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The Contributory Roles of Th17 Lymphocyte and Cytotoxic T Lymphocyte at the Hair Bulge Region as Well as the Hair Bulb Area in the Chronic Alopecia Areata Patients

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ABSTRACT

Background: Alopecia areata (AA) is a T cell-mediated autoimmune disease that targets hair follicles and interrupts hair regrowth. The microenvironment of the effector T cells and their related cytokines may affect immunopathogenesis around the hair bulb/bulge.

Objective: To determine the contributory roles of the effector T cell subsets and related cytokines to the pathogenesis of AA.

Methods: We investigated the correlation between histopathological grades and four clinical prognostic factors in 331 patients with AA, and analyzed the topography of T cell infiltrates and related cytokines around the hair bulb/bulge according to histopathological grades through immunohistochemical and double immunofluorescence studies on a subset of AA specimens.

Results: First, the groups with more severe histopathological grades were associated with earlier onset, longer duration, more hair loss, as well as poorer therapeutic outcomes. Second, the pattern of CD4 and CD8 expression around the hair bulb/bulge varied by histopathological grade, with staining density decreasing in the following order: type 1>type 2>type 3. In addition, interferon-γ and transforming growth factor-β1 expression appeared denser in the peribulbar area. Interestingly, the denser CCR6+ cells (Th17 cells) showed more infiltration than CCR5+ cells (Th1 cells) around the hair bulb/bulge as histopathological grade worsened.

Conclusion: The insidious destruction of bulge stem cells and hair bulb matrix stem cells results in more severe hair loss in patients with chronic AA, which is mediated by Th17 lymphocyte and cytotoxic T lymphocyte infiltration. Furthermore, Th17 lymphocytes may play an even more important role than cytotoxic T cells in the development of AA.

No MeSH data available.


Expression of CCR6 and CCL20 within type 1 hair bulges (A~C), type 2 hair bulges (D~F), and type 3 hair bulges (G~I).
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Figure 5: Expression of CCR6 and CCL20 within type 1 hair bulges (A~C), type 2 hair bulges (D~F), and type 3 hair bulges (G~I).

Mentions: By double immunofluorescence, CCR6+ lymphocytes infiltrated the intra- or peri-bulbar areas (Bb) in a denser pattern with greater histopathology (Fig. 3), and CCL20 was expressed in epithelial cells of the hair bulb. CCR5+ lymphocytes also infiltrated at intra- or peri-bulbar areas (Bb) in a denser pattern with greater histopathology (Fig. 4). More specifically, CCR6+ lymphocytes also infiltrated at the bulge region (Bg), and with greater histopathology showed denser infiltration of CCR6+ lymphocytes (Fig. 5).


The Contributory Roles of Th17 Lymphocyte and Cytotoxic T Lymphocyte at the Hair Bulge Region as Well as the Hair Bulb Area in the Chronic Alopecia Areata Patients
Expression of CCR6 and CCL20 within type 1 hair bulges (A~C), type 2 hair bulges (D~F), and type 3 hair bulges (G~I).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383740&req=5

Figure 5: Expression of CCR6 and CCL20 within type 1 hair bulges (A~C), type 2 hair bulges (D~F), and type 3 hair bulges (G~I).
Mentions: By double immunofluorescence, CCR6+ lymphocytes infiltrated the intra- or peri-bulbar areas (Bb) in a denser pattern with greater histopathology (Fig. 3), and CCL20 was expressed in epithelial cells of the hair bulb. CCR5+ lymphocytes also infiltrated at intra- or peri-bulbar areas (Bb) in a denser pattern with greater histopathology (Fig. 4). More specifically, CCR6+ lymphocytes also infiltrated at the bulge region (Bg), and with greater histopathology showed denser infiltration of CCR6+ lymphocytes (Fig. 5).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Alopecia areata (AA) is a T cell-mediated autoimmune disease that targets hair follicles and interrupts hair regrowth. The microenvironment of the effector T cells and their related cytokines may affect immunopathogenesis around the hair bulb/bulge.

Objective: To determine the contributory roles of the effector T cell subsets and related cytokines to the pathogenesis of AA.

Methods: We investigated the correlation between histopathological grades and four clinical prognostic factors in 331 patients with AA, and analyzed the topography of T cell infiltrates and related cytokines around the hair bulb/bulge according to histopathological grades through immunohistochemical and double immunofluorescence studies on a subset of AA specimens.

Results: First, the groups with more severe histopathological grades were associated with earlier onset, longer duration, more hair loss, as well as poorer therapeutic outcomes. Second, the pattern of CD4 and CD8 expression around the hair bulb/bulge varied by histopathological grade, with staining density decreasing in the following order: type 1>type 2>type 3. In addition, interferon-γ and transforming growth factor-β1 expression appeared denser in the peribulbar area. Interestingly, the denser CCR6+ cells (Th17 cells) showed more infiltration than CCR5+ cells (Th1 cells) around the hair bulb/bulge as histopathological grade worsened.

Conclusion: The insidious destruction of bulge stem cells and hair bulb matrix stem cells results in more severe hair loss in patients with chronic AA, which is mediated by Th17 lymphocyte and cytotoxic T lymphocyte infiltration. Furthermore, Th17 lymphocytes may play an even more important role than cytotoxic T cells in the development of AA.

No MeSH data available.