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Dai Z, Chen J, Chang Y, Christiano AM. Selective inhibition of JAK3 signaling is sufficient to reverse alopecia areata. JCI Insight 2021; 6:142205. [PMID: 33830087 PMCID: PMC8119218 DOI: 10.1172/jci.insight.142205] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 02/25/2021] [Indexed: 12/19/2022] Open
Abstract
The Janus kinase/signal transducers and activators of transcription (JAK/STAT) are key intracellular mediators in the signal transduction of many cytokines and growth factors. Common γ chain cytokines and interferon-γ that use the JAK/STAT pathway to induce biological responses have been implicated in the pathogenesis of alopecia areata (AA), a T cell-mediated autoimmune disease of the hair follicle. We previously showed that therapeutic targeting of JAK/STAT pathways using the first-generation JAK1/2 inhibitor, ruxolitinib, and the pan-JAK inhibitor, tofacitinib, was highly effective in the treatment of human AA, as well as prevention and reversal of AA in the C3H/HeJ mouse model. To better define the role of individual JAKs in the pathogenesis of AA, in this study, we tested and compared the efficacy of several next-generation JAK-selective inhibitors in the C3H/HeJ mouse model of AA, using both systemic and topical delivery. We found that JAK1-selective inhibitors as well as JAK3-selective inhibitors robustly induced hair regrowth and decreased AA-associated inflammation, whereas several JAK2-selective inhibitors failed to restore hair growth in treated C3H/HeJ mice with AA. Unlike JAK1, which is broadly expressed in many tissues, JAK3 expression is largely restricted to hematopoietic cells. Our study demonstrates inhibiting JAK3 signaling is sufficient to prevent and reverse disease in the preclinical model of AA.
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Affiliation(s)
| | | | | | - Angela M. Christiano
- Department of Dermatology and
- Department of Genetics and Development, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York, USA
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Dai Z, Wang EHC, Petukhova L, Chang Y, Lee EY, Christiano AM. Blockade of IL-7 signaling suppresses inflammatory responses and reverses alopecia areata in C3H/HeJ mice. SCIENCE ADVANCES 2021; 7:eabd1866. [PMID: 33811067 PMCID: PMC11060042 DOI: 10.1126/sciadv.abd1866] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
The interleukin-7 (IL-7) signaling pathway plays an important role in regulation of T cell function and survival. We detected overexpression of IL-7 in lesional skin from both humans and C3H/HeJ mice with alopecia areata (AA), a T cell-mediated autoimmune disease of the hair follicle. We found that exogenous IL-7 accelerated the onset of AA by augmenting the expansion of alopecic T cells. Conversely, blockade of IL-7 stopped the progression of AA and reversed early AA in C3H/HeJ mice. Mechanistically, we observed that IL-7Rα blockade substantially reduced the total number of most T cell subsets, but relative sparing of regulatory T cells (Tregs). We postulated that short-term anti-IL-7Rα treatment in combination with a low dose of Treg-tropic cytokines might improve therapeutic efficacy in AA. We demonstrated that short-term IL-7Rα blockade in combination with low doses of Treg-tropic cytokines enhanced therapeutic effects in the treatment of AA, and invite further clinical investigation.
