Mechanisms of Tolerance and Potential Therapeutic Interventions in Alopecia Areata

May 2017 in “ Pharmacology & therapeutics ”

Gabriel Skogberg, Sonya Jackson, Annika Åstrand

Alopecia Areata autoimmune disorder immune tolerance central tolerance peripheral tolerance gut permeability local skin changes AA

Studysummary This review discusses the mechanisms underlying immune tolerance failure in alopecia areata and highlights potential therapeutic avenues for restoring hair growth and achieving sustained remission, but reports no new clinical results. Our plain-language summary of this paper — not a Tressless recommendation.

This review discussed the mechanisms of compromised immune tolerance in Alopecia Areata (AA), an autoimmune disorder linked to other autoimmune diseases. It highlighted that AA involves a break in central and peripheral tolerance, increased gut permeability, and local skin changes. The review suggested that targeting these tolerance breaks could lead to effective treatments to restore hair growth and maintain remission.

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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.

research An Integrated Transcriptome Atlas of Embryonic Hair Follicle Progenitors, Their Niche, and the Developing Skin

173 citations , August 2015 in “Developmental cell”

This study characterizes gene expression patterns in embryonic hair follicle progenitors and their niche, identifying signaling pathways like axon guidance that may drive cellular rearrangements for hair follicle formation.

research Imbalance of T-Helper 17 and Regulatory T Cells in Patients with Alopecia Areata

62 citations , June 2015 in “The Journal of Dermatology”

This study found that patients with alopecia areata had higher levels of Th17 cells and lower levels of regulatory T cells compared to healthy controls, suggesting an immune imbalance in these patients.

research Hair Regrowth in Alopecia Areata Patients Following Stem Cell Educator Therapy

55 citations , April 2015 in “BMC medicine”

This study found that the Stem Cell Educator therapy improved hair regrowth and quality of life in patients with severe alopecia areata by restoring immune balance and protecting hair follicles from autoimmune damage.

research Drug Discovery for Alopecia: Gone Today, Hair Tomorrow

70 citations , February 2015 in “Expert Opinion on Drug Discovery”

This review discusses current knowledge on the biological mechanisms of different types of alopecia but reports no new clinical findings; the authors highlight future research directions, especially regarding epidermal stem cells and immune pathways.

research The Autoimmune Basis of Alopecia Areata: A Comprehensive Review

162 citations , October 2014 in “Autoimmunity reviews”

This review discusses alopecia areata, highlighting its autoimmune aspects, environmental triggers, and current treatment options, but reports no new clinical results; recent studies suggest JAK pathway intervention may offer therapeutic potential.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

The Possible Implication of the S250C Variant of the Autoimmune Regulator Protein in a Patient with Autoimmunity and Immunodeficiency: In Silico Analysis Suggests a Molecular Pathogenic Mechanism for the Variant

research The Possible Implication of the S250C Variant of the Autoimmune Regulator Protein in a Patient with Autoimmunity and Immunodeficiency: In Silico Analysis Suggests a Molecular Pathogenic Mechanism for the Variant

11 citations , July 2014 in “Gene”

This study reports a unique case of common variable immunodeficiency with autoimmunity linked to a heterozygous S250C variant in the autoimmune regulator gene, suggesting a potential molecular basis for this combination.

research Overview of Alopecia Areata

110 citations , December 2013 in “The journal of investigative dermatology. Symposium proceedings/The Journal of investigative dermatology symposium proceedings”

This article reviews current understanding of alopecia areata, its genetic and immune factors, and discusses ongoing research and treatment development, without presenting new experimental results.

research Tolerance Induction by Hair-Specific Keratins in Murine Alopecia Areata

18 citations , July 2013 in “Journal of Leukocyte Biology”

The study suggests that vaccination with soluble keratin peptides K71 and K31 significantly delayed the onset and progression of autoimmune alopecia areata in mice by inducing T cell anergy.

research Genetic Basis of Alopecia Areata

40 citations , October 2012 in “Dermatologic clinics”

This review highlights the need for a deeper understanding of the genetic mechanisms in alopecia areata to develop evidence-based treatments, but it provides no new experimental results.

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 Hair Follicle as a Target of Stress Hormones and Autoimmune Reactions

61 citations , September 2010 in “Journal of Dermatological Science”

This review discusses the interplay between hormonal and immune systems in hair follicles and reports no new results, highlighting the need for further research on their role in skin biology and alopecia areata.

research Trichohyalin Is a Potential Major Autoantigen in Human Alopecia Areata

66 citations , July 2010 in “Journal of Proteome Research”

This study suggests that an immune response to trichohyalin and keratin 16 may contribute to the pathogenesis of alopecia areata.

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 The Hair Follicle as a Dynamic Mini-Organ

759 citations , February 2009 in “Current Biology”

This review summarizes fundamental concepts and recent advancements in hair follicle biology, including insights from mouse models into broader molecular and cellular processes relevant to regeneration and development.

research Lymphocytes, Neuropeptides, And Genes Involved In Alopecia Areata

286 citations , August 2007 in “Journal of Clinical Investigation”

This review examines the interplay of genetics and neuroimmunology in alopecia areata, highlighting its potential to inform broader autoimmunity research, but reports no new findings.

research Alopecia Areata: A Tissue-Specific Autoimmune Disease of the Hair Follicle

185 citations , August 2005 in “Autoimmunity Reviews”

This review discusses alopecia areata as a model for studying tissue-directed autoimmune diseases and reports no new clinical findings.

research Autoimmunity: Alopecia Areata

143 citations , January 2004 in “Journal of Investigative Dermatology Symposium Proceedings”

This review discusses the autoimmune nature of alopecia areata, potential therapeutic targets, and highlights the need for further studies on immunomodulatory treatments and genetic factors, but it reports no new clinical results.

research Role of the Autoimmune Regulator (AIRE) Gene in Alopecia Areata: Strong Association of a Potentially Functional AIRE Polymorphism With Alopecia Universalis

86 citations , December 2002 in “Tissue Antigens”

In this study, researchers found that the AIRE G961C variant is a significant risk factor for severe alopecia areata and early-onset cases, particularly in patients with alopecia universalis.

research Transient CD44 Variant Isoform Expression and Reduction in CD4+/CD25+ Regulatory T Cells in C3H/HeJ Mice with Alopecia Areata

77 citations , June 2002 in “Journal of Investigative Dermatology”

CD44 variant changes start alopecia areata, but don't maintain it.

research Role of Cytotoxic T Cells in Chronic Alopecia Areata

127 citations , January 2000 in “Journal of Investigative Dermatology”

This study found that pro-inflammatory cytokines and apoptotic mechanisms, specifically involving granzyme B and Fas pathways, are associated with chronic alopecia areata, indicating their potential role in the disease's persistence.

research Alopecia Areata Associated With Myasthenia Gravis And Thymoma: A Case Of Alopecia With Marked Improvement Following Thymectomy And High-Level Prednisolone Administration

21 citations , December 1997 in “The Journal of Dermatology”

In this case report, a 57-year-old Japanese woman with alopecia areata, associated with myasthenia gravis and thymoma, showed significant improvement after undergoing thymectomy and receiving high doses of glucocorticosteroids.

research Distribution of Major Histocompatibility Antigens in Normal Skin

68 citations , December 1983 in “British Journal of Dermatology”

This study found HLA and beta 2-microglobulin antigens in various skin structures, with specific localization patterns in keratinocytes and hair follicle components, but not in eccrine or apocrine glands.