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Hussein RS, Atia T, Bin Dayel S. Impact of Thyroid Dysfunction on Hair Disorders. Cureus 2023; 15:e43266. [PMID: 37692605 PMCID: PMC10492440 DOI: 10.7759/cureus.43266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Hair loss is a problem for everyone, regardless of their age or sex. The three most prevalent types of hair loss, telogen effluvium, alopecia areata, and androgenetic alopecia, have been associated with a variety of risk factors. Strong evidence links thyroid hormones (THs) to hair loss. THs control the growth, differentiation, metabolism, and thermogenesis of body cells. The skin is a significant target organ for THs; however, the cellular and molecular causes of thyroid dysfunction-related skin diseases remain unknown. Hyperthyroidism, hypothyroidism, and drug-induced hypothyroidism can induce widespread hair shedding. Little information is available regarding the incidence and effects of thyroid dysfunction on hair problems. This study aimed to review the impact and prevalence of thyroid disorders on hair loss. The conclusions drawn from this study highlight the underestimated prevalence and impact of thyroid disorders on hair loss. The review of scientific articles, including original research, review articles, and a case report, provides a comprehensive understanding of the topic. This research adds to the existing literature by enhancing our understanding of the relationship between thyroid dysfunction and hair disorders. It contributes to the body of evidence by reviewing relevant studies and summarizing the impact of thyroid disorders on hair loss. The study also highlights the gaps in knowledge and the need for more research in this area to improve the diagnosis and management of hair disorders associated with thyroid dysfunction.
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Affiliation(s)
- Ramadan S Hussein
- Department of Internal Medicine, Dermatology Unit, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, SAU
| | - Tarek Atia
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, SAU
| | - Salman Bin Dayel
- Department of Internal Medicine, Dermatology Unit, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, SAU
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2
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Watson VE, Faniel ML, Kamili NA, Krueger LD, Zhu C. Immune-mediated alopecias and their mechanobiological aspects. Cells Dev 2022; 170:203793. [PMID: 35649504 PMCID: PMC10681075 DOI: 10.1016/j.cdev.2022.203793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/24/2022] [Indexed: 02/06/2023]
Abstract
Alopecia is a non-specific term for hair loss clinically diagnosed by the hair loss pattern and histological analysis of patient scalp biopsies. The immune-mediated alopecia subtypes, including alopecia areata, lichen planopilaris, frontal fibrosing alopecia, and central centrifugal cicatricial alopecia, are common, significant forms of alopecia subtypes. For example, alopecia areata is the most common autoimmune disease with a lifetime incidence of approximately 2% of the world's population. In this perspective, we discuss major results from studies of immune-mediated alopecia subtypes. These studies suggest the key event in disease onset as the collapse in immune privilege, which alters the hair follicle microenvironment, e.g., upregulation of major histocompatibility complex molecules and increase of cytokine production, and results in immune cell infiltration, inflammatory responses, and damage of hair follicles. We note that previous studies have established that the hair follicle has a complex mechanical microenvironment, which may regulate the function of not only tissue cells but also immune cell infiltrates. This suggests a potential for mechanobiology to contribute to alopecia research by adding new methods, new approaches, and new ways of thinking, which is missing in the existing literature. To fill this a gap in the alopecia research space, we develop a mechanobiological hypothesis that alterations in the hair follicle microenvironment, specifically in the mechanically responsive tissues and cells, partially due to loss of immune privilege, may be contributors to disease pathology. We further focus our discussion on the potential for applying mechanoimmunology to the study of T cell infiltrates in the hair follicle, as they are considered primary contributors to alopecia pathology. To establish the connection between the mechanoimmunological hypothesis and immune-mediated alopecia subtypes, we discuss what is known about the role of T cells in immune-mediated alopecia subtypes, using the most extensively studied AA as our model.
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Affiliation(s)
- Valencia E Watson
- Wallace H. Coulter Department of Biomedical Engineering, USA; Bioengineering PhD Program, USA; Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Makala L Faniel
- Wallace H. Coulter Department of Biomedical Engineering, USA; Bioengineering PhD Program, USA; Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Loren D Krueger
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Cheng Zhu
- Wallace H. Coulter Department of Biomedical Engineering, USA; Bioengineering PhD Program, USA; Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA.
