Pathogenesis and regenerative therapy in vitiligo and alopecia areata: focus on hair follicle

    January 2025 in “ Frontiers in Medicine
    Yuan Zhou, Yu-Xuan Zhang, Yuyun Xiong, Yumei Li
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    TLDR Hair follicles are key to treating vitiligo and alopecia areata, but challenges exist.
    The document examines the pathogenesis and regenerative therapies for vitiligo and alopecia areata (AA), focusing on hair follicles. It highlights the immune privilege of hair follicles, which protects stem cells from autoimmune attacks, and the potential for repigmentation therapy in vitiligo due to surviving melanocytes. In AA, the breakdown of follicular immune privilege leads to hair loss. The study discusses the role of hair follicle stem cells and dermal papilla cells in hair restoration, exploring the use of induced pluripotent stem cells and mesenchymal stem cells for bioengineering hair follicles. Treatments like JAK inhibitors and minoxidil show effectiveness for AA, while autologous hair follicle cell transplantation shows promise for vitiligo. The document emphasizes the complex immune mechanisms involved and suggests hair follicles as a focal point for therapeutic interventions, though challenges such as treatment unpredictability and adverse reactions remain.
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