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Affiliation(s)
- Zhenpeng Dai
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Eddy Hsi Chun Wang
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Lynn Petukhova
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Yuqian Chang
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Eunice Yoojin Lee
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Angela M Christiano
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
- Department of Genetics and Development, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Abedini R, Alipour E, Ghandi N, Nasimi M. Utility of Dermoscopic Evaluation in Predicting Clinical Response to Diphencyprone in a Cohort of Patients with Alopecia Areata. Int J Trichology 2020; 12:107-113. [PMID: 33223734 PMCID: PMC7659740 DOI: 10.4103/ijt.ijt_73_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Alopecia areata (AA) is a chronic and inflammatory disease of hair follicles, causing nonscarring alopecia. While the various types of treatment have been investigated, the definite cure for AA has not been established yet. Objectives: The objective of this study is to evaluate the clinical and dermoscopic features of patients with AA to identify the factors with prognostic values in diphenylcyclopropenone (DPCP) response rate. Methods: Eighty patients with AA were included, and baseline hair loss was calculated based on the severity alopecia tool (SALT) score. The characteristic dermoscopic features of AA were evaluated by two skilled dermatologists separately at baseline, 12 and 24 weeks afterward. Results: The mean SALT score in the 1st, 12th, and 24th week was 77 ± 24.7, 80 ± 27, and 71 ± 35.6, respectively, which were not significantly different over this time period (P = 0.085). SALT score correlated negatively with the short vellus hair/field (ρ = −0.361, P = 0.02), broken hair/field (ρ = −0.317, P = 0.044), and tapering hair/field (ρ = −0.388, P = 0.012) in the 1st week. Forty-one patients continued treatment courses over 24 weeks. Six patients had good response, 11 achieved partial response, and 24 had no hair regrowth. Statistically significant correlation was observed between treatment response and duration of disease (P = 0.04), frequency of relapses (P = 0.033), type of alopecia, and number of black dots (P = 0.028). The mean for all dermoscopic findings showed descending process during our three follow-up sessions which was statistically significant for black dot (P = 0.015) and broken hair (P = 0.006). Conclusion: The number of black dot per field initially was negatively correlated to DPCP therapy and the frequency of dermoscopic findings reduced during the treatment process.
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Affiliation(s)
- Robabeh Abedini
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Alipour
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ghandi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nasimi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Bertoli MJ, Sadoughifar R, Schwartz RA, Lotti TM, Janniger CK. Female pattern hair loss: A comprehensive review. Dermatol Ther 2020; 33:e14055. [PMID: 32700775 DOI: 10.1111/dth.14055] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 12/28/2022]
Abstract
Female pattern hair loss is a common form of hair loss in women that increases in incidence with age. The etiology is unknown with numerous factors identified that influence its onset. Female pattern hair loss may be viewed as a marker for an increased risk of cardiovascular and metabolic disease. New treatments include microneedling, low-level laser therapy, and autologous fat transfer. This article focuses on the pathophysiology, diagnosis, systemic associations, and current treatments for female pattern hair loss, which is the most common cause of alopecia in women.
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Affiliation(s)
- Mia J Bertoli
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Wolf JJ, Hudson Baker P. Alopecia Areata: Factors That Impact Children and Adolescents. JOURNAL OF ADOLESCENT RESEARCH 2018. [DOI: 10.1177/0743558418768248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Research suggests that several factors affect children and adolescents with alopecia areata (AA). While hair loss is mostly associated with individuals undergoing chemotherapy, AA also causes individuals to lose the hair on their scalp and elsewhere on the body. This loss can be particularly devastating to children and adolescents, and can affect them socially, as well as psychologically. A mixed method research design was used to combine survey data with interview transcripts and field notes to capture a more detailed picture of AA and its effect on children and adolescents. The data reported here were extracted from a larger study utilizing nine demographic items, four independent variable items (gender, age, duration of diagnosis, age of onset), and 27 dependent variable items regarding impact factors. Subsequently, six follow-up interview questions were used with a small group for additional context. An exploratory factor analysis revealed five impact factors: Confidence/Self-Esteem, Psychological Effects, Appearance/Acceptance, Socialization, and Communication. Female participants reported significantly greater difficulty adjusting and managing AA than did their male counterparts. While most participants revealed a positive attitude about themselves, the majority were affected psychologically by this condition. Open communication with family and friends gave comfort and support to the vast majority.
