Żeberkiewicz Marta, Rudnicka Lidia, Malejczyk Jacek
Department of Histology and Embryology, Center for Biostructure Research, Medical University of Warsaw, Warsaw, Poland.
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
Cent Eur J Immunol. 2020;45(3):325-333. doi: 10.5114/ceji.2020.101264. Epub 2020 Nov 1.
Alopecia areata is a condition that affects hair follicles and leads to hair loss ranging from small well-defined patches to complete loss of all body hair. Despite its high incidence, the pathobiology is not fully understood, and no single concept could be universally accepted. Alopecia areata is mostly considered to be an autoimmune disease, in which the collapse of hair follicle immune privilege plays a key role. Higher incidence rate in the female population and increased overall risk of other autoimmune disorders militate in favor of autoimmune hypothesis. Antibodies against multiple components of hair follicles almost exclusively attack in anagen phase, where melanogenesis takes place. It suggests involvement of melanogenesis-associated autoantigens as a target epitope. Some investigators believed that alopecia areata is not a truly autoimmune disease but is only 'consistent with' autoimmune mechanisms. High frequency of a positive family history up to 42% may reflects the contribution of heredity factors. In addition, no specific target autoantigen has been identified so far, and autoantibodies to hair follicle-associated antigens are detectable in normal individuals.
斑秃是一种影响毛囊并导致脱发的疾病，脱发范围从小的边界清晰的斑块到全身毛发完全脱落。尽管其发病率很高，但其病理生物学尚未完全了解，没有一个单一的概念能被普遍接受。斑秃大多被认为是一种自身免疫性疾病，其中毛囊免疫特权的丧失起关键作用。女性人群中较高的发病率以及其他自身免疫性疾病总体风险的增加支持了自身免疫假说。针对毛囊多种成分的抗体几乎只在黑素生成发生的生长期进行攻击。这表明与黑素生成相关的自身抗原作为靶表位参与其中。一些研究人员认为斑秃并非真正的自身免疫性疾病，而只是“符合”自身免疫机制。高达42%的阳性家族史高频率可能反映了遗传因素的作用。此外，迄今为止尚未确定特异性的靶自身抗原，且在正常个体中也可检测到针对毛囊相关抗原的自身抗体。
