Latest Understanding and Treatment of Alopecia Areata
November 2016
TLDR New treatments for alopecia areata, like JAK inhibitors and immunomodulators, are promising.
Alopecia areata (AA) is a common autoimmune disease targeting hair follicles, leading to hair loss on the scalp and body. The disease is triggered by the collapse of immune privilege in anagen-phase hair follicles, causing an autoimmune response involving CD8+T cells. Psychological stress can exacerbate this condition by affecting the immune and hormonal systems of hair follicles. Key factors in AA pathogenesis include immune privilege guardians (ACTH, α-MSH, TGF-β), NKG2D+ cells, and stress hormones (CRH, substance P). Effective treatments are still needed, with future therapies potentially focusing on modifying hair follicle immune privilege and stress. Recent studies have shown that JAK inhibitors, immunomodulators, Tregs, platelet-rich plasma therapy, statins, and prostaglandin analogues, used in other autoimmune diseases, may be effective for AA. The article reviews these new understandings and treatments related to the perifollicular endocrine/immunology of AA.