corticosteroids are the most supported first-line treatment for pediatric alopecia areata, with contact immunotherapy as the next best option.

research Combined Diet and Supplementation Therapy Resolves Alopecia Areata in a Pediatric Patient: A Case Study

3 citations , November 2020 in “Curēus”

This case report describes an eight-year-old male with alopecia areata who achieved complete remission within five months following a diet and supplementation regimen rich in vitamins and zinc.

research Hair Follicle Immune Privilege and Its Collapse in Alopecia Areata

134 citations , July 2020 in “Experimental dermatology”

This review discusses immune privilege in anagen hair follicles and its collapse in alopecia areata, emphasizing the importance of restoring this function for effective management and disease relapse prevention.

Efficacy and Safety of Topical Calcipotriol 0.005% Versus Topical Clobetasol 0.05% in the Management of Alopecia Areata: An Intrasubject Pilot Study

research Efficacy and Safety of Topical Calcipotriol 0.005% Versus Topical Clobetasol 0.05% in the Management of Alopecia Areata: An Intrasubject Pilot Study

10 citations , April 2020 in “Dermatology and therapy”

In this study of 35 patients with scalp alopecia areata, calcipotriol ointment led to faster and greater hair regrowth than clobetasol, though differences were not statistically significant.

research Alopecia Areata and Toxic Metals

4 citations , January 2020 in “Skin appendage disorders”

This study highlighted that toxic metals, particularly thallium, arsenic, selenium, and mercury, are commonly associated with cases of alopecia areata.

research The Role of Diet as an Adjuvant Treatment in Scarring and Nonscarring Alopecia

17 citations , January 2020 in “Skin appendage disorders”

This review suggests that the Mediterranean diet, protein-rich diets, and soy may support hair health in nonscarring alopecias like androgenetic alopecia.

research Serum Ferritin and Vitamin D Levels Should Be Evaluated in Patients With Diffuse Hair Loss Prior to Treatment

6 citations , January 2020 in “Postepy Dermatologii I Alergologii”

This article recommends assessing serum ferritin and vitamin D levels in patients with diffuse hair loss before starting treatment, but it reports no new clinical results.

research Vitamin D Receptor Gene Polymorphism in Chronic Telogen Effluvium: A Case-Control Study

7 citations , October 2019 in “Clinical, Cosmetic and Investigational Dermatology”

This study found that specific polymorphisms in the VDR gene, Taq1, and Cdx1, were significantly associated with increased risk of chronic telogen effluvium in women.

research Comparative Study of Efficacy of Topical Mometasone with Calcipotriol Versus Mometasone Alone in the Treatment of Alopecia Areata

9 citations , January 2019 in “International Journal of Trichology”

In this study, combining topical calcipotriol with mometasone results in greater improvement in alopecia areata treatment compared to using mometasone alone, as evidenced by a more significant reduction in SALT score over 24 weeks.

research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations , December 2018 in “Journal of autoimmunity”

This review discusses genetic and environmental factors contributing to autoimmunity in alopecia areata and reports no new clinical findings, emphasizing the need for further study on its aetiology and pathophysiology.

research An Investigation of Vitamin D Status in Alopecia Areata

37 citations , June 2018 in “Clinical and Experimental Medicine”

This study found that patients with alopecia areata had significant systemic inflammation and vitamin D deficiency, with both conditions more pronounced as disease severity increased.

research Alopecia Areata and the Gut: The Link Opens Up for Novel Therapeutic Interventions

48 citations , May 2018 in “Expert Opinion on Therapeutic Targets”

This review discusses how modern lifestyle factors affecting gut health may contribute to Alopecia Areata in genetically predisposed individuals, reporting no new results but suggesting the need for long-term interventions.

research Alopecia Areata: A Review of Disease Pathogenesis

191 citations , May 2018 in “British journal of dermatology/British journal of dermatology, Supplement”

This study reviewed recent theories on alopecia areata's pathogenesis, highlighting its autoimmune nature due to immune privilege disruption in hair follicles, and noted current treatments have limited efficacy with high relapse rates, underscoring the need for further research into its mechanisms for better therapies.

