Alopecia areata (AA) is a chronic relapsing inflammatory disorder characterised by non-scarring hair loss on the scalp and/or body. As Prof. Wilma Bergfeld of the Cleveland Clinic indicated, in healthy subjects there is an immune privilege of the hair follicle . A loss of this immune privilege leads to AA.
Genome-wide association studies implicated ligands for the Natural Killer Group 2D (NKG2D) receptor (a product of the KLRK1 gene) in disease pathogenesis . In a murine model of AA, a type I cytotoxic pathway has been demonstrated as responsible for the disease state, with NKG2D-expressing CD8+ cytolytic T-lymphocytes necessary for the induction of the disease. Upregulation of IL-15 in the outer root sheath of the hair follicle activates cytolytic T-lymphocytes, which in turn produce Interferon (IFN)γ, leading to activation of the hair follicle and upregulation of IL-15, NKG2D ligands, and major histocompatibility complex (MHC) molecules, all of which target the hai...
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