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Patel NU, Oussedik E, Grammenos A, Pichardo-Geisinger R. A Case Report Highlighting the Effective Treatment of Alopecia Universalis With Tofacitinib in an Adolescent and Adult Patient. J Cutan Med Surg 2018; 22:439-442. [DOI: 10.1177/1203475418760512] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Nupur U. Patel
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Elias Oussedik
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alexandra Grammenos
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Jin W, Zheng H, Shan B, Wu Y. Changes of serum trace elements level in patients with alopecia areata: A meta-analysis. J Dermatol 2017; 44:588-591. [PMID: 28150385 DOI: 10.1111/1346-8138.13705] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 10/24/2016] [Indexed: 12/31/2022]
Abstract
Abnormalities of serum trace elements are involved in the etiology and pathogenesis of alopecia areata (AA); however, the results of published studies are controversial. The purpose of the present study is to investigate the alterations of serum level of trace elements and AA using a meta-analysis approach. We searched all articles indexed in PubMed, Embase and Science Citation Index published up to 30 April 2016 concerning the association between serum level of zinc, copper, iron/ferritin, selenium or magnesium and AA. Ten eligible articles involving 764 subjects were identified. Overall, pooled analysis indicated that patients with AA had a lower serum level of zinc (P < 10-4 ) and selenium (P < 10-4 ) than the healthy controls. However, there was no significant difference between the AA patients and controls in the levels of serum copper (P = 0.81), serum iron (P = 0.36), serum ferritin (P = 0.37) and serum magnesium (P = 0.07). This meta-analysis suggests that low serum levels of zinc and selenium seem to be important risk factors for AA.
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Affiliation(s)
- Waishu Jin
- Department of Dermatology, Yuhuangding Hospital, Yantai, China
| | - Haibo Zheng
- Department of Dermatology, Changchun Center Hospital, Changchun, China
| | - Baihui Shan
- Department of Dermatology and Venerology, No. 2 Hospital of Jilin University, Changchun, China
| | - Yi Wu
- Department of Dermatology and Venerology, No. 2 Hospital of Jilin University, Changchun, China
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Interleukin-4 -590 T>C and interleukin-4 receptor Q551R A>G gene polymorphisms in Saudi cases with alopecia areata. J Egypt Public Health Assoc 2017; 90:20-3. [PMID: 25853541 DOI: 10.1097/01.epx.0000461326.05328.d3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Immunogenetic factors are known to play a role in the pathogenesis of alopecia areata (AA). This study aimed at investigating the association between AA with the polymorphisms of interleukin-4 (IL-4) promoter and receptor (IL-4R) genes. PATIENTS AND METHODS This work is a case-control study that was conducted on 76 AA patients from Qassim region, Saudi Arabia. Patients were compared with 93 normal healthy controls from the same locality. Genomic DNA was extracted and processed using real-time PCR amplification for characterization of IL-4 -590 T>C and IL-4R Q551R A>G gene polymorphisms. RESULTS Cases of AA showed a higher frequency of the IL-4 -590 CC homozygous genotype compared with controls (63.2 vs. 53.8%, P>0.05) with a lower frequency of the TT genotype (5.3 vs. 10.8%); yet, both were statistically nonsignificant (P>0.05). Regarding the IL-4R Q551R A>G polymorphism, cases and controls showed nearly equal frequencies of all variants, that is, with no significant difference. Although the frequency of the IL-4 C and the IL-4R A alleles was higher among cases than among controls (78.9 vs. 71.5% and 78.8 vs. 72.6%, respectively), this was also statistically nonsignificant (P>0.05). Comparing case subgroups in terms of their age of onset, sex, disease severity, consanguinity, and family history showed no statistically significant difference regarding the studied genetic variant. CONCLUSION IL-4 -590 and IL-4R Q551R gene polymorphisms are not associated with the susceptibility and the clinical pattern of AA in Saudi patients. We recommend further research studies involving the estimation of cytokines both in the serum and in the local skin lesions or in cultured skin cells to figure out whether Th1 or Th2 pathways play a specific role in the pathogenesis of AA.
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Ardigò M, Agozzino M, Franceschini C, Donadio C, Abraham LS, Barbieri L, Sperduti I, Berardesca E, González S. Reflectance confocal microscopy for scarring and non-scarring alopecia real-time assessment. Arch Dermatol Res 2016; 308:309-18. [DOI: 10.1007/s00403-016-1657-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 03/21/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
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Abstract
Nail disorders are a common presenting complaint for both the primary care physician and the dermatologist. Nail diagnoses are broad in scope and include infectious, inflammatory, and neoplastic conditions. Onychomycosis is an especially common nail condition, and treatment should always be preceded by appropriate fungal studies for confirmation of diagnosis. Inflammatory conditions of the nail unit can mimic onychomycosis, and a dermatologist can assist with diagnosis and treatment recommendations. Likewise, subungual tumors often require biopsy, and should be evaluated by a dermatologist who is experienced in nail evaluation and treatment.