research Mediterranean Diet: Fresh Herbs And Fresh Vegetables Decrease The Risk Of Androgenetic Alopecia In Males

12 citations , November 2017 in “Archives of Dermatological Research”

This study suggests that high consumption of raw vegetables and fresh herbs, which are part of the Mediterranean diet, may reduce the risk of androgenetic alopecia in genetically predisposed men.

research The Role of Micronutrients in Alopecia Areata: A Review

63 citations , May 2017 in “American Journal of Clinical Dermatology”

This review found that patients with alopecia areata may have lower levels of vitamin D, zinc, and folate, but conflicting evidence precludes definitive clinical recommendations for micronutrient supplementation.

research Efficacy and Safety of Topical Calcipotriol in Management of Alopecia Areata: A Pilot Study

39 citations , January 2017 in “Dermatologic Therapy”

This study found that topical calcipotriol lotion resulted in hair regrowth in 59.1% of alopecia areata patients, with better response observed in those with lower serum vitamin D levels.

research Increased Blood Levels of NKG2D+CD4+ T Cells in Patients with Alopecia Areata

7 citations , December 2016 in “Journal of the American Academy of Dermatology”

In this study, researchers found that patients with alopecia areata had a significant increase in NKG2D+CD4+ T cell levels in their blood compared to healthy controls.

research CXCR3 Blockade Inhibits T Cell Migration Into the Skin and Prevents Development of Alopecia Areata

64 citations , July 2016 in “Journal of Immunology”

In this study, blocking the CXCR3 receptor in mice prevented the development of alopecia areata by inhibiting the accumulation of specific T cells in the skin, suggesting a potential therapeutic approach for humans.

research Assessment of Vitamin D Receptors in Alopecia Areata and Androgenetic Alopecia

20 citations , May 2016 in “Journal of Cosmetic Dermatology”

This study suggests that lower serum and tissue vitamin D receptor levels in alopecia areata and androgenetic alopecia patients may play a role in the pathogenesis of these hair diseases.

research Serum Biotin Levels in Women Complaining of Hair Loss

71 citations , January 2016 in “International Journal of Trichology”

This study found that 38% of women with hair loss had a biotin deficiency, suggesting oral biotin supplementation should be based on confirmed biotin deficiency rather than as a general treatment.

research Functional Interpretation of Genome-Wide Association Study Evidence in Alopecia Areata

55 citations , October 2015 in “Journal of Investigative Dermatology”

Alopecia areata is linked to immune-related genes, suggesting JAK inhibitors as a potential treatment.

research Alopecia Areata Profiling Shows TH1, TH2, and IL-23 Cytokine Activation Without Parallel TH17/TH22 Skewing

176 citations , August 2015 in “The journal of allergy and clinical immunology/Journal of allergy and clinical immunology/The journal of allergy and clinical immunology”

This study identified a distinct cytokine activation signature in alopecia areata, involving TH2, TH1, IL-23, and IL-9/TH9 pathways, suggesting potential targeting strategies similar to those in psoriasis and atopic dermatitis.

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144 citations , July 2015 in “Clinical, Cosmetic and Investigational Dermatology”

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research Topical Calcipotriol Therapy for Mild-to-Moderate Alopecia Areata: A Retrospective Study

38 citations , June 2015 in “PubMed”

This study found that topical calcipotriol may safely and effectively treat mild-to-moderate patchy alopecia areata, with significant hair regrowth observed in the majority of participants over 12 weeks.

research Combination Therapy with Zinc Gluconate and PUVA for Alopecia Areata Totalis: An Adjunctive but Crucial Role of Zinc Supplementation

16 citations , March 2015 in “Dermatologic therapy”

This study reported two cases of alopecia areata where hair regrowth was achieved with zinc gluconate and sulfur amino acids after relapse post-PUVA cessation, suggesting potential zinc responsiveness in some patients.

research Investigation of Oxidative Stress in Patients with Alopecia Areata and Its Relationship with Disease Severity, Duration, Recurrence, and Pattern

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This study found that patients with alopecia areata had reduced erythrocyte SOD and GSH-Px activities and elevated plasma MDA levels, suggesting a potential role of oxidative stress in the disease's pathogenesis.

