Tobin Desmond J
Department of Biomedical Sciences, University of Bradford, Bradford, England.
J Investig Dermatol Symp Proc. 2003 Oct;8(2):176-81. doi: 10.1046/j.1087-0024.2003.00805.x.
Alopecia areata is a common disfiguring hair loss disorder that primarily affects the hair follicle as it enters the prolonged growth phase called anagen. The last few years have yielded an explosion of more rigorously obtained data on the etiology and pathogenesis of this disorder. While a consensus is rapidly building in support of an autoimmune pathogenesis, there are still several enigmatic issues to be resolved. These include the possibility that alopecia areata is really a multientity disorder with causes that are multifactorial. This will have important implications for the research scientist's search for the jigsaw puzzle's largest missing piece--the identification of the target autoantigen(s). There is now much evidence that autoimmune diseases with both T and B cell components have shared target autoantigens/epitopes. It is likely that alopecia areata is similar, as there is now very strong evidence for the generation of autoantibodies as well as autoreactive T cells to hair follicles in the pathogenesis of this disease. The following brief review outlines the progress we have made over the last five to ten years in the characterization of hair follicle antigens targeted by antibodies in alopecia areata. Results of these studies now show that the elicitation of antibodies to hair follicle-specific proteins is a highly conserved phenomenon in all affected species studied to date. Candidate autoantigens that have been identified include the 44/46 kDa hair-specific keratin (expressed in the precortical zone of anagen hair follicles) and trichohyalin (an important intermediate filament-associated protein) expressed in the inner root sheath of the growing hair follicle. Moreover, there is evidence that anti-hair follicle antibodies are modulated during the disease process, can occur before clinically detectable hair loss, and may be reduced in titer during successful treatment. Preliminary data from passive transfer experiments suggest that in some species these antibodies may disrupt hair cycling. We are currently applying a more molecular approach (e.g., cDNA library screening) to identify hair follicle antigens truly associated with the onset of the disorder.
斑秃是一种常见的导致容貌受损的脱发疾病,主要影响进入称为生长期的延长生长阶段的毛囊。在过去几年中,关于这种疾病的病因和发病机制,已产生了大量经过更严格获取的数据。虽然迅速形成了支持自身免疫发病机制的共识,但仍有几个谜一般的问题有待解决。这些问题包括斑秃实际上可能是一种具有多因素病因的多实体疾病的可能性。这对于研究科学家寻找拼图中最大的缺失部分——鉴定靶自身抗原——将具有重要意义。现在有很多证据表明,具有T细胞和B细胞成分的自身免疫性疾病具有共同的靶自身抗原/表位。斑秃可能类似,因为现在有非常有力的证据表明,在这种疾病的发病机制中,会产生针对毛囊的自身抗体以及自身反应性T细胞。以下简要综述概述了我们在过去五到十年中在斑秃中抗体靶向的毛囊抗原表征方面取得的进展。这些研究结果现在表明,针对毛囊特异性蛋白质产生抗体是迄今为止所有研究的受影响物种中高度保守的现象。已鉴定出的候选自身抗原包括44/46 kDa毛发特异性角蛋白(在生长期毛囊的皮质前区表达)和在生长中的毛囊内根鞘中表达的毛透明蛋白(一种重要的中间丝相关蛋白)。此外,有证据表明抗毛囊抗体在疾病过程中受到调节,可在临床上可检测到脱发之前出现,并且在成功治疗期间可能滴度降低。被动转移实验的初步数据表明,在某些物种中,这些抗体可能会扰乱毛发周期。我们目前正在应用一种更具分子性的方法(例如cDNA文库筛选)来鉴定与该疾病发病真正相关的毛囊抗原。