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3
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Mancino G, Miro C, Di Cicco E, Dentice M. Thyroid hormone action in epidermal development and homeostasis and its implications in the pathophysiology of the skin. J Endocrinol Invest 2021; 44:1571-1579. [PMID: 33683663 PMCID: PMC8285348 DOI: 10.1007/s40618-020-01492-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023]
Abstract
Thyroid hormones (THs) are key endocrine regulators of tissue development and homeostasis. They are constantly released into the bloodstream and help to regulate many cell functions. The principal products released by the follicular epithelial cells are T3 and T4. T4, which is the less active form of TH, is produced in greater amounts than T3, which is the most active form of TH. This mechanism highlights the importance of the peripheral regulation of TH levels that goes beyond the central axis. Skin, muscle, liver, bone and heart are finely regulated by TH. In particular, skin is among the target organs most influenced by TH, which is essential for skin homeostasis. Accordingly, skin diseases are associated with an altered thyroid status. Alopecia, dermatitis and vitiligo are associated with thyroiditis and alopecia and eczema are frequently correlated with the Graves' disease. However, only in recent decades have studies started to clarify the molecular mechanisms underlying the effects of TH in epidermal homeostasis. Herein, we summarize the most frequent clinical epidermal alterations linked to thyroid diseases and review the principal mechanisms involved in TH control of keratinocyte proliferation and functional differentiation. Our aim is to define the open questions in this field that are beginning to be elucidated thanks to the advent of mouse models of altered TH metabolism and to obtain novel insights into the physiopathological consequences of TH metabolism on the skin.
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Affiliation(s)
- G Mancino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - C Miro
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - E Di Cicco
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - M Dentice
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy.
- CEINGE-Biotecnologie Avanzate Scarl, Naples, Italy.
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4
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Uchida Y, Gherardini J, Schulte-Mecklenbeck A, Alam M, Chéret J, Rossi A, Kanekura T, Gross CC, Arakawa A, Gilhar A, Bertolini M, Paus R. Pro-inflammatory Vδ1 +T-cells infiltrates are present in and around the hair bulbs of non-lesional and lesional alopecia areata hair follicles. J Dermatol Sci 2020; 100:129-138. [PMID: 33039243 DOI: 10.1016/j.jdermsci.2020.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND It is widely accepted that NKG2D+cells are critically involved in alopecia areata (AA) pathogenesis. However, besides being expressed in CD8+T-cells and NK cells, NKG2D is also found in human γδT-cells. AA lesional hair follicles (HFs) overexpress NKG2D and γδTCR activating ligands, e.g. MICA and CD1d, and chemoattractants for γδT-cells, such as CXCL10. OBJECTIVE To investigate whether abnormal activities of γδT-cells may be involved in AA pathogenesis. METHODS We analyzed the number and activation status of γδT-cells in human healthy, lesional and non-lesional AA scalp biopsies by FACS and/or quantitative (immuno-)histomorphometry. RESULTS In healthy human scalp skin, the few skin-resident γδT-cells were found to be mostly Vδ1+, non-activated (CD69-NKG2Ddim) and positive for CXCL10, and CXCL12 receptors. These Vδ1+T-cells predominantly localized in/around the HF infundibulum. In striking contrast, the number of Vδ1+T-cells was significantly higher around and even inside the proximal (suprabulbar and bulbar) epithelium of lesional AA HFs. These cells also showed a pro-inflammatory phenotype, i.e. higher NKG2D, and IFN-γ and lower CD200R expression. Importantly, more pro-inflammatory Vδ1+T-cells were seen also around non-lesional AA HFs. Lesional AA HFs also showed significantly higher expression of CXCL12. CONCLUSION Our pilot study introduces skin-resident γδT-cells as a previously overlooked, but potentially important, mostly (auto-)antigen-independent, new innate immunity protagonist in AA pathobiology. The HF infiltration of these activated, IFN-γ-releasing cells already around non-lesional AA HFs suggest that Vδ1+T-cells are involved in the early stages of human AA pathobiology, and may thus deserve therapeutic targeting for optimal AA management.
