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Yamaguchi HL, Yamaguchi Y, Peeva E. Pathogenesis of Alopecia Areata and Vitiligo: Commonalities and Differences. Int J Mol Sci 2024; 25:4409. [PMID: 38673994 PMCID: PMC11049978 DOI: 10.3390/ijms25084409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/13/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Both alopecia areata (AA) and vitiligo are distinct, heterogenous, and complex disease entities, characterized by nonscarring scalp terminal hair loss and skin pigment loss, respectively. In AA, inflammatory cell infiltrates are in the deep reticular dermis close to the hair bulb (swarm of bees), whereas in vitiligo the inflammatory infiltrates are in the epidermis and papillary dermis. Immune privilege collapse has been extensively investigated in AA pathogenesis, including the suppression of immunomodulatory factors (e.g., transforming growth factor-β (TGF-β), programmed death-ligand 1 (PDL1), interleukin-10 (IL-10), α-melanocyte-stimulating hormone (α-MSH), and macrophage migration inhibitory factor (MIF)) and enhanced expression of the major histocompatibility complex (MHC) throughout hair follicles. However, immune privilege collapse in vitiligo remains less explored. Both AA and vitiligo are autoimmune diseases that share commonalities in pathogenesis, including the involvement of plasmacytoid dendritic cells (and interferon-α (IFN- α) signaling pathways) and cytotoxic CD8+ T lymphocytes (and activated IFN-γ signaling pathways). Blood chemokine C-X-C motif ligand 9 (CXCL9) and CXCL10 are elevated in both diseases. Common factors that contribute to AA and vitiligo include oxidative stress, autophagy, type 2 cytokines, and the Wnt/β-catenin pathway (e.g., dickkopf 1 (DKK1)). Here, we summarize the commonalities and differences between AA and vitiligo, focusing on their pathogenesis.
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Affiliation(s)
| | - Yuji Yamaguchi
- Inflammation & Immunology Research Unit, Pfizer, Collegeville, PA 19426, USA
| | - Elena Peeva
- Inflammation & Immunology Research Unit, Pfizer, Cambridge, MA 02139, USA;
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Li Y, Yang M, Zhang R, Liu W, Zhang K, Wen W, Yi L, Wang Q, Hao M, Yang H, Chang J, Li J. Evaluation of serum immunoglobulins concentrations and distributions in vitiligo patients. Immunol Res 2017; 64:1150-1156. [PMID: 27417998 DOI: 10.1007/s12026-016-8809-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Vitiligo is a dermatological disorder with an autoimmune mechanism characterized by production of a variety of autoantibodies. Different levels of immunoglobulins can indicate the presence and the stage of some autoimmune diseases. We aimed to investigate serum IgA, IgM and IgG subclass levels and melanocyte-reactive antibodies in 65 vitiligo patients by the immunonephelometric assay (35 healthy people as controls). Compared with normal controls, a significant increase in total IgG, IgG1 and IgG2 (p = .005, p = .003 and p = .043, respectively) was observed in progressive nonsegmental vitiligo patients. Also, we found a significant decrease in IgG3 (p = .000 and p = .023) in progressive nonsegmental vitiligo patients and segmental patients. Moreover, we found the serum levels of IgG4 subclass in stable nonsegmental patients were significantly higher than those in normal controls (p = .018). Compared with controls, the positive rates of melanocyte-reactive antibodies were higher in progressive nonsegmental patients and stable nonsegmental patients (p = .032 and p = .046, respectively). Furthermore, we found higher level of IgG4 and lower level of IgM in male than those in female. Higher IgG1 level was also observed in patients with a family history than in those without a family history. In addition, there was a significant inverse correlation between the concentrations of IgG4 and disease duration. Our evaluation about the level of immunoglobulins might provide a useful insight into the pathological process of vitiligo.
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Affiliation(s)
- Yulong Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Min Yang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Rui Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Wan Liu
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Kuo Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Wei Wen
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Lang Yi
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Qiaoxian Wang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Mingju Hao
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hui Yang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China
| | - Jianmin Chang
- Department of Dermatology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.