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Affiliation(s)
- Lauren K Biesbroeck
- Division of Dermatology, University of Washington School of Medicine, 1959 Northeast Pacific Street, BB-1353, Box 356524, Seattle, WA 98195-6524, USA.
| | - Philip Fleckman
- Division of Dermatology, University of Washington School of Medicine, 1959 Northeast Pacific Street, BB-1353, Box 356524, Seattle, WA 98195-6524, USA
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Regrowth of upper eyelid eyelashes after making a surgical incision on the upper eyelid in a case of severe alopecia areata. Ophthalmic Plast Reconstr Surg 2013; 30:e2-3. [PMID: 23467284 DOI: 10.1097/iop.0b013e3182873cb4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alopecia areata can affect only the scalp (alopecia totalis) or whole body (alopecia universalis). The authors report a case of eyelash regrowth induced by a minor surgical procedure in a 44-year-old Caucasian man with alopecia universalis. The mechanism of the regrowth of eyelashes after a surgical procedure remains unanswered and further studies may help elucidate this phenomenon.
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Werner B, Mulinari-Brenner F. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - part I. An Bras Dermatol 2013; 87:742-7. [PMID: 23044568 DOI: 10.1590/s0365-05962012000500012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 04/25/2011] [Indexed: 02/08/2023] Open
Abstract
Diffuse androgenetic alopecia (female pattern hair loss), telogen effluvium, and diffuse alopecia areata may have similar clinical manifestations. Subtle details on physical examination and dermoscopy of the scalp may help to identify those disorders. The authors present a practical discussion on how to approach the patient with diffuse alopecia, considering clinical history, physical examination, and dermoscopic findings. If the diagnosis remains unclear after a careful analysis of the clinical signs, a scalp biopsy may help to distinguish between the three diseases. In this first part of our study, an objective review of female androgenetic alopecia is presented and the most important histological changes are discussed.
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Abstract
Background: Alopecia areata (AA) shows several well-defined dermoscopic features which may help in confirming diagnosis in AA. Aims: We carried out a study to examine the dermoscopic features of AA and develop a protocol for diagnosis of AA by dermoscopy. Materials and Methods: Dermoscopy was performed in 66 patients with AA. Hanse HVS-500NP dermoscope (magnification of ×32 and ×140) was used. Results: The mean age of the patients (46 males and 20 females) was 26.85 years. The mean age of onset was 25.15 years. The mean duration of alopecia was 10.3 months. Most common AA in our study was patchy type (57/66, 87.7%). Single patch was seen in 24 patients and multiple patches in 33 patients. Diffuse AA was seen in five patients. Ophiasis and alopecia universalis were seen in two patients each. Nail changes were fine pitting (4), ridging (2), thinning of nail plate (2). Twenty nail dystrophy, distal onycholysis, striate leukonychia and coarse pitting were seen in one patient each. Intralesional triamcinolone acetonide was the most common therapy offered. Others were oral betamethasone minipulse therapy, dexamethasone pulse, minoxidil, anthralin and corticosteroids. The most common dermoscopic finding was yellow dots seen in 54 patients (81.8%), followed by black dots (44 patients, 66.6%), broken hairs (36 patients, 55.4%), short vellus hair (27 patients, 40.9%) and tapering hairs (8 patients, 12.1%). Conclusions: The most common dermoscopic finding of AA in our study was yellow dots, followed by black dots, broken hairs, short vellus hair and tapering hairs. Dermoscopic findings were not affected by the type of AA or the severity of the disease.
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Affiliation(s)
- Mandar Mane
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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Abstract
Alopecia Areata (AA) is a common non-scarring alopecia directed against the anagenic hair follicle. Various treatment modalities have been used for the treatment of severe AA. Topical immunotherapy is the best documented treatment so far for severe and refractory AA. Dinitrochlorobenzene (DNCB), squaric acid dibutylester (SADBE), and diphencyprone (DPCP) are the contact allergens used for this purpose. DNCB has been found to be mutagenic by the Ames test and is largely replaced by DPCP and SADBE. DPCP and SADBE are both known to be non-mutagenic compounds and have comparable efficacy results and relapse rates. SADBE requires special solvents and additives to maintain its potency and is more expensive than the rest. DPCP has a response rate varying from 60% in severe Alopecia Areata to 17% in patients with alopecia totalis or universalis, and shows about 88 to 100% high response rate in patients with patchy Alopecia Areata.