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Affiliation(s)
- Youhei Uchida
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Jennifer Gherardini
- Monasterium Laboratory, Skin and Hair Research Solutions GmbH, Münster, Germany; Dr. Phillip Frost Dept. of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andreas Schulte-Mecklenbeck
- Department of Neurology & Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Majid Alam
- Department of Dermatology & Venereology, Hamad Medical Corporation & Translational Research Institute, Academic Health System, Doha, Qatar
| | - Jérémy Chéret
- Dr. Phillip Frost Dept. of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alfredo Rossi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, University "La Sapienza'', Rome, Italy
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Catharina C Gross
- Department of Neurology & Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Akiko Arakawa
- Department of Dermatology, University of Munich (LMU), Munich, Germany
| | - Amos Gilhar
- Skin Research Laboratory, Technion-Israel Institute of Technology, Haifa, Israel
| | - Marta Bertolini
- Monasterium Laboratory, Skin and Hair Research Solutions GmbH, Münster, Germany
| | - Ralf Paus
- Monasterium Laboratory, Skin and Hair Research Solutions GmbH, Münster, Germany; Dr. Phillip Frost Dept. of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Centre for Dermatology Research, University of Manchester, MAHSC, and Manchester NIHR Biomedical Research Centre, Manchester, UK.
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5
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Ito T, Suzuki T, Funakoshi A, Fujiyama T, Tokura Y. CCR5 is a novel target for the treatment of experimental alopecia areata. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2020. [DOI: 10.1002/cia2.12092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Taisuke Ito
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Takahiro Suzuki
- Department of Dermatology & Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Atsuko Funakoshi
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Toshiharu Fujiyama
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Yoshiki Tokura
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
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6
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Toward Predicting the Spatio-Temporal Dynamics of Alopecia Areata Lesions Using Partial Differential Equation Analysis. Bull Math Biol 2020; 82:34. [PMID: 32095960 DOI: 10.1007/s11538-020-00707-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/29/2020] [Indexed: 12/12/2022]
Abstract
Hair loss in the autoimmune disease, alopecia areata (AA), is characterized by the appearance of circularly spreading alopecic lesions in seemingly healthy skin. The distinct spatial patterns of AA lesions form because the immune system attacks hair follicle cells that are in the process of producing hair shaft, catapults the mini-organs that produce hair from a state of growth (anagen) into an apoptosis-driven regression state (catagen), and causes major hair follicle dystrophy along with rapid hair shaft shedding. In this paper, we develop a model of partial differential equations (PDEs) to describe the spatio-temporal dynamics of immune system components that clinical and experimental studies show are primarily involved in the disease development. Global linear stability analysis reveals there is a most unstable mode giving rise to a pattern. The most unstable mode indicates a spatial scale consistent with results of the humanized AA mouse model of Gilhar et al. (Autoimmun Rev 15(7):726-735, 2016) for experimentally induced AA lesions. Numerical simulations of the PDE system confirm our analytic findings and illustrate the formation of a pattern that is characteristic of the spatio-temporal AA dynamics. We apply marginal linear stability analysis to examine and predict the pattern propagation.
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7
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Wang ECE, Higgins CA. Immune cell regulation of the hair cycle. Exp Dermatol 2020; 29:322-333. [PMID: 31903650 DOI: 10.1111/exd.14070] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/14/2019] [Accepted: 12/31/2019] [Indexed: 12/11/2022]
Abstract
The ability to manipulate the mammalian hair cycle will lead to novel therapies and strategies to combat all forms of alopecia. Thus, in addition to the epithelial-mesenchymal interactions in the hair follicle, niche and microenvironmental signals that accompany the phases of growth, regression and rest need to be scrutinized. Immune cells are well described in skin homeostasis and wound healing and have recently been shown to play an important role in the mammalian hair cycle. In this review, we will summarize our current knowledge of the role of immune cells in hair cycle control and discuss their relevance to human hair cycling disorders. Increased attention to this aspect of the hair cycle will provide new avenues to manipulate hair regeneration in humans and provide better insight into developing better ex vivo models of hair growth.
