Treatment of Alopecia Areata: What Is New on the Horizon?

The document discussed new drug treatment opportunities for alopecia areata based on a genome-wide association study that implicated T cell and natural killer (NK)-cell activation pathways. It highlighted the UL 16-binding protein (ULBP3) gene cluster on chromosome 6q25, which produces NKG2D-activating ligands that can trigger an autoimmune response. Increased expression of ULBP3 was found in hair follicles of patients with active disease, suggesting that T cells are attracted to the hair follicle by these ligands, leading to the characteristic "swarm of bees" infiltrate. Future treatments may involve drugs that block the NKG2D ligand-receptor interaction, halt activated T cells, or modify the inflammatory cytokine network, with many drugs used for other autoimmune diseases potentially being effective for alopecia areata.