Hair Follicles from Alopecia Areata Patients Exhibit Alterations in Immune Privilege-Associated Gene Expression in Advance of Hair Loss

A basic knowledge of the hair growth cycle is needed to evaluate disorders of hair growth. This chapter presents a broad overview of the physiology and evaluation of hair growth, as well as discussions of specific types of alopecia. The epidemiology, pathogenesis, diagnosis, and treatment of androgenetic alopecia, the most common type of nonscarring hair loss, are covered. Diffuse hair shedding is generalized hair loss over the entire scalp. Diagnosis and treatment of telogen effluvium, anagen arrest (anagen effluvium), and other causes of diffuse hair shedding are covered in detail. Alopecia areata, typically characterized by patchy hair loss; cicatricial alopecia, which results from permanent scarring of the hair follicles; and miscellaneous causes of hair loss are also discussed. Tables list the causes of diffuse and cicatricial alopecia, telogen effluvium, and miscellaneous chemicals and categories of drugs that can cause alopecia, as well as miscellaneous causes of hair loss. Included is an algorithm outlining the approach to diagnosing nonscarring alopecia, as well as a variety of clinical photographs. This review contains 9 highly rendered figures, 6 tables, and 42 references.

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Gene Expression of Indoleamine 2,3 Dioxygenase 1, Insulin-Growth Factor 1 and Red/IK Cytokine in Alopecia Areata

Notulae Scientia Biologicae ◽

10.15835/nsb639406 ◽

2014 ◽

Vol 6 (3) ◽

pp. 263-266

Author(s):

Simona Corina ȘENILĂ ◽

Ovidiu BĂLĂCESCU ◽

Loredana BĂLĂCESCU ◽

Elisabeta CANDREA ◽

Loredana UNGUREANU ◽

...

Keyword(s):

Gene Expression ◽

Hair Follicle ◽

Mhc Class I ◽

Alopecia Areata ◽

Fas Ligand ◽

Immune Privilege ◽

Mrna Levels ◽

Insulin Growth Factor ◽

Qrt Pcr ◽

Anagen Hair

Alopecia areata (AA) is a chronic, T-cell mediated autoimmune disease directed against the hair follicle, which partially evolves due to a loss of the immune privilege of the anagen hair follicle. The immune privilege is maintained by several factors, including a downregulation of MHC class I and II, local immunosupressants and expression of Fas ligand. The purpose of the study was to evaluate several factors involved in the collapse and restoration of the immune privilege. We investigated IDO1, IGF1 and red/IK gene expression in lesional and perilesionalscalp biopsies from alopecia areata patients. Seven paired punch-biopsies were taken from the active edge of alopecic plaque and from the perilesional scalp. Expression of IDO1, IGF1 and red/IK genes was performed by qRT-PCR. In lesional tissue, IGF1, IDO1 and red/IK genes showed an increase in the mRNA levels as compared with the perilesional scalp. By comparing the pairs of data for the investigated genes, IDO1was statistically upregulated in the lesional area. No significant differences were observed between the gene expression in mild or severe AA, from the lesional or perilesional areas. IDO1 mRNA expression was higher in patients with a relapse duration of less than 6 months as compared to patients with a relapse duration of more than 6 months; levels of IGF1 and red/IK mRNA are increased in lesionals compared to perilesional scalp area.

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Trichoscopy of Alopecia Areata: Hair Loss Feature Extraction and Computation Using Grid Line Selection and Eigenvalue

Computational and Mathematical Methods in Medicine ◽

10.1155/2020/6908018 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Sunyong Seo ◽

Jinho Park

Keyword(s):

Hair Loss ◽

Alopecia Areata ◽

Eating Habits ◽

Hair Follicles ◽

Smart Device ◽

Light Reflection ◽

Grid Line ◽

Feature Based ◽

Line Selection ◽

Vellus Hairs

Recently, the hair loss population, alopecia areata patients, is increasing due to various unconfirmed reasons such as environmental pollution and irregular eating habits. In this paper, we introduce an algorithm for preventing hair loss and scalp self-diagnosis by extracting HLF (hair loss feature) based on the scalp image using a microscope that can be mounted on a smart device. We extract the HLF by combining a scalp image taken from the microscope using grid line selection and eigenvalue. First, we preprocess the photographed scalp images using image processing to adjust the contrast of microscopy input and minimize the light reflection. Second, HLF is extracted through each distinct algorithm to determine the progress degree of hair loss based on the preprocessed scalp image. We define HLF as the number of hair, hair follicles, and thickness of hair that integrate broken hairs, short vellus hairs, and tapering hairs.

