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Mediation of Alopecia Areata by Cooperation Between CD4+ and CD8+ T Lymphocytes

2002; American Medical Association; Volume: 138; Issue: 7 Linguagem: Inglês

10.1001/archderm.138.7.916

1538-3652

Amos Gilhar, Marina Landau, Bedia Assy, Raya Shalaginov, Sima Serafimovich, Richard S. Kalish,

melanin and skin pigmentation

Objective: To determine the role of CD4 + and CD8 + T lymphocytes in the pathogenesis of alopecia areata.Design: Relapse of alopecia areata was induced in autologous human scalp grafts on Prkdc scid mice by injection of activated T lymphocytes derived from lesional skin.CD4 + and CD8 + T cells were separated by magnetic beads before injection.Setting: University-based dermatology practice.Participants: Eleven patients with either alopecia totalis or severe alopecia areata.Main Outcome Measures: Hair regrowth, hair loss, and immunohistochemical findings of scalp explants.Intervention: Transfer of scalp T cells to autologous lesional scalp explants on Prkdc scid mice.Results: Injection of unseparated T cells and mixed CD4 + plus CD8 + T cells resulted in significant hair loss (PϽ.01) in 5 of 5 experiments.However, injection of purified CD4 + or CD8 + T cells alone did not result in reproducible hair loss.CD4 + and CD8 + T cells induced follicular expression of intercellular adhesion molecule 1 (CD54), HLA-DR, and HLA-A, HLA-B, and HLA-C after injection into scalp grafts.Conclusions: CD4 + and CD8 + T cells have a role in the pathogenesis of alopecia areata.It is hypothesized that CD8 + T cells act as the effector cells, with CD4 + T cell help.It is now necessary to look for HLA-A, HLA-B, and HLA-C associations with alopecia areata.Therapeutic manipulations that interfere with CD8 + activity should be examined.