Drug Discovery Opinion

Alopecia areata is a type of hair loss that typically begins with one or more small bald patches on the scalp, beard area or elsewhere. The patches appear quite quickly and the hair may re-grow after a few months – or the condition may persist for several years with recurrences of patchy baldness and hair re-growth. The condition can also result in total loss of scalp hair (alopecia totalis) and, in a small number of cases, total loss of all body hair (alopecia universalis).

Alopecia areata is thought to be an autoimmune disease in which the immune system attacks the hair follicle, although the follicle is not destroyed since hair can re-grow. There also appears to be a hereditary component to the disease and a team lead by investigators at Columbia University Medical Center has now identified eight regions in the genome that are linked to the condition. The associated regions include some that have been linked to other autoimmune diseases including type I diabetes, rheumatoid arthritis, systemic lupus erythematosus, celiac disease, and systemic sclerosis. Of particular interest for its potential role in the onset of disease is the ULBP (cytomegalovirus UL16-binding protein) gene cluster that has not previously been associated with autoimmune disease. Expression of ULBP3 proteins, which act as activating ligands for the NKG2D receptor on natural killer cells, is markedly upregulated in hair follicles affected by alopecia areata.

The study is published in the journal Nature.

Since drugs that target some of the pathways involved in alopecia areata have already been developed to treat other autoimmune diseases, the researchers hope that their discovery will lead quickly to treatments for hair loss caused by alopecia areata. The team are also developing a genetic test that should be able to help predict the likely course of the disease in a particular individual.

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