research Evaluation of Serum Homocysteine, High-Sensitivity CRP, and RBC Folate in Patients with Alopecia Areata

18 citations , October 2014 in “Indian Journal of Dermatology”

This study found that patients with alopecia areata have lower levels of RBC folate, correlating negatively with the disease's severity and extent.

research Vitamin D Deficiency in Alopecia Areata

105 citations , March 2014 in “British journal of dermatology/British journal of dermatology, Supplement”

In this study, patients with alopecia areata were found to have significantly lower serum vitamin D levels compared to those with vitiligo and healthy individuals, with lower levels correlating with increased disease severity.

Higher Body Mass Index Is Associated With Greater Severity of Alopecia in Men With Male-Pattern Androgenetic Alopecia in Taiwan: A Cross-Sectional Study

research Higher Body Mass Index Is Associated With Greater Severity of Alopecia in Men With Male-Pattern Androgenetic Alopecia in Taiwan: A Cross-Sectional Study

38 citations , November 2013 in “Journal of The American Academy of Dermatology”

This study found that higher BMI was significantly associated with more severe hair loss in men with male-pattern and early-onset androgenetic alopecia.

research Methylenetetrahydrofolate Reductase C677T Mutation in Patients with Alopecia Areata in Turkish Population

15 citations , August 2013 in “Gene”

This study found that the MTHFR gene C677T mutation appears to be a susceptibility factor for alopecia areata in the Turkish population.

research Endogenous Retinoids in the Pathogenesis of Alopecia Areata

54 citations , September 2012 in “The journal of investigative dermatology/Journal of investigative dermatology”

This study suggests that vitamin A influences the immune response and hair cycle, affecting the progression of alopecia areata in mouse models.

research Alopecia Areata as a Model for T Cell-Dependent Autoimmune Diseases

28 citations , May 2012 in “Experimental Dermatology”

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research Alopecia Areata: An Autoimmune Disease Causing Hair Loss

421 citations , April 2012 in “The New England Journal of Medicine”

Alopecia Areata is an autoimmune condition causing hair loss with no cure and treatments that often don't work well.

research Advances in the Management of Alopecia Areata

51 citations , December 2011 in “The Journal of Dermatology”

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research Abnormal Epigenetic Modifications in Peripheral Blood Mononuclear Cells from Patients with Alopecia Areata

48 citations , September 2011 in “British Journal of Dermatology”

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Transcriptional Profiling in Alopecia Areata Defines Immune and Cell Cycle Control Related Genes Within Disease-Specific Signatures

research Transcriptional Profiling in Alopecia Areata Defines Immune and Cell Cycle Control Related Genes Within Disease-Specific Signatures

61 citations , September 2010 in “Genomics”

This study found distinct gene expression profiles in alopecia areata-affected skin, suggesting T-cell mediated immune responses and unique gene profiles between different stages of the disease.

research Genome-Wide Association Study in Alopecia Areata Implicates Both Innate and Adaptive Immunity

717 citations , June 2010 in “Nature”

This study identified key genetic regions associated with alopecia areata, highlighting both acquired and innate immune involvement, with a novel link to the upregulation of ULBP ligands in autoimmune disease.

research Alopecia Areata Update

244 citations , January 2010 in “Journal of the American Academy of Dermatology”

This review discusses treatment options for alopecia areata and suggests tailored treatment plans, noting the challenges posed by spontaneous remission and limited high-quality clinical trials.

research Phase I/II Randomized Bilateral Half-Head Comparison of Topical Bexarotene 1% Gel for Alopecia Areata

44 citations , October 2009 in “Journal of the American Academy of Dermatology”

This study reported that 1% bexarotene gel was well tolerated and possibly effective for inducing partial hair regrowth in alopecia areata, but more rigorous trials are needed to confirm its efficacy.

