Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management

Clinical Reviews in Allergy & Immunology, Journal Year: 2021, Volume and Issue: 61(3), P. 403 - 423

Published: Aug. 17, 2021

Language: Английский

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Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: a randomised, double-blind, multicentre, phase 2b–3 trial

The Lancet, Journal Year: 2023, Volume and Issue: 401(10387), P. 1518 - 1529

Published: April 14, 2023

Language: Английский

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An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Frontiers in Immunology, Journal Year: 2022, Volume and Issue: 13

Published: Aug. 30, 2022

Alopecia Areata (AA) is a common autoimmune disease characterized by non-scarring hair loss ranging from patches on the scalp to complete involving entire body. Disease onset hypothesized follow collapse of immune privilege follicle, which results in an increase self-peptide/MHC expression along follicular epithelium. Hair associated with infiltration follicle putatively self-reactive T cells. This process thought skew microenvironment away typically homeostatic state towards one active inflammation. imbalance mediated part dominating presence specific cytokines. While interferon-γ (IFNγ) has been identified as key player AA pathogenesis, many other cytokines have also shown play pivotal roles. Mechanistic studies animal models highlighted contribution gamma chain (γ c ) such IL-2, IL-7, and IL-15 augmenting disease. IFNγ γ signal through pathways receptor activation Janus kinases (JAKs) transducers activators transcription (STATs). Based these findings, JAK/STAT targeted for purposes therapeutic intervention clinical setting. Case reports series described use small molecule JAK inhibitors leading regrowth among patients. Furthermore, emerging trial show great promise position treatment strategy patients severe or recalcitrant Demonstrated efficacy large-scale trials inhibitor baricitinib led first-in-disease FDA-approved June 2022. review aims highlight signaling various involved how targeting those may impact outcomes both laboratory settings.

Language: Английский

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Deciphering the molecular mechanisms of stem cell dynamics in hair follicle regeneration

Experimental & Molecular Medicine, Journal Year: 2024, Volume and Issue: 56(1), P. 110 - 117

Published: Jan. 5, 2024

Abstract Hair follicles, which are connected to sebaceous glands in the skin, undergo cyclic periods of regeneration, degeneration, and rest throughout adult life mammals. The crucial function hair follicle stem cells is maintain these growth cycles. Another vital aspect activity melanocyte cells, differentiate into melanin-producing melanocytes, contributing skin pigmentation. Sebaceous gland also have a pivotal role maintaining barrier by regenerating mature sebocytes. These maintained specialized microenvironment or niche regulated internal external signals, determining their dynamic behaviors homeostasis regeneration. tightly controlled various factors secreted components around as well immune-mediated damage aging, metabolic status, stress. In this study, we review diverse cell regulatory related molecular mechanisms regeneration disease conditions. Molecular insights would provide new perspectives on disorder treatment.

Language: Английский

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European recommendations for management of immune checkpoint inhibitors‐derived dermatologic adverse events. The EADV task force ‘Dermatology for cancer patients’ position statement

Journal of the European Academy of Dermatology and Venereology, Journal Year: 2021, Volume and Issue: 36(3), P. 332 - 350

Published: Dec. 15, 2021

The introduction of immune checkpoint inhibitors (ICIs) opened a new era in oncologic therapy. favourable profile ICIs terms efficacy and safety can be overshadowed by the development immune-related adverse events (irAEs). Dermatologic irAEs (dirAEs) appear about 40% patients undergoing immunotherapy mainly include maculopapular, psoriasiform, lichenoid eczematous rashes, auto-immune bullous disorders, pigmentary pruritus, oral mucosal lesions, hair nail changes, as well few rare potentially life-threatening toxicities. EADV task force Dermatology for Cancer Patients merged clinical experience so-far published data, incorporated quantitative qualitative characteristics each specific dirAEs, released dermatology-derived, phenotype-specific treatment recommendations cutaneous toxicities (including levels evidence grades recommendation). basic principle management is that interventions should tailored to serve equilibrium between patients' relief from symptoms signs skin toxicity preservation an unimpeded treatment.

Language: Английский

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Alopecia areata – Current understanding and management

JDDG Journal der Deutschen Dermatologischen Gesellschaft, Journal Year: 2022, Volume and Issue: 20(1), P. 59 - 90

Published: Jan. 1, 2022

Alopecia areata (AA) is a chronic, immune-mediated disease characterized by acute or chronic non-scarring hair loss, with heterogeneity in clinical manifestations ranging from patchy loss to complete scalp and body loss. An overview of the up-to-date pathophysiology underlying signaling pathways involved AA together diagnostic therapeutic recommendations will be provided. Current treatments, including topical, systemic injectable interventions show varying response frequent relapses reflecting unmet need. Thus, new emerging concepts approaches, Janus kinase inhibitors are eagerly awaited. Traditional therapies discussed, order provide physicians guidance for management. Since latter so challenging often tends take course, it can have an enormous psychosocial burden on patients, compromising their quality life causing depression anxiety. Therefore, aspects need evaluated addressed, implement appropriate psychological support when needed.

