Alopecia areata: pathogenesis and potential for therapy

Lu, Wei; Shapiro, Jerry; Yu, Man; Barekatain, Armin; Lo, Blanche Ka Ki; Finner, Andreas M.; McElwee, Kevin J.

doi:10.1017/s146239940601101x

Cited by 68 publications

(62 citation statements)

References 140 publications

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“…15,16 Type of AA: In the present study most common type of AA is patchy type 73%, followed by ophiasis in 7%, sisaphio in 7%, totalise in 4%, universalise in 3%, reticulate in 3%, diffuse in 3% of cases which were comparable to Thomas et al 5 study.…”

Section: Absolute Eosinophil Count and Serum Ige Levelssupporting

confidence: 88%

A Clinical and Investigatory Study of Alopecia Areata With Special Reference to Systemic Associations in 100 Patients

Guruprasad¹,

Chalam²,

Priyadarshini³

et al. 2015

jemds

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BACKGROUND: Alopecia areata is an autoimmune condition with a worldwide occurrence. It usually presents as patchy, non-scarring hair loss. There is a paucity of clinical data in Indians. OBJECTIVES: To study the clinical profile and to know the association with various systemic and dermatological disorders. METHODS: A descriptive study was conducted on 100 cases of alopecia areata after taking informed consent, over a period of 16 months from December 2012 to April 2014. A detailed history of the patient regarding associated systemic and dermatological disorders and various autoimmune disorders were documented, relevant investigations were done. RESULTS: Incidence of alopecia areata in patients attending dermatology out-patient department was 1.7%. There was slight male preponderance (51%). Most common age group involved was 20-40yrs. (47%). Alopecia areata was higher among low socioeconomic group (62%). Recurrences of AA was noted in 14% of cases. Stress acting as triggering factor in 12%. Pregnancy and postpartum accounted for 4% of cases. Atopic dermatitis was noted in 1%, seborrheic dermatitis was noted in 1%, lichen planus was noted in 2%, psoriasis noted in 1% cases. Average age of onset of alopecia areata in atopics was 7.9 years. Occiput was the most common site accounting for 39.3% of cases. Nail pitting was noted in 7% of cases. In 2 cases 20 nail dystrophy was noted. Patchy type was the most common type of alopecia seen in 73% of patients. As per IKEDAS classification -71% cases belonged to common type, 18% to atopic type, 5% to pre hypertensive, 6% to autoimmune type. Bronchial asthma was noted in 3%, Diabetes mellitus in 5%, hypothyroidism noted in 12% of cases.

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Section: Absolute Eosinophil Count and Serum Ige Levelssupporting

confidence: 88%

A Clinical and Investigatory Study of Alopecia Areata With Special Reference to Systemic Associations in 100 Patients

Guruprasad¹,

Chalam²,

Priyadarshini³

et al. 2015

jemds

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“…Hair follicles have superior regenerative ability [92], and it may also be possible that the CTL action is somewhat restrained by any residual IP activity.…”

Section: Cd8 + Cytotoxic Lymphocyte Mediated Hair Follicle Disruptionmentioning

confidence: 99%

The role of lymphocytes in the development and treatment of alopecia areata

Guo

Cheng

Shapiro

et al. 2015

Expert Review of Clinical Immunology

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SummaryAlopecia areata (AA) development is associated with both innate and adaptive immune cell activation, migration to peri-and intra-follicular regions, and hair follicle disruption. Both CD4+ and CD8+ lymphocytes are abundant in AA lesions; however, CD8+ cytotoxic T lymphocytes are more likely to enter inside hair follicles, circumstantially suggesting that they have a significant role to play in AA development. Several rodent models recapitulate important features of the human autoimmune disease and demonstrate that CD8+ cytotoxic T lymphocytes are fundamentally required for AA induction and perpetuation. However, the initiating events, the selfantigens involved, and the molecular signaling pathways, all need further exploration. Studying CD8+ cytotoxic T lymphocytes and their fate decisions in AA development may reveal new and improved treatment approaches.

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“…9,13 Patients with AA have an increased frequency of circulating organ-specific and non-organ-specific auto antibodies compared with normal subjects, and a variety of non-specific abnormalities in peripheral T-cell numbers and function. Circulating hair follicle specific IgG auto antibodies have been found in patients with AA 14,15 but their pathogenic role is uncertain. The presence of lymphocytes around and within the hair follicles and the ability to promote hair regrowth with the use of immunosuppressive agents is consistent with an autoimmune hypothesis.…”

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confidence: 99%