Department of Dermatology, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Dermatology, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA; Gates Center for Regenerative Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
J Invest Dermatol. 2020 Jan;140(1):29-37. doi: 10.1016/j.jid.2019.03.1142. Epub 2019 Jun 10.
Vitiligo and alopecia areata (AA) are common autoimmune conditions characterized by white spots on the skin (vitiligo) and bald spots on the scalp (AA), which significantly impact patients' lives by damaging their appearance and function. Melanocytes are the target of immune destruction in vitiligo and are hypothesized to be the site of immune attack in AA. This inflammatory process can be partially reversed by immunosuppressive drugs. Both conditions demonstrate regenerative components that are just now being identified. In this review, we focus on the regenerative medicine aspects of vitiligo and AA, using experimental data from human, mouse, and in vitro models, summarizing the key pathways involved in repopulation of the epidermis with melanocytes in vitiligo and in regrowth of hair follicles in AA. We also discuss treatments that may activate these pathways. Of the regenerative treatments, JAK inhibitors and bimatoprost stimulate repopulation of depleted cells in both diseases, intralesional injections of autologous concentrated platelet-rich plasma and minoxidil showed some benefit in AA, and phototherapy with narrowband UVB was shown to be effective especially in vitiligo. Finally, we discuss future treatments based on the mobilization of stem cells to regenerate anagen hair follicles in AA and intraepidermal melanocytes in vitiligo.
白癜风和斑秃（AA）是常见的自身免疫性疾病，其特征是皮肤出现白斑（白癜风）和头皮出现秃斑（AA），这些疾病严重影响了患者的生活，损害了他们的外貌和功能。黑素细胞是白癜风中免疫破坏的靶标，据推测也是 AA 中免疫攻击的部位。这个炎症过程可以部分被免疫抑制药物逆转。这两种疾病都表现出再生成分，而这些成分才刚刚被确定。在这篇综述中，我们重点关注白癜风和 AA 的再生医学方面，使用来自人类、小鼠和体外模型的实验数据，总结了在白癜风中表皮内黑素细胞再增殖和 AA 中毛囊再生长中涉及的关键途径。我们还讨论了可能激活这些途径的治疗方法。在再生治疗中，JAK 抑制剂和比马前列素刺激两种疾病中耗竭细胞的再增殖，局部注射自体浓缩血小板富血浆和米诺地尔在 AA 中显示出一定的益处，窄带 UVB 光疗在白癜风中尤其有效。最后，我们根据动员干细胞来再生 AA 中的生长期毛囊和白癜风中的表皮内黑素细胞讨论未来的治疗方法。