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Affiliation(s)
- Gurcharan Singh
- Department of Dermatology and STD, Sri Devaraj Urs Medical College, Tamaka, Kolar - 563 101, India
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Sánchez-Ramón S, Gil J, Cianchetta-Sívori M, Fernández-Cruz E. [Alopecia universalis in an adult after routine tetanus toxoid vaccine]. Med Clin (Barc) 2011; 136:318. [PMID: 20451934 DOI: 10.1016/j.medcli.2010.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 03/22/2010] [Accepted: 03/23/2010] [Indexed: 12/27/2022]
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Civaş E, Aksoy B, Aksoy HM, Eski M, Yucel K. Hair transplantation for therapy-resistant alopecia areata of the eyebrows: is it the right choice? J Dermatol 2011; 37:823-6. [PMID: 20883369 DOI: 10.1111/j.1346-8138.2010.00872.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Alopecia areata is a common skin disorder of presumed autoimmune etiology and it usually shows an unpredictable course. Treatment of alopecia areata is challenging. There is very little information on the use of surgical therapies for the treatment of alopecia areata in the medical published work. A 24-year-old male patient was referred to a private hair transplantation clinic owned by one of the authors for the treatment of therapy-resistant alopecia areata affecting both eyebrows. He had quickly lost all body hair 4 years prior beginning from the scalp. He received psoralen and ultraviolet A (PUVA) therapy for alopecia universalis and all body hair re-grew except his eyebrows. Alopecia areata was stable for the 18 months following the last medical treatment he received. Because there was no response to various medical therapeutic agents, we decided to transplant occipital hairs to the eyebrow area. After the patient understood and accepted all risks, occipital hairs were transplanted to the eyebrows by using the follicular unit extraction technique. Postoperatively, the patient did not receive any topical or systemic therapies for alopecia areata. Although 40% hair re-growth was detected in his eyebrows at 1 year postoperation, this rate was 80% by 2 years postoperation. However, there was resistance to re-growth in the medial eyebrow regions. New eyebrows grew as occipital hairs and required trimming. His satisfaction from the surgical procedure was 90% at the end of the 24th postoperative month. Surgical treatment of diseases like alopecia areata is still controversial. Our case report offers an additional contribution to the published work on the surgical methods used in the treatment of stable alopecia areata.
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Serum Interleukin-4 and Total Immunoglobulin E in Nonatopic Alopecia Areata Patients and HLA-DRB1 Typing. Dermatol Res Pract 2010; 2010:503587. [PMID: 20671941 PMCID: PMC2910459 DOI: 10.1155/2010/503587] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 06/01/2010] [Indexed: 02/07/2023] Open
Abstract
Background. Interleukin-4 (IL-4), a Th2 cytokine, can stimulate immunoglobulin E (IgE) transcription. No previous studies evaluated the genetic mechanisms in nonatopic AA patients with elevated serum IgE.
Objective. To compare serum IL-4 and total IgE levels between Egyptian nonatopic AA patients and healthy subjects and to investigate a possible relation to HLA-DRB1 alleles. Results. Serum IL-4 and total IgE were measured by ELISA in 40 controls and 54 nonatopic AA patients. Patients' HLA-DRB1 typing by sequence specific oligonucleotide probe technique was compared to normal Egyptian population. We found significantly elevated serum IL-4 and total IgE in AA patients (particularly alopecia universalis, AU, and chronic patients) (P < .01). HLA-DRB1*11 is a general susceptibility/chronicity allele. DRB1*13 is a protective allele. DRB1*01 and DRB1*07 are linked to chronicity. Localized AA showed decreased DRB1*03 and DRB1*07. Extensive forms showed increased DRB1*08 and decreased DRB1*04. Elevated IL4 and IgE were observed in patients with DRB1*07 and DRB1*11 not DRB1*04.
