Understanding autoimmunity of vitiligo and alopecia areata

Current Opinion in Pediatrics - Tập 28 Số 4 - Trang 463-469 - 2016
Jillian F. Rork1, Mehdi Rashighi1, John E. Harris1,2,3,4
1Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
2e-mail: [email protected]
3fax: +1 508 856 5463
4to John E. Harris, Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, LRB 225, 364 Plantation Street, Worcester, MA 01605, USA. Tel: +1 508 856 1982

Tóm tắt

Purpose of review Vitiligo and alopecia areata are common, disfiguring skin diseases. Treatment options are limited and include nontargeted approaches, such as corticosteroids, topical calcineurin inhibitors, narrow band ultraviolet B phototherapy, and other immune-modifying agents. The purpose of this article is to review shared, novel mechanisms between vitiligo and alopecia areata, as well as discuss how they inform the development of future targeted treatments. Recent findings Vitiligo and alopecia areata are both autoimmune diseases, and striking similarities in pathogenesis have been identified at the level of both the innate and adaptive immune system. Increased reactive oxygen species and high cellular stress level have been suggested as the initiating trigger of the innate immune system in both diseases, and genome-wide association studies have implicated risk alleles that influence both innate and adaptive immunity. Most importantly, mechanistic studies in mouse models of vitiligo and alopecia areata have specifically implicated an interferon (IFN)γ-driven immune response, including IFNγ, IFNγ-induced chemokines, and cytotoxic CD8+ T cells as the main drivers of disease pathogenesis. These recent discoveries may reveal an effective strategy to develop new treatments, and several proof-of-concept clinical studies support this hypothesis. Summary The identification of IFNγ-driven immune signaling pathways has enabled discoveries of potential new treatments for vitiligo and alopecia areata, and supports initiation of larger clinical trials.

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Current Opinion in Pediatrics

Tập 28 Số 4

463-469

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