Language: Английский

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Alopecia Areata: A Review of the Role of Oxidative Stress, Possible Biomarkers, and Potential Novel Therapeutic Approaches

Antioxidants, Journal Year: 2023, Volume and Issue: 12(1), P. 135 - 135

Published: Jan. 6, 2023

Alopecia areata (AA) is a dermatological condition characterized by non-scarring hair loss. Exact etiopathogenesis of AA still unknown although it known that several factors contribute to the collapse hair-follicle (HF)-immune-privileged (IP) site. Oxidative stress (OS) plays an important role in skin diseases. The aim this review was clarify OS pathogenesis and diagnosis, discuss potential treatment options. Oxidative-stress markers are altered serum samples patients with AA, confirming general pro-oxidative status AA. induces MHC class I chain-related A (MICA) expression HF keratinocytes activates receptor NKG2D, expressed NK cells CD8+ T cytotoxic leading destabilization immune-privileged site through production IFN-γ stimulates JAK1 JAK2 pathways. also KEAP1-NRF2 pathway, antioxidant system contributes homeostasis. In addition, decrease ATG5 LC3B matrix increase p62 levels indicates reduction intrafollicular autophagy during evolution Potential biomarkers could be: malondialdehyde (MDA), advanced glycation end-products (AGEs), ischemic-modified albumin (IMA). JAK inhibitors new frontier use nutraceuticals modulate balance, combination standard treatments, represent promising therapeutic tools.

Language: Английский

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Alopecia Areata: Current Treatments and New Directions

American Journal of Clinical Dermatology, Journal Year: 2023, Volume and Issue: 24(6), P. 895 - 912

Published: Aug. 22, 2023

Language: Английский

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Inhibition of T-cell activity in alopecia areata: recent developments and new directions

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: Nov. 6, 2023

Alopecia areata (AA) is an autoimmune disease that has a complex underlying immunopathogenesis characterized by nonscarring hair loss ranging from small bald patches to complete of scalp, face, and/or body hair. Although the etiopathogenesis AA not yet been fully characterized, immune privilege collapse at follicle (HF) followed T-cell receptor recognition exposed HF autoantigens autoreactive cytotoxic CD8 + T cells now understood play central role. Few treatment options are available, with Janus kinase (JAK) 1/2 inhibitor baricitinib (2022) and selective JAK3/tyrosine expressed in hepatocellular carcinoma (TEC) ritlecitinib (2023) being only US Food Drug Administration–approved systemic medications thus far for severe AA. Several other treatments used off-label limited efficacy suboptimal safety tolerability. With increased understanding T-cell–mediated inflammatory pathogenesis AA, additional therapeutic pathways beyond JAK inhibition currently under investigation development therapies. This narrative review presents detailed overview about role T-cell–signaling focus on those targeted drugs clinical A summary new targeting these expert commentary future directions drug importance multiple also provided this review.

Language: Английский

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Differential impact of environmental factors on systemic and localized autoimmunity

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: May 22, 2023

The influence of environmental factors on the development autoimmune disease is being broadly investigated to better understand multifactorial nature pathogenesis and identify potential areas intervention. Areas particular interest include lifestyle, nutrition, vitamin deficiencies autoimmunity chronic inflammation. In this review, we discuss how lifestyles dietary patterns may contribute or modulate autoimmunity. We explored concept through a spectrum several diseases including Multiple Sclerosis (MS), Systemic Lupus Erythematosus (SLE) Alopecia Areata (AA) affecting central nervous system, whole body, hair follicles, respectively. A clear commonality between conditions here low Vitamin D, well-researched hormone in context with pleiotropic immunomodulatory anti-inflammatory effects. While levels are often correlated activity progression MS AA, relationship less SLE. Despite strong associations autoimmunity, lack conclusive evidence which elucidates its role contributing simply as result similar vein, other vitamins impacting course these overall diet lifestyle. Recent work exploring effects interventions showed that balanced was linked improvement clinical parameters, comorbid conditions, quality life for patients. patients MS, SLE certain diets supplements lower incidence improved symptoms. Conversely, obesity during adolescence higher while it associated organ damage. Autoimmunity thought emerge from complex interplay genetic background. Although scope review focuses factors, imperative elaborate interaction susceptibility environment due origin disease. Here, offer comprehensive about recent lifestyle translation into therapeutic interventions.

Language: Английский

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