Conclusion. Serum IL-4 and IgE are elevated in nonatopic AA patients, particularly AU and chronic disease. Relevant susceptibility, chronicity, and severity HLADRB1 alleles may have a role in determining type, magnitude, and duration of immune response in AA favouring increased IL4 and IgE.
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Sohn KC, Jang S, Choi DK, Lee YS, Yoon TJ, Jeon EK, Kim KH, Seo YJ, Lee JH, Park JK, Kim CD. Effect of thioredoxin reductase 1 on glucocorticoid receptor activity in human outer root sheath cells. Biochem Biophys Res Commun 2007; 356:810-5. [PMID: 17382897 DOI: 10.1016/j.bbrc.2007.03.065] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Accepted: 03/10/2007] [Indexed: 01/01/2023]
Abstract
Alopecia areata (AA) is a common disease of patchy hair loss on the scalp that can progress to cover the entire scalp and eventually the entire body. Intralesional injection of corticosteroids is the first-line therapy for adult patients, however some patients do not respond to glucocorticoid treatment effectively. To delineate the molecular mechanism underlying glucocorticoid insensitivity, we examined the expression of glucocorticoid receptor (GR) and thioredoxin reductase 1 (TrxR1). In some case of glucocorticoid-resistant AA patients, the expression of TrxR1 was decreased in outer root sheath (ORS). We then investigated the effect of TrxR1 on GR activity using recombinant adenoviruses. Overexpression of TrxR1 markedly increased GR activity in ORS cells cultured in vitro. In addition, TrxR1 protected GR activity against H(2)O(2). Finally, TrxR1-enhanced GR activity was significantly inhibited by the overexpression of dominant negative form of Trx (Trx(C32S/C35S)). These results suggest that decreased TrxR1 may be one putative cause for glucocorticoid resistance in AA, through the impact on intracellular redox system.
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Affiliation(s)
- Kyung-Cheol Sohn
- Department of Dermatology and Research Institute for Medical Sciences, School of Medicine, Chungnam National University, 640 Daesa-dong, Daejeon 301-040, Republic of Korea
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Affiliation(s)
- Linda S Nield
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, USA
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Wiedemeyeer K, Schill WB, LOser C. Diseases on hair follicles leading to hair loss part I: nonscarring alopecias. Skinmed 2004; 3:209-14. [PMID: 15249781 DOI: 10.1111/j.1540-9740.2004.02326.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Hair follicles are unique structures with exceptional regenerative potential. They are believed to be crucial for epidermal homeostasis and reepithelialization after damage to human skin. Like other, more active and quickly proliferating organ systems, hair follicles may be easily disturbed in their normal growth cycle by systemic and local influences, including specific skin diseases. This may lead to hair loss, a very common complaint in men and women. The difficulties in reviewing the diseases of hair follicles lay in the long list of different etiologic factors (infectious, autoimmune, inflammatory, neoplastic, physical, chemical, congenital) and a still missing classification system according to etiopathogenetic principles. In this article (Part I of II), the structure and function of hair follicles, the diagnostic approach to diseases causing hair loss, and the most common nonscarring alopecias (telogen effluvium, anagen effluvium, androgenetic alopecia, and alopecia areata) are reviewed in regard to pathogenesis, clinical findings, and current options of treatment. Part II will focus on scarring alopecias.
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Parish LC, Witkowski JA. Quackery and the dermatologist. Skinmed 2004; 3:185-6. [PMID: 15249776 DOI: 10.1111/j.1540-9740.2004.03596.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Bouayed Abdelmoula N, Portnoï MF, Amouri A, Arladan A, Chakroun M, Saad A, Hchicha M, Turki H, Rebai T. Turner syndrome female with a small ring X chromosome lacking the XIST, an unexpectedly mild phenotype and an atypical association with alopecia universalis. ACTA ACUST UNITED AC 2004; 47:305-13. [PMID: 15337477 DOI: 10.1016/j.anngen.2004.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2003] [Accepted: 03/25/2004] [Indexed: 12/23/2022]
Abstract
Rearranged X chromosome in Turner syndrome (TS) are generally well tolerated but in cases of ring X chromosomes and of X/autosome translocations the incidence of mental retardation and other congenital abnormalities can be significantly higher. These abnormal phenotypes can be ascribed to failed or partial X inactivation. Here, we report a 10-year-old female who was referred for a cytogenetic analysis because she developed an alopecia universalis. The patient, of normal intelligence, had been found to have traits of TS, especially short stature. A first cytogenetic analysis showed a no mosaic 45,X karyotype. Since, the risk of developing gonadoblastoma in TS patients with mosaicism for a Y derivative chromosome and because association of alopecia universalis and TS is uncommon, fluorescence in situ hybridization (FISH) was performed to search for a second cell population. Our patient was found to have a mosaic 45,X/46,X,+r. FISH analysis using sex chromosome probes permitted us to identify the very small marker as a ring X chromosome, detected in 90% of cells. The ring appeared to be formed almost totally of alphoid sequences with breakpoints in the juxtacentromeric region. The r(X) does not include the XIST locus and may, therefore, not be subject to X-inactivation. Unexpectedly mild phenotype in our patient and its association with alopecia universalis will be discussed.
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Affiliation(s)
- N Bouayed Abdelmoula
- Laboratoire d'Histologie Embryologie, Faculté de Médecine de Sfax, avenue Magida Boulila, Sfax CP 3028, Tunisia.
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Zöller M, Freyschmidt-Paul P, Vitacolonna M, McElwee KJ, Hummel S, Hoffmann R. Chronic delayed-type hypersensitivity reaction as a means to treat alopecia areata. Clin Exp Immunol 2004; 135:398-408. [PMID: 15008971 PMCID: PMC1808967 DOI: 10.1111/j.1365-2249.2003.02380.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The acute phase of alopecia areata (AA) is characterized by an increase in CD44v3+ and CD44v10+ skin-infiltrating leucocytes (SkIL). Induction of a contact eczema, one of the therapeutic options in AA, can be mitigated strongly by a blockade of CD44v10. The observation that induction of a delayed type hypersensitivity (DTH) reaction abrogates an autoimmune reaction, where both responses apparently use similar effector mechanisms, is surprising and prompted us to search for the underlying mechanisms. AA-affected C3H/HeJ mice were treated with the contact sensitizer SADBE (squaric acid dibutylester) and leucocyte subpopulations and their activation state was evaluated in SkIL and draining lymph nodes. AA-affected mice exhibited an increased number of SkIL with a predominance of T lymphocytes. After treatment with the contact sensitizer SADBE recovery of SkIL was reduced and monocytes predominated. However, a significantly increased number of leucocytes was recovered from draining lymph nodes. Draining lymph node cells from untreated and treated AA mice exhibited all signs of recent activation with high-level expression of co-stimulatory and accessory molecules and an increased percentage of CD44v3+ and CD44v10+ leucocytes. In contrast, SkIL of SADBE-treated AA mice contained relatively few activated T cells and reduced numbers of CD44v3+ and CD44v10+ cells. Thus, the activation state and the distribution of leucocyte subsets in SADBE-treated AA mice are consistent with a blockade of leucocyte extravasation. Accordingly, the therapeutic effect of long-term SADBE treatment may rely on impaired leucocyte traffic.
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Affiliation(s)
- M Zöller
- Department of Tumor Progression and Tumor Defense, German Cancer Research Center, Heidelberg, Germany.
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Gundogan C, Greve B, Raulin C. Treatment of alopecia areata with the 308-nm xenon chloride excimer laser: Case report of two successful treatments with the excimer laser. Lasers Surg Med 2004; 34:86-90. [PMID: 15004817 DOI: 10.1002/lsm.20002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Alopecia areata is a common disease of unknown etiology; it causes significant cosmetic and psycho-social distress for most of the people it affects. We report on an innovative form of treatment in two patients with typical alopecia areata on the capillitium. STUDY DESIGN/PATIENTS AND METHODS We successfully treated two patients whose alopecia areata had worsened progressively for 3 and 14 weeks. The treatment involved the use of a 308 nm xenon chloride excimer laser (dosage 300-2,300 mJ/cm(2) per session). RESULTS After 11 and 12 sessions within a 9-week and 11-week period, the entire affected focus showed homogenous and thick regrowth. No relapse was observed during the follow-up period of 5 and 18 months. CONCLUSIONS The use of the excimer laser is an effective, elegant, and safe means of treatment and has good tolerability. Analogous to topical treatment of alopecia areata, the immunosuppressive mechanism of the excimer laser can be interpreted as an induction of T-cell apoptosis. This new means of treatment has yet to be discussed in medical literature. Further studies with greater numbers are needed to assess its potential more precisely and evaluate the excimer laser in treating alopecia areata.