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Affiliation(s)
- Etienne C E Wang
- Skin Research Institute of Singapore (SRIS), National Skin Centre, Singapore, Singapore
| | - Claire A Higgins
- Department of Bioengineering, Imperial College London, London, UK
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8
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Alam M, Bertolini M, Gherardini J, Keren A, Ponce L, Chéret J, Alenfall J, Dunér P, Nilsson AH, Gilhar A, Paus R. An osteopontin-derived peptide inhibits human hair growth at least in part by decreasing fibroblast growth factor-7 production in outer root sheath keratinocytes. Br J Dermatol 2019; 182:1404-1414. [PMID: 31487385 DOI: 10.1111/bjd.18479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Given that unwanted hair growth (hirsutism, hypertrichosis) can cause major psychological distress, new pharmacological treatment strategies with safe and effective hair growth inhibitors that do not destroy the hair follicle (HF) and its stem cells need to be developed. OBJECTIVES To establish if osteopontin-derived fragments may modulate human hair growth given that human HFs express the multifunctional, immunomodulatory glycoprotein, osteopontin. METHODS Our hypothesis was tested ex vivo and in vivo by using a newly generated, toxicologically well-characterized, modified osteopontin-derived peptide (FOL-005), which binds to the HF. RESULTS In organ-cultured human HFs and scalp skin, and in human scalp skin xenotransplants onto SCID mice, FOL-005 treatment (60 nmol L-1 to 3 μmol L-1 ) significantly promoted premature catagen development without reducing the number of keratin 15-positive HF stem cells or showing signs of drug toxicity. Genome-wide DNA microarray, quantitative reverse-transcriptase polymerase chain reaction and immunohistochemistry revealed decreased expression of the hair growth promoter, fibroblast growth factor-7 (FGF7) by FOL-005, while cotreatment of HFs with recombinant FGF7 partially abrogated FOL-005-induced catagen promotion. CONCLUSIONS With caveats in mind, our study identifies this osteopontin-derived peptide as an effective, novel inhibitory principle for human hair growth ex vivo and in vivo, which deserves systematic clinical testing in hirsutism and hypertrichosis. What's already known about this topic? The treatment of unwanted hair growth (hypertrichosis, hirsutism) lacks pharmacological intervention, with only few and often unsatisfactory treatments available. Osteopontin is prominently expressed in human HFs and has been reported to be elevated during catagen in the murine hair cycle. What does this study add? We tested the effects on hair growth of a novel, osteopontin-derived fragment (FOL-005) ex vivo and in vivo. In human hair follicles, high-dose FOL-005 significantly reduces hair growth both ex vivo and in vivo. What is the translational message? High-dose FOL-005 may provide a new therapeutic opportunity as a treatment for unwanted hair growth.
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Affiliation(s)
- M Alam
- Monasterium Laboratory - Skin and Hair Research Solutions GmbH, Münster, Germany.,Mediteknia Skin & Hair Lab, Las Palmas de Gran Canaria, Spain.,Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - M Bertolini
- Monasterium Laboratory - Skin and Hair Research Solutions GmbH, Münster, Germany
| | - J Gherardini
- Monasterium Laboratory - Skin and Hair Research Solutions GmbH, Münster, Germany
| | - A Keren
- Laboratory for Skin Research, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - L Ponce
- Monasterium Laboratory - Skin and Hair Research Solutions GmbH, Münster, Germany
| | - J Chéret
- Monasterium Laboratory - Skin and Hair Research Solutions GmbH, Münster, Germany
| | | | - P Dunér
- Follicum AB, Lund, Sweden.,Department of Clinical Sciences, Lund University, Lund, Sweden
| | - A H Nilsson
- Follicum AB, Lund, Sweden.,Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - A Gilhar
- Laboratory for Skin Research, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - R Paus
- Centre for Dermatology Research, University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester, U.K.,Dr. Philip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, U.S.A
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9
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Florian P, Flechsenhar KR, Bartnik E, Ding‐Pfennigdorff D, Herrmann M, Bryce PJ, Nestle FO. Translational drug discovery and development with the use of tissue‐relevant biomarkers: Towards more physiological relevance and better prediction of clinical efficacy. Exp Dermatol 2019; 29:4-14. [DOI: 10.1111/exd.13942] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 02/28/2019] [Accepted: 03/26/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Peter Florian
- Department of Type 1/17 Immunology and Arthritis Sanofi Frankfurt Germany
| | | | - Eckart Bartnik
- Department of Type 1/17 Immunology and Arthritis Sanofi Frankfurt Germany
| | | | - Matthias Herrmann
- Department of Type 1/17 Immunology and Arthritis Sanofi Frankfurt Germany
| | - Paul J. Bryce
- Department of Type 2 Inflammation and Fibrosis Sanofi Cambridge Massachusetts
| | - Frank O. Nestle
- Global Head of Immunology Therapeutic Research Area Sanofi Cambridge Massachusetts
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10
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Aumond S, Bitton E. The eyelash follicle features and anomalies: A review. JOURNAL OF OPTOMETRY 2018; 11:211-222. [PMID: 30017866 PMCID: PMC6147748 DOI: 10.1016/j.optom.2018.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/19/2018] [Accepted: 05/26/2018] [Indexed: 05/03/2023]
Abstract
The primary role of eyelashes is to protect and maintain the health of the lid margin. However, the mechanisms to fulfill this role are not fully understood. Unraveling these mechanisms will stand to greatly improve the efficiency of eye care professionals' interventions in anomalies of the eyelashes. The aim of this article is to provide a review on eyelashes including highlights and new avenues for research; the biology of both the lash and its follicle; the pathophysiology and management of lash anomalies by eye care professionals; and the effect of iatrogenic factors on lashes. Using the database of Ovid MEDLINE, we reviewed studies specifically directed on human/mammalian eyelashes and key articles on current trends in scalp hair methodologies that can be applicable to lash research. The eyelash morphology, pigmentation and growth rate have been documented using techniques ranging from lash imaging to follicle immunohistochemistry. Furthermore, studies have demonstrated that the lash follicle is sensitive to many factors of the external environment, a variety of systemic/topical medications and cosmetics. Recently, aerodynamic studies using a mammalian eye model confirmed that an optimal lash length was needed so that eyelashes serve a protective role in reducing the number of particles that can reach the eye. Despite recent advances in lash research, studies are still scarce, due to the limited availability of the human lid for sampling. This review brings awareness that further research is needed with respect to eyelashes and will hopefully reduce the gap with scalp hair research.
