Hope for alopecia areata sufferers?

Alopecia areata strikes one or two people in every 1,000 in the UK and can occur at any age, affecting men and women equally. Yet, despite the reach of this autoimmune-related hair loss disease, there are no clinically-proven treatments. Current research is now aimed at investigating genetic therapies.

The hair loss condition typically presents as small, circular patches of baldness on the scalp. In most instances, hair will regrow back, but they may reoccur, appear elsewhere on the scalp or develop into a more severe form of hair loss such as alopecia totalis, which means total loss of hair on the scalp, or total hair loss across scalp and body, known as alopecia universalis.

What causes alopecia areata?

Alopecia areata is an autoimmune disease whereby the immune system, which should protect your body from disease, starts to attacks healthy tissue such as the hair cells which should be resistant. As immune cells invade the hair follicle, it forces the follicle from the growth phase of the hair cycle, switching off production and pigmentation function.

The precise trigger for alopecia areata is unknown, although genetic susceptibility is considered a factor, which has made developing an effective therapy challenging. The available treatments, such as cortisone injections, suppress the immune system. However, these work temporarily and do not restore immunity to the hair follicles.

The future of alopecia areata treatments

Genetic therapy which interferes with the signaling pathways is now a hot topic of alopecia areata research. In 2014, geneticists at Columbia University, New York, released early-stage research that found positive results in using the Janus Kinase (JAK) inhibitor Ruxolitinib to block the signals that instruct the immune cells to attack. Initially developed to treat bone marrow cancer, the study found that it restored hair growth in three patients that had suffered from a severe form of alopecia areata for many years.

Another drug, Tofacitinib Citrate, developed to treat the autoimmune condition rheumatoid arthritis, also inhibits the JAK pathways and has shown great success in reversing hair loss in isolated cases.

Recently, a US biopharmaceutical company has announced its plans to investigate a variation of Ruxolitinib as an alopecia areata treatment. The first phase of its clinical evaluation of CTP-543 will take place this year, with a full study to follow in 2017. The modifications of Ruxolitinib seem to show that it retains its JAK inhibition ability while showing improved metabolic stability.

Ruxolitinib and Tofacitinib are powerful drugs, with quite serious potential side effects, so although these genetic therapies could be the future of alopecia areata treatment, the challenge will be to develop a drug that has a high success rate but with minimal possible complications.

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