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Alopecia – Forever Bald? Rambam-Technion Collaboration Reveals Better Treatment Could Be On the Way

Publication Date: 6/22/2023 12:00 PM

Alopecia areata, a genetic autoimmune disease causing body baldness, is psychologically devastating and difficult to treat. A recent collaborative research project between Rambam Health Care Campus (Rambam) and the Technion-Israel Institute of Technology (Technion), both in Haifa, Israel, physician-scientists have revealed another possible cause.

Professor Amos Gilhar, one of lead researchers for the study on alopecia areata. Photography:Rambam HCCProfessor Amos Gilhar, one of lead researchers for the study on alopecia areata. Photography:Rambam HCC

Alopecia areata (alopecia) is a disease caused when the body’s immune system attacks hair follicles, where hair is formed, causing hair loss. Hair can be lost from any part of the body. Bald spots on the head and face are common; but sometimes, all body hair is lost.

A study led by Professor Amos Gilhar and in collaboration with Dr. Aviad Keren, both of the Technion, Professor Rimma Laufer Britva of Rambam’s Department of Dermatology, Professor Yehuda Ullman, director of the Division of Surgery, Dr. Marta Bertolini of the Monasterium Laboratory in Germany, and Dr. Ralf Paus of the University of Manchester, has uncovered evidