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Treatment of alopecia areata: "What is new on the horizon?"

Maria K Hordinsky1

  • 1Department of Dermatology, University of Minnesota, Minneapolis, Minnesota 55455, USA. hordi001@umn.edu

Dermatologic Therapy
|June 22, 2011
PubMed

Insights

New research on alopecia areata implicates T cell and NK-cell activation pathways. Targeting ULBP3 gene cluster and NKG2D receptor interactions offers promising new therapeutic strategies for this autoimmune condition.

Area of Science:

  • Immunology
  • Genetics
  • Dermatology

Background:

  • Alopecia areata is an autoimmune disease targeting hair follicles.
  • Genome-wide association studies suggest T cell and natural killer (NK)-cell activation pathways are involved.
  • The ULBP3 gene cluster on chromosome 6q25 plays a role in immune response.

Purpose of the Study:

  • To explore new drug treatment opportunities for alopecia areata.
  • To investigate the role of the ULBP3 gene cluster and NKG2D receptor in alopecia areata pathogenesis.
  • To identify potential therapeutic targets for future clinical trials.

Main Methods:

  • Genome-wide association study analysis.
  • Examination of ULBP3 gene expression in scalp biopsy specimens.
  • Postulation of T cell attraction to hair follicles via NKG2D-activating ligands.

Main Results:

  • T cell and NK-cell activation pathways are implicated in alopecia areata.
  • Increased ULBP3 expression is observed in hair follicles of patients with active disease.
  • NKG2D-activating ligands may attract T cells to hair follicles, causing the characteristic "swarm of bees" infiltrate.

Conclusions:

  • Targeting the interaction between NKG2D-activating ligands and the NKG2D receptor presents a potential therapeutic strategy.
  • Inhibiting activated T cells or modifying the inflammatory cytokine network are other viable treatment approaches.
  • Drugs used for other autoimmune diseases may be effective for alopecia areata.

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