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Yamazaki M, Miura Y, Tsuboi R, Ogawa H. Linear polarized infrared irradiation using Super Lizer is an effective treatment for multiple-type alopecia areata. Int J Dermatol 2003; 42:738-40. [PMID: 12956694 DOI: 10.1046/j.1365-4362.2003.01968.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Super Lizer trade mark is a linear polarized light instrument, which has been used with good effect in orthopedics and anesthesiology to treat arthralgia and neuralgia with a high output of infrared radiation. AIM To test Super Lizer trade mark 's efficacy for the treatment of alopecia areata. METHODS Fifteen patients over 18 years of age, diagnosed with alopecia areata and displaying symptoms of patchy hair loss, were topically irradiated with infrared radiation using the Super Lizer trade mark. The patients were irradiated intermittently for an interval of 3 min once every week or every 2 weeks. RESULTS Seven of 15 (46.7%) of the irradiated areas showed hair regrowth 1.6 months earlier than the nonirradiated areas (chi2 official approval, P = 0.003). With regard to adverse effects caused by Super Lizer trade mark treatment, only one patient complained of a sensation of heat in the irradiated area. CONCLUSIONS These findings suggest that Super Lizer trade mark, with its noninvasive properties, is a useful apparatus for the treatment of mild forms of alopecia areata.
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Affiliation(s)
- Masashi Yamazaki
- Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.
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Sato K, Seio K, Sekine M. Squaryl group as a new mimic of phosphate group in modified oligodeoxynucleotides: synthesis and properties of new oligodeoxynucleotide analogues containing an internucleotidic squaryldiamide linkage. J Am Chem Soc 2002; 124:12715-24. [PMID: 12392419 DOI: 10.1021/ja027131f] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This paper describes the synthesis and properties of a new type of modified oligodeoxynucleotide containing a neutral but highly polarized squaryl group as a novel mimic of the phosphate group. A modified thymidine dimer derivative (TsqT) having a squaryldiamide linkage was synthesized in almost quantitative yield by a two-step substitution of diethyl squarate with 3'-amino-5'-O-(4,4'-dimethoxytrityl)-3'-deoxythymidine and 5'-amino-5'-deoxythymidine. The CD and UV studies of TsqT suggest that this dimer has basically a structure similar to that of TpT. The NMR studies of TsqT show a unique property, namely, that the squaryl group of TsqT is influenced by Mg2+ concentration. The ab initio calculations of TsqT showed a highly polarized structure resembling that of a phosphate group. This dimer structural motif was finally incorporated into oligodeoxynucleotides by use of the phosphoramidite approach. The hybridization affinity of these modified oligodeoxynucleotides for the complementary and mismatched oligodeoxynucleotides was studied in detail by using Tm experiments. Consequently, it turned out that in a matched duplex of 5'-d(CGCATsqTAGCC)-3'/5'-d(GGCTAATGCG)-3' the A-T base pairs at the modified site can be preserved, but instead thermal destabilization of the overall structure was observed. To estimate the structure of the duplex, two kinds of fluorescein chromophores (fluorescein (FL) and cyanine 3 (Cy3)) were introduced into the 5'-terminal site of 5'-d(GACGCATsqTAGCCGAT)-3' and 5'-d(ATCGGCTAATGCGTC)-3', respectively. The fluorescence resonance energy transfer experiments using these functionalized oligodeoxynucleotides suggest that the matched duplexes have a bent structure at the modified site. This conclusion was also strongly supported by computational MM and MD simulations.
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Affiliation(s)
- Kousuke Sato
- Contribution from the Department of Life Science, Faculty of Bioscience and Biotechnology, Tokyo Institute of Technology, Nagatsuta, Midoriku, Yokohama 226-8501, Japan
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