| | - Jinming Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730, People's Republic of China. .,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
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Abstract
While some autoimmune disorders remain extremely rare, others largely predominate the epidemiology of human autoimmunity. Notably, these include psoriasis, diabetes, vitiligo, thyroiditis, rheumatoid arthritis and multiple sclerosis. Thus, despite the quasi-infinite number of "self" antigens that could theoretically trigger autoimmune responses, only a limited set of antigens, referred here as superautoantigens, induce pathogenic adaptive responses. Several lines of evidence reviewed in this paper indicate that, irrespective of the targeted organ (e.g. thyroid, pancreas, joints, brain or skin), a significant proportion of superautoantigens are highly expressed in the synaptic compartment of the central nervous system (CNS). Such an observation applies notably for GAD65, AchR, ribonucleoproteins, heat shock proteins, collagen IV, laminin, tyrosine hydroxylase and the acetylcholinesterase domain of thyroglobulin. It is also argued that cognitive alterations have been described in a number of autoimmune disorders, including psoriasis, rheumatoid arthritis, lupus, Crohn's disease and autoimmune thyroiditis. Finally, the present paper points out that a great majority of the "incidental" autoimmune conditions notably triggered by neoplasms, vaccinations or microbial infections are targeting the synaptic or myelin compartments. On this basis, the concept of an immunological homunculus, proposed by Irun Cohen more than 25 years ago, is extended here in a model where physiological autoimmunity against brain superautoantigens confers both: i) a crucial evolutionary-determined advantage via cognition-promoting autoimmunity; and ii) a major evolutionary-determined vulnerability, leading to the emergence of autoimmune disorders in Homo sapiens. Moreover, in this theoretical framework, the so called co-development/co-evolution model, both the development (at the scale of an individual) and evolution (at the scale of species) of the antibody and T-cell repertoires are coupled to those of the neural repertoires (i.e. the distinct neuronal populations and synaptic circuits supporting cognitive and sensorimotor functions). Clinical implications and future experimental insights are also presented and discussed.
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Affiliation(s)
- Serge Nataf
- Bank of Tissues and Cells, Lyon University Hospital (Hospices Civils de Lyon), CarMeN Laboratory, INSERM 1060, INRA 1397, INSA Lyon, Université Claude Bernard Lyon-1, Lyon, F-69000, France
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Dainichi T, Kabashima K. Alopecia areata: What's new in epidemiology, pathogenesis, diagnosis, and therapeutic options? J Dermatol Sci 2016; 86:3-12. [PMID: 27765435 DOI: 10.1016/j.jdermsci.2016.10.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
Abstract
Alopecia areata (AA) is a common and stressful disorder that results in hair loss, and resistant to treatment in some cases. Experimental and clinical evidence suggests that AA is caused by autoimmune attack against the hair follicles. The precise pathomechanism, however, remains unknown. Here, we focus on the recent progress in multidisciplinary approaches to the epidemiology, pathogenesis, and new treatments of AA in 996 publications from January 2010 to July 2016, and provide an overview of the current understanding in clinical management and research directions.
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Affiliation(s)
- Teruki Dainichi
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Singapore Immunology Network (SIgN) and Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore; PRESTO, Japan Science and Technology Agency, Kawaguchi, Japan
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Avalos-Díaz E, Pérez-Pérez E, Rodríguez-Rodríguez M, Pacheco-Tovar MG, Herrera-Esparza R. Autoimmune vitiligo in rheumatic disease in the mestizo Mexican population. Biomed Rep 2016; 5:176-180. [PMID: 27446537 PMCID: PMC4950649 DOI: 10.3892/br.2016.700] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/01/2016] [Indexed: 12/27/2022] Open
Abstract
Vitiligo is a chronic disease characterized by the dysfunction or destruction of melanocytes with secondary depigmentation. The aim of the present study was to determine the prevalence of vitiligo associated with autoimmune rheumatic diseases. The clinical records from a 10-year database of patients with rheumatic diseases and associated vitiligo was analysed, with one group of patients having autoimmune rheumatic disease and another non-autoimmune rheumatic disease. Available serum samples were used to assess the anti-melanocyte antibodies. A total of 5,251 individual clinical files were archived in the last 10 years, and these patients underwent multiple rheumatology consultations, with 0.3% of the group presenting with vitiligo. The prevalence of vitiligo in the autoimmune rheumatic disease group was 0.672%, which was mainly associated with lupus and arthritis. However, patients with more than one autoimmune disease had an increased relative risk to develop vitiligo, and anti-melanocyte antibodies were positive in 92% of these patients. By contrast, the prevalence was 0.082% in the group that lacked autoimmune rheumatic disease and had negative autoantibodies. In conclusion, the association between vitiligo and autoimmune rheumatic diseases was relatively low. However, the relative risk increased when there were other autoimmune comorbidities, such as thyroiditis or celiac disease. Therefore, the presence of multiple autoimmune syndromes should be suspected.
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Affiliation(s)
- Esperanza Avalos-Díaz
- Department of Immunology, UACB, Universidad Autónoma de Zacatecas, Zacatecas 98040, Mexico
| | - Elena Pérez-Pérez
- Department of Immunology, UACB, Universidad Autónoma de Zacatecas, Zacatecas 98040, Mexico
| | | | | | - Rafael Herrera-Esparza
- Department of Immunology, UACB, Universidad Autónoma de Zacatecas, Zacatecas 98040, Mexico
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