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Hair Follicle Melanocytes Initiate Autoimmunity in Alopecia Areata: a Trigger Point

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Abstract

Alopecia areata (AA) is characterized by common non-scarring alopecia due to autoimmune disorders. To date, the specific pathogenesis underlying AA remains unknown. Thus, AA treatment in the dermatological clinic is still a challenge. Numerous clinical observations and experimental studies have established that melanocytes may be the trigger point that causes hair follicles to be attacked by the immune system. A possible mechanism is that the impaired melanocytes, under oxidative stress, cannot be repaired in time and causes apoptosis. Melanocyte-associated autoantigens are released and presented, inducing CD8+ T cell attacks. Thereafter, amplification of the immune responses further spreads to the entire hair follicle (HF). The immune privilege of HF subsequently collapses, leading to AA. Herein, we present a narrative review on the roles of melanocytes in AA pathogenesis, aiming to provide a better understanding of this disease from the melanocyte’s perspective.

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Funding

This work was supported by the National Natural Science Foundation of China (No. 81872517); Hangzhou Medical Key Discipline Construction Project (No. (2021)21–3); and Science and Technology Special Project of Biomedicine and Health Industry in Hangzhou (No. 2021WJCY156).

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  1. Department of Dermatology, Hangzhou Third People’s Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, West Lake Ave 38, Hangzhou, 310009, People’s Republic of China

    Bo Xie & Xiuzu Song

  2. Graduate School, Zhejiang Chinese Medical University, Binwen Rd 548, Hangzhou, 310053, People’s Republic of China

    Jiayi Sun

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Bo Xie, Jiayi Sun, and Xiuzu Song drafted the manuscript. All the authors edited and approved the final version of the manuscript.

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Xie, B., Sun, J. & Song, X. Hair Follicle Melanocytes Initiate Autoimmunity in Alopecia Areata: a Trigger Point. Clinic Rev Allerg Immunol 63, 417–430 (2022). https://doi.org/10.1007/s12016-022-08954-w

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