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Affiliation(s)
- Sarah Aumond
- École d'optométrie, Université de Montréal, 3744 Rue Jean-Brillant, Montréal, Québec, Canada H3T 1P1.
| | - Etty Bitton
- École d'optométrie, Université de Montréal, 3744 Rue Jean-Brillant, Montréal, Québec, Canada H3T 1P1
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11
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Shin JM, Choi DK, Sohn KC, Koh JW, Lee YH, Seo YJ, Kim CD, Lee JH, Lee Y. Induction of alopecia areata in C3H/HeJ mice using polyinosinic-polycytidylic acid (poly[I:C]) and interferon-gamma. Sci Rep 2018; 8:12518. [PMID: 30131581 PMCID: PMC6104095 DOI: 10.1038/s41598-018-30997-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 08/09/2018] [Indexed: 11/09/2022] Open
Abstract
Alopecia areata (AA) is a chronic, relapsing hair-loss disorder that is considered to be a T-cell-mediated autoimmune disease. Several animal models for AA have been created to investigate the pathophysiology and screen for effective therapeutic targets. As C3H/HeJ mice develop AA spontaneously in a low frequency, a novel animal model is needed to establish an AA-like condition faster and more conveniently. In this study, we present a novel non-invasive AA rodent model that avoids skin or lymph-node cell transfer. We simply injected C3H/HeJ mice subcutaneously with interferon-gamma (IFNγ) along with polyinosinic:polycytidylic acid (poly[I:C]), a synthetic dsRNA, to initiate innate immunity via inflammasome activation. Approximately 80% of the IFNγ and poly(I:C) co-injected mice showed patchy AA lesions after 8 weeks. None of the mice displayed hair loss in the IFNγ or poly(I:C) solely injection group. Immunohistochemical staining of the AA lesions revealed increased infiltration of CD4+ and CD8+ cells infiltration around the hair follicles. IFNγ and poly(I:C) increased the expression of NLRP3, IL-1β, CXCL9, CXCL10, and CXCL11 in mouse skin. Taken together, these findings indicate a shorter and more convenient means of AA animal model induction and demonstrate that inflammasome-activated innate immunity is important in AA pathogenesis.
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Affiliation(s)
- Jung-Min Shin
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Dae-Kyoung Choi
- Biomedical Research Institute, Chungnam National University Hospital, Daejeon, Korea
| | - Kyung-Cheol Sohn
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jung-Woo Koh
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Ho Lee
- Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Joon Seo
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Chang Deok Kim
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeung-Hoon Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea.
