A team of noted scientists has released a report into the causes of Alopecia Areata, the autoimmune disorder that usually leads to sudden, patchy hair loss. The work is set to inch the medical community ever nearer to a much more complete understanding of the condition.
The team comprises C. Herbert Pratt from the Department of Genetic Resource Sciences at the Jackson Laboratory in Maine, Lloyd E. King and John P Sundberg from the Vanderbilt University Medical Centre in Nashville, and two names well-known to anyone with an interest in thinning hair: dermatology expert Angela M. Christiano of Columbia University in New York and the UK’s Andrew G. Messenger from the Royal Hallamshire Hospital in Sheffield.
Given the team's credentials, the new paper on Alopecia Areata a condition which will affect up to two per cent of the population in their lifetime is being taken very seriously.
In it, the doctors explain how recent advances in the understanding of the molecular mechanisms of the condition have revealed new treatments and the possibility of remission in the near future. The team explains how skin biopsies of affected skin show a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in the anagen (growing) phase.
It further states that: “Genetic studies in patients and mouse models have shown that Alopecia Areata is a complex, polygenic disease. Several genetic susceptibility loci were identified to be associated with signalling pathways that are important to hair follicle cycling and development.”
What this means is that Alopecia Areata is caused not by a single gene but the combined action of more than one gene meaning it is similar in some ways to diabetes. In fact, one immunologist has suggested the condition is a kind of “diabetes of the hair follicle.”
Belgravia uses currently available Alopecia Areata treatment options, based around topical applications of recommended formulations of high strength minoxidil. This approach is generally suitable for male and female patients aged 16 years and over, and has certainly seen many success stories.
What the new report does is pave the way for new treatments which come at Alopecia Areata from a different angle, and few people seem to have been as instrumental in the development of these as Angela M. Christiano, one of the co-authors of the paper. Dr Christiano, pictured, has perhaps been more motivated than many in her field because she personally struggled with the autoimmune condition and has dedicated much of her career to helping people like her who have experienced thinning hair.
One of the products that she has been especially involved with is the JAK inhibitor drug ruxolitinib, developed to treat myelofibrosis (a rare bone marrow cancer) that has shown itself to be exceptionally promising as a possible future treatment option for people with severe forms of Alopecia Areata, including its rare related conditions Alopecia Universalis, which leads to total hair loss on the head, and Alopecia Totalis, which causes the complete loss of hair on the entire body - both of which are currently untreatable.
A small clinical trial into the use of ruxolitinib was recently overseen by Dr Christiano at Columbia University in New York, where her pioneering team is based. In the trial, three-quarters of the patients demonstrated what was deemed “a remarkable response to treatment” by the doctors, with an average regrowth rate of 92 per cent.
Importantly, the team states that no serious adverse effects were reported. This is significant, as questions about the safety of powerful drugs like ruxolitinib linger and may prove to count against the drug or any derivatives if these fears prove to be warranted during any attempts to take the product to market as a treatment for Alopecia Areata. Should wider ranging, larger scale clinical trials provide satisfactory results on safety, tolerability and efficacy, the expected release date is currently estimated at 2020/2021.
Unfortunately, at present, both ruxolitinib and tofacitinib another JAK inhibitor that is being tested for its potential as a cure for Alopecia Areata are expensive, with figures in excess of $4,000 for a pack of 60 Xeljanz (tofacitinib) and over $11,500 for a 60 pack of Jakafi (ruxolitinib) quoted on drugs.com.
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