The Therapeutic Effect and Changed Serum Zinc Level After Zinc Supplementation in Alopecia Areata Patients with Low Serum Zinc Level

research The Therapeutic Effect and Changed Serum Zinc Level After Zinc Supplementation in Alopecia Areata Patients with Low Serum Zinc Level

65 citations , January 2009 in “Annals of Dermatology”

In this study, oral zinc supplementation for twelve weeks increased serum zinc levels in alopecia areata patients with low zinc, showing positive hair regrowth in 66.7% of participants, though this was not statistically significant.

research Retinol Esterification by DGAT1 Is Essential for Retinoid Homeostasis in Murine Skin

91 citations , November 2008 in “Journal of biological chemistry/The Journal of biological chemistry”

This study found that DGAT1 functions as a key enzyme in murine skin to regulate retinoic acid levels and prevent retinoid toxicity, impacting hair cycle and sensitivity to retinol.

research The Diagnosis and Treatment of Iron Deficiency and Its Potential Relationship to Hair Loss

207 citations , April 2006 in “Journal of The American Academy of Dermatology”

This review discusses the complexities of diagnosing and treating iron deficiency related to nutritional anemia and hair loss, concluding that routine screening and supplementation for hair loss are not yet supported by sufficient evidence.

research Decreased Serum Ferritin Is Associated With Alopecia in Women

163 citations , November 2003 in “Journal of Investigative Dermatology”

This study found that women with androgenetic alopecia or alopecia areata have significantly lower serum ferritin levels than those without hair loss, suggesting a potential link between these types of alopecia and decreased iron stores.

research Characterization of Hair Follicle Antigens Targeted by the Anti-Hair Follicle Immune Response

148 citations , September 2003 in “Journal of Investigative Dermatology Symposium Proceedings”

Alopecia areata is an autoimmune disorder causing hair loss, linked to specific hair follicle antigens and genetic factors.

research Dietary Soy Oil Content and Soy-Derived Phytoestrogen Genistein Increase Resistance to Alopecia Areata Onset in C3H/HeJ Mice

61 citations , February 2003 in “Experimental Dermatology”

This study found that increasing dietary soy oil content reduced alopecia areata development in C3H/HeJ mice, though genistein injection showed no significant effect.

research Onion Juice (Allium Cepa L.), A New Topical Treatment For Alopecia Areata

95 citations , June 2002 in “The Journal of Dermatology”

In this study, using topical crude onion juice significantly improved hair regrowth in patients with patchy alopecia areata compared to tap water.

research Causes of Hair Loss and Developments in Hair Rejuvenation

69 citations , February 2002 in “International Journal of Cosmetic Science”

This review discusses genetic and nutritional causes of hair loss, highlighting that around 90% of treated men show noticeable hair regrowth with a dual inhibitor, while women's hair loss may improve by correcting iron and l-lysine deficiencies.

research Lack of the Vitamin D Receptor Is Associated with Reduced Epidermal Differentiation and Hair Follicle Growth

180 citations , January 2002 in “The journal of investigative dermatology/Journal of investigative dermatology”

This study observed that vitamin D receptor knockout mice exhibit impaired epidermal differentiation and progressive hair loss, suggesting the importance of the vitamin D receptor in normal skin and hair follicle development.

research Antioxidants and Lipid Peroxidation Status in the Blood of Patients with Alopecia

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This study observed that patients with alopecia had increased lipid peroxidation and decreased antioxidants, including lower beta-carotene, GSH levels, and GSH-Px activity, compared to healthy controls.

research Does Tissue Iron Status Have a Role in Female Alopecia?

34 citations , July 1999 in “Journal of The European Academy of Dermatology and Venereology”

Iron deficiency is not a significant cause of hair loss in women.

The Importance of Adequate Serum Ferritin Levels During Oral Cyproterone Acetate and Ethinyl Estradiol Treatment of Diffuse Androgen-Dependent Alopecia in Women

research The Importance of Adequate Serum Ferritin Levels During Oral Cyproterone Acetate and Ethinyl Estradiol Treatment of Diffuse Androgen-Dependent Alopecia in Women

83 citations , April 1992 in “Clinical Endocrinology”

This study found that treatment with cyproterone acetate and ethinyl oestradiol increased hair density in women with diffuse androgen-dependent alopecia, particularly when serum ferritin levels were above 40 μg/l.

research Hair Changes Due to Zinc Deficiency in a Case of Sucrose Malabsorption

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