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12
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Alopecia areata. J Am Acad Dermatol 2018; 78:1-12. [DOI: 10.1016/j.jaad.2017.04.1141] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 04/04/2017] [Accepted: 04/10/2017] [Indexed: 01/01/2023]
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13
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Darwin E, Hirt PA, Fertig R, Doliner B, Delcanto G, Jimenez JJ. Alopecia Areata: Review of Epidemiology, Clinical Features, Pathogenesis, and New Treatment Options. Int J Trichology 2018; 10:51-60. [PMID: 29769777 PMCID: PMC5939003 DOI: 10.4103/ijt.ijt_99_17] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Alopecia areata (AA) is a complex autoimmune condition that causes nonscarring hair loss. It typically presents with sharply demarcated round patches of hair loss and may present at any age. In this article, we review the epidemiology, clinical features, pathogenesis, and new treatment options of AA, with a focus on the immunologic mechanism underlying the treatment. While traditional treatment options such as corticosteroids are moderately effective, a better understanding of the disease pathogenesis may lead to the development of new treatments that are more directed and effective against AA. Sources were gathered from PubMed, Embase, and the Cochrane database using the keywords: alopecia, alopecia areata, hair loss, trichoscopy, treatments, pathogenesis, and epidemiology.
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Affiliation(s)
- Evan Darwin
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Penelope A Hirt
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Raymond Fertig
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Brett Doliner
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Gina Delcanto
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
| | - Joaquin J Jimenez
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fl 33136, USA
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14
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Abstract
Recent genetic and preclinical studies have increased our understanding of the immunopathogenesis of alopecia areata (AA). This has allowed expedited development of targeted therapies for the treatment of AA, and a paradigm shift in our approach and understanding of autoimmunity and the hair follicle. The synergy between preclinical studies, animal models, and translational studies has led to unprecedented advances in the treatment options for AA, ultimately benefiting patients who have had little recourse. In this review, we summarize the scientific field of contemporary AA research, and look forward to potential new technologies and developments.
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15
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Toward the Clonotype Analysis of Alopecia Areata-Specific, Intralesional Human CD8+ T Lymphocytes. J Investig Dermatol Symp Proc 2016; 17:9-12. [PMID: 26551936 DOI: 10.1038/jidsymp.2015.31] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Alopecia areata (AA) is an organ-restricted autoimmune disease that mainly affects the hair follicle (HF). Several findings support a key primary effector role of CD8+ T cells in the disease pathogenesis. Autoreactive CD8+ T cells are not only present in the characteristic peribulbar inflammatory cell infiltrate of lesional AA HFs but are also found to be infiltrating in lesional HF epithelium where they are thought to recognize major histocompatibility complex class I-presented (auto-)antigens. However, the latter still remain unidentified. Therefore, one key aim in AA research is to identify the clonotypes of autoaggressive, intralesional CD8+ T cells. Therapeutically, this is important (a) so that these lymphocytes can be selectively eliminated or inhibited, (b) to identify the-as yet elusive-key (auto-)antigens in AA, and/or (c) to induce peripheral tolerance against the latter. Therefore, we have recently embarked on a National Alopecia Areata Foundation-supported project that attempts to isolate disease-specific, intralesional CD8+ T cells from AA skin in order to determine their TCR clonotype, using two complementary strategies. The first method is based on the enzymatic skin digestion from lesional AA skin, followed by either MACS technology and single-cell picking or FACS cell sorting, while the second method on laser microdissection. The identification of disease-specific TCRs can serve as a basis for specific AA immunotherapy along the lines sketched above and may possibly also provide prognostic biomarkers. If successful, this research strategy promises to permit, at long last, the causal therapy of AA.
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16
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Xu Y, Liu J, Hua L, Xiao Y, Tian Y, Guo S, Zhang X, He C, Wang L, Yu Y. An immune regulatory CCT repeat containing oligodeoxynucleotide capable of causing hair loss in male mice. Hum Exp Toxicol 2016; 35:1161-1172. [PMID: 26764315 DOI: 10.1177/0960327115626579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An oligodeoxynucleotide with CCT repeats (CCT ODN) has been found in our previous study to selectively downregulate Toll-like receptor 7/9 (TLR7/9)-mediated immune responses both in vitro and in vivo. In this study, we unexpectedly found that CCT ODN induced severe patchy hair loss around the mouth in male F1 mice (female Balb/c × male C57BL/6) with lupus-like nephritis induced by injecting allogenic lymphocytes and also in male Balb/c mice, but not in female F1 mice and Balb/c mice and either gender of C57BL/6 mice. Increased infiltration of natural killer group 2, member D (NKG2D+) cells in hair loss skin and upregulated interferon-gamma (IFN-γ) messenger RNA expression in cultured splenocytes were observed in male Balb/c mice. The CCT ODN-conditioned supernatants of cultured mouse splenocytes caused catagen-like changes to hair follicles (HFs). We hypothesized that the CCT ODN could induce patchy hair loss in the male mice with certain genetic traits by mobilizing NKG2D+ cells to HFs and by inducing the production of IFN-γ from immune cells. Taken together these data indicated that a gender and genetic preference of immune-regulatory oligonucleotides is causing unexpected clinical situations such as hair loss.