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Effective management of indralupta (alopecia areata) with jalaukavacharan - a case report

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v6i5th.169 ◽

2018 ◽

Vol 6 (5th) ◽

Author(s):

Likhita Sureshrao Dhage ◽

Pournima Daware

Keyword(s):

Case Report ◽

Hair Loss ◽

Alopecia Areata ◽

Hair Follicles ◽

Effective Management

Panchkarma is said to be best treatment for disease curing by its root. According to Acharyas it is said that untreatable diseases can be treated with Raktamokshan . Raktamokshan is fifth karma among Panchkarma. Indralupta came under kshudra rogas. Indralupta (alopecia areata) is the disease where hair loss in patient in the form of patches over scalp is seen. Considering etiopathogenesis of Indralupta Vyadhi, Raktamokshan is said to be best treatment. In this case report, patient with Indralupta over scalp is treated with Jalaukavacharan. It not only work on localized hair loss but also promote hair follicles to grow new hairs.

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Childhood Alopecia Areata: An Overview of Treatment and Recent Patents

Recent Patents on Inflammation & Allergy Drug Discovery ◽

10.2174/1872213x14999200728145822 ◽

2020 ◽

Vol 14 ◽

Author(s):

Kam L. Hon ◽

David C.K. Luk ◽

Alexander K.C. Leung ◽

Chantel Ng ◽

Steven K.F. Loo

Keyword(s):

Hair Loss ◽

Alopecia Areata ◽

Coal Tar ◽

Psychological Impact ◽

Hair Follicles ◽

The Body ◽

Whole Body ◽

Treatment Modalities ◽

Topical Treatments ◽

Clinical Queries

Background: Alopecia Areata (AA) is a systemic autoimmune condition which usually starts in childhood. Objective: This article aims to review genetics, therapy, prognosis and recent patents for AA. Methods: We used clinical queries and keywords of “alopecia areata” AND “childhood” as search engine. Patents were searched using the key term “alopecia areata” in Patents.google.com and freepatentsonline.com. Results: Due to an immune mediated damage of the hair follicles, hair is lost from the scalp and other areas of the body temporarily or even permanently. Children with AA are generally healthy. Evidence of genetic association and increased predisposition for AA was found by studying families with affected members. Pathophysiologically, T- lymphocytes attack hair follicles and cause inflammation and destruction of the hair follicles and hair loss. In mild cases, there would be well demarcated round patchy scalp hair loss. The pathognomonic “exclamation mark hairs” may be seen at lesion periphery. In more severe cases, the hair loss may affect the whole scalp and even the whole body. The clinical course is also variable which may range from transient episodes of recurrent patchy hair loss to an indolent gradually deteriorating severe hair loss. The treatment of AA depends on factors including patients’ age, extent of the hair loss, duration of disease, psychological impact, availability and side effect profile of the treatments. For localized patchy alopecia, topical application of corticosteroids and/or intralesional corticosteroids are the treatment of choice. Other topical treatments include minoxidil, anthralin, coal tar and immunotherapy. In severe resistant cases, systemic immunosuppressants may be considered. Although herbal medicine, acupuncture, complementary and alternative medicine may be tried on children in some Asian communities, the evidence to support these practices are lacking. To date, only few recent patents exist in topical treatments including Il-31, laser and herbal medications. Clinical efficacy is pending for these treatment modalities. Conclusions: None of the established therapeutic options are curative. However, newer treatment modalities including excimer laser, interleukin-31 antibodies and biologics are evolving so that there may be significant advances in treatment in the near future. AA can be psychosocially devastating. It is important to assess the quality of life, degree of anxiety, social phobia and mood of the patients and their families. Psychological support is imperative for those who are adversely affected psychosocially.

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EP06 Successful treatment of alopecia universalis with rituximab therapy

Rheumatology ◽

10.1093/rheumatology/keaa109.005 ◽

2020 ◽

Vol 59 (Supplement_2) ◽

Author(s):

Anuoluwapo R Oke ◽

Steven Young-Min

Keyword(s):

B Cell ◽

Mhc Class I ◽

Hair Loss ◽

Alopecia Areata ◽

Hair Follicles ◽

Class I ◽

Whole Body ◽

Type I ◽

Alopecia Universalis ◽

First Report

Abstract Background Alopecia universalis (AU) is a severe subtype of alopecia areata (AA), in which there is non-scarring hair loss affecting the whole body. The pathogenesis involves, increased MHC class I expression in hair follicles, loss of hair follicle immune privilege and autoimmune-mediated damage to pigmented hair. There is no cure for alopecia areata, and though mild cases may have a good chance of either spontaneous or treatment-induced recovery, the prognosis of complete hair loss is poor with less than 10% recovery. Treatment remains a challenge with no reliably effective therapy and in the absence of well-evaluated trials, isolated case reports can influence practice. Here, we present the first report of AU being successfully treated with rituximab with remarkably sustained improvement at 6 years follow up. This case is also the first report of AU developing in adult dermatomyositis (DM) and we speculate upon the implications for the aetiopathogenesis of both conditions. Methods A 55-year-old lady, presented with proximal limb weakness, lethargy, a non-itchy rash, pleurisy and breathlessness. The serum creatinine kinase (3369 u/L) and anti-Jo-1 antibodies were elevated consistent with antisynthetase syndrome and a diagnosis of dermatomyositis was made. There was an initial response to corticosteroids and cyclophosphamide. She then relapsed and was treated with IV rituximab. Seventeen months after her initial presentation, she developed widespread hair loss sparing only white hairs (making Telogen Effluvium unlikely), combined with a concurrent relapse of her dermatomyositis. A diagnosis of alopecia universalis (AU) was made. A further course of IV rituximab therapy administered at this stage led to an excellent response in both her dermatomyositis and AU. At three months review, both the AU and the dermatomyositis had entered remission and this has been sustained 6 years on. Results Please refer to the conclusion section. Conclusion Disease activity in dermatomyositis has been linked with the expression of type I Interferon IFN and this may induce MHC class I expression that is identified on muscle biopsy. It may be that similar type I IFN action on hair follicles may have triggered the development of AU in our case. Whilst this is the first report of AU occurring with adult dermatomyositis, there has been a report of AU occurring in juvenile dermatomyositis. There are also other reports of other combinations of autoimmune conditions occurring with both DM & AU. This case also demonstrates that rituximab, an anti-CD 20 B cell therapy, maybe a useful treatment option in alopecia areata and universalis. This has not been reported elsewhere. Despite postulation that AU is a mainly T cell-driven disease, this case demonstrates that B cells may play a role, in much the same way that we now recognise the importance of B cell involvement in RA. Disclosures A.R. Oke None. S. Young-Min None.

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Recent Advances in the Pathogenesis of Autoimmune Hair Loss Disease Alopecia Areata

Clinical and Developmental Immunology ◽

10.1155/2013/348546 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 31

Author(s):

Taisuke Ito

Keyword(s):

Hair Follicle ◽

Alopecia Areata ◽

Viral Infections ◽

Cytotoxic T Cells ◽

Hair Follicles ◽

Immune Privilege ◽

Recent Advances ◽

Associated Proteins ◽

A Cell ◽

Anagen Hair

Alopecia areata is considered to be a cell-mediated autoimmune disease, in which autoreactive cytotoxic T cells recognize melanocyte-associated proteins such as tyrosinase. This review discusses recent advances in the understanding of the pathogenesis of alopecia areata, focusing on immunobiology and hormonal aspects of hair follicles (HFs). The HF is a unique “miniorgan” with its own immune and hormonal microenvironment. The immunosuppressive milieu of the anagen hair bulb modulated by immunosuppressive factors is known as “hair follicle immune privilege.” The collapse of the hair follicle immune privilege leads to autoimmune reactions against hair follicle autoantigens. Alopecia areata is sometimes triggered by viral infections such as influenza that causes excess production of interferons (IFN). IFN-γis one of the key factors that lead to the collapse of immune privilege. This paper reviews the interactions between the endocrine and immune systems and hair follicles in the pathogenesis of alopecia areata.

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Autoantibodies to Hair Follicles in C3H/HeJ Mice With Alopecia Areata–Like Hair Loss

Journal of Investigative Dermatology ◽

10.1111/1523-1747.ep12335848 ◽

1997 ◽

Vol 109 (3) ◽

pp. 329-333 ◽

Cited By ~ 54

Author(s):

Desmond J. Tobin ◽

John P. Sundberg ◽

Lloyd E. King ◽

Dawnalyn Boggess ◽

Jean-Claude Bystryn

Keyword(s):

Hair Loss ◽

Alopecia Areata ◽

Hair Follicles

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Differential diagnostic criteria of alopecia areata

Russian Journal of Skin and Venereal Diseases ◽

10.18821/1560-9588-2016-19-6-359-364 ◽

2016 ◽

Vol 19 (6) ◽

pp. 359-364

Author(s):

A. M Baltabaev ◽

V. P Tkachev ◽

M. K Baltabaev

Keyword(s):

Differential Diagnosis ◽

Diagnostic Criteria ◽

Hair Loss ◽

Alopecia Areata ◽

Hair Follicles ◽

Psychosocial Status ◽

Immune Mediated ◽

Diagnostic Approaches ◽

Dermatological Disorders ◽

The Individual

Alopecia areata is a poliethiologic immune mediated condition, associated with lesion of the hair follicles, leading to disruption of growing cycle and subsequent hair loss. Taking into account the different age of patients and repeated recurrence despite of the therapy, as well as changes in the appearance of the individual affecting psychosocial status, patchy hair loss refers to the category of socially important disorders. The introduction of computer technologies facilitated diagnostic approaches through developing of specific criteria for the diagnosis of alopecia areata, which improved its differentiation with similar dermatological conditions. This publication intended to review and analyze of clinical cases of several dermatological disorders which remind clinics of different forms of alopecia areata. The importance of trichoscopy was shown to provide differential diagnosis in various hair-loss conditions to evaluate morphometric hair and skin characteristics.

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