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Affiliation(s)
- Y Xu
- 1 Department of Molecular Biology, College of Basic Medical Sciences, Norman Bethune Health Science Center, Jilin University, Changchun, Jilin, China
| | - J Liu
- 1 Department of Molecular Biology, College of Basic Medical Sciences, Norman Bethune Health Science Center, Jilin University, Changchun, Jilin, China
| | - L Hua
- 2 Department of Immunology, College of Basic Medical Sciences, Norman Bethune Unit of Medicine, Jilin University, Changchun, Jilin, China
| | - Y Xiao
- 1 Department of Molecular Biology, College of Basic Medical Sciences, Norman Bethune Health Science Center, Jilin University, Changchun, Jilin, China
| | - Y Tian
- 3 Department of Dermatology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - S Guo
- 1 Department of Molecular Biology, College of Basic Medical Sciences, Norman Bethune Health Science Center, Jilin University, Changchun, Jilin, China
| | - X Zhang
- 2 Department of Immunology, College of Basic Medical Sciences, Norman Bethune Unit of Medicine, Jilin University, Changchun, Jilin, China
| | - C He
- 2 Department of Immunology, College of Basic Medical Sciences, Norman Bethune Unit of Medicine, Jilin University, Changchun, Jilin, China
| | - L Wang
- 1 Department of Molecular Biology, College of Basic Medical Sciences, Norman Bethune Health Science Center, Jilin University, Changchun, Jilin, China
| | - Y Yu
- 2 Department of Immunology, College of Basic Medical Sciences, Norman Bethune Unit of Medicine, Jilin University, Changchun, Jilin, China
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17
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Smith SEP, Maus RLG, Davis TR, Sundberg JP, Gil D, Schrum AG. Maternal IL-6 can cause T-cell-mediated juvenile alopecia by non-scarring follicular dystrophy in mice. Exp Dermatol 2015; 25:223-8. [PMID: 26660334 DOI: 10.1111/exd.12914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 12/16/2022]
Abstract
Aiming to decipher immunological mechanisms of the autoimmune disorder alopecia areata (AA), we hypothesized that interleukin-6 (IL-6) might be associated with juvenile-onset AA, for which there is currently no experimental model. Upon intramuscular transgenesis to overexpress IL-6 in pregnant female C57BL/6 (B6) mice, we found that the offspring displayed an initial normal and complete juvenile hair growth cycle, but developed alopecia around postnatal day 18. This alopecia was patchy and reversible (non-scarring) and was associated with upregulation of Ulbp1 expression, the only mouse homolog of the human AA-associated ULBP3 gene. Alopecia was also associated with inflammatory infiltration of hair follicles by lymphocytes, including alpha-beta T cells, which contributed to surface hair loss. Despite these apparently shared traits with AA, lesions were dominated by follicular dystrophy that was atypical of human AA disease, sharing some traits consistent with B6 alopecia and dermatitis. Additionally, juvenile-onset alopecia was followed by complete, spontaneous recovery of surface hair, without recurrence of hair loss. Prolonging exposure to IL-6 prolonged the time to recovery, but once recovered, repeating high-dose IL-6 exposure de novo did not re-induce alopecia. These data suggest that although substantial molecular and cellular pathways may be shared, functionally similar alopecia disorders can occur via distinct pathological mechanisms.
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Affiliation(s)
- Stephen E P Smith
- Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Rachel L G Maus
- Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Tessa R Davis
- Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Diana Gil
- Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Adam G Schrum
- Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA
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Sundberg JP, McElwee K, Brehm MA, Su L, King LE. Animal Models for Alopecia Areata: What and Where? J Investig Dermatol Symp Proc 2015; 17:23-6. [PMID: 26551940 PMCID: PMC4722955 DOI: 10.1038/jidsymp.2015.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Disease is not limited to humans. Rather, humans are but another mammal in a continuum, and as such, often share similar if not identical diseases with other mammalian species. Alopecia areata (AA) is such a disease. Natural disease occurs in humans, nonhuman primates, many domestic animals, and laboratory rodents. However, to be useful as models of human disease, affected animals need to be readily available to the research community, closely resemble the human disease, be easy to work with, and provide reproducible data. To date, the laboratory mouse (most if not all of the C3H substrains) and the Dundee experimental bald rat fit these criteria. Manipulations using full-thickness skin grafts or specific immune cell transfers have improved the models. New mouse models that carry a variety of genetic-based immunodeficiencies can now be used to recapitulate the human immune system and allow for human full-thickness skin grafts onto mice to investigate human-specific mechanistic and therapeutic questions. These models are summarized here including where they can currently be obtained from public access repositories.
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Affiliation(s)
- John P. Sundberg
- The Jackson Laboratory, Bar Harbor, ME
- Department of Medicine, Division of Dermatology, Vanderbilt University, Nashville, TN
| | - Kevin McElwee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Michael A. Brehm
- Program in Molecular Medicine, Diabetes Center of Excellence, University of Massachusetts Medical School, Worcester, MA
| | - Lishan Su
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC
| | - Lloyd E. King
- Department of Medicine, Division of Dermatology, Vanderbilt University, Nashville, TN
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Ali N, Hosseini M, Vainio S, Taïeb A, Cario‐André M, Rezvani H. Skin equivalents: skin from reconstructions as models to study skin development and diseases. Br J Dermatol 2015; 173:391-403. [DOI: 10.1111/bjd.13886] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2015] [Indexed: 12/17/2022]
Affiliation(s)
- N. Ali
- Laboratory of Developmental Biology Faculty of Biochemistry and Molecular Medicine University of Oulu and Biocenter Oulu Aapistie 5A 90220 Oulu Finland
- Inserm U 1035 33076 Bordeaux France
- Université de Bordeaux 146 rue Léo Saignat 33076 Bordeaux France
| | - M. Hosseini
- Inserm U 1035 33076 Bordeaux France
- Université de Bordeaux 146 rue Léo Saignat 33076 Bordeaux France
| | - S. Vainio
- Laboratory of Developmental Biology Faculty of Biochemistry and Molecular Medicine University of Oulu and Biocenter Oulu Aapistie 5A 90220 Oulu Finland
| | - A. Taïeb
- Inserm U 1035 33076 Bordeaux France
- Université de Bordeaux 146 rue Léo Saignat 33076 Bordeaux France
- Centre de Référence pour les Maladies Rares de la Peau Bordeaux France
- Département de Dermatologie & Dermatologie Pédiatrique CHU de Bordeaux Bordeaux France
| | - M. Cario‐André
- Inserm U 1035 33076 Bordeaux France
- Université de Bordeaux 146 rue Léo Saignat 33076 Bordeaux France
- Centre de Référence pour les Maladies Rares de la Peau Bordeaux France
| | - H.R. Rezvani
- Inserm U 1035 33076 Bordeaux France
- Université de Bordeaux 146 rue Léo Saignat 33076 Bordeaux France
- Centre de Référence pour les Maladies Rares de la Peau Bordeaux France
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Abstract
INTRODUCTION Hair loss or alopecia affects the majority of the population at some time in their life, and increasingly, sufferers are demanding treatment. Three main types of alopecia (androgenic [AGA], areata [AA] and chemotherapy-induced [CIA]) are very different, and have their own laboratory models and separate drug-discovery efforts. AREAS COVERED In this article, the authors review the biology of hair, hair follicle (HF) cycling, stem cells and signaling pathways. AGA, due to dihydrotesterone, is treated by 5-α reductase inhibitors, androgen receptor blockers and ATP-sensitive potassium channel-openers. AA, which involves attack by CD8(+)NK group 2D-positive (NKG2D(+)) T cells, is treated with immunosuppressives, biologics and JAK inhibitors. Meanwhile, CIA is treated by apoptosis inhibitors, cytokines and topical immunotherapy. EXPERT OPINION The desire to treat alopecia with an easy topical preparation is expected to grow with time, particularly with an increasing aging population. The discovery of epidermal stem cells in the HF has given new life to the search for a cure for baldness. Drug discovery efforts are being increasingly centered on these stem cells, boosting the hair cycle and reversing miniaturization of HF. Better understanding of the molecular mechanisms underlying the immune attack in AA will yield new drugs. New discoveries in HF neogenesis and low-level light therapy will undoubtedly have a role to play.
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Affiliation(s)
- Zenildo Santos
- Massachusetts General Hospital, Wellman Center for Photomedicine , Boston, MA 02114 , USA +1 617 726 6182 ; +1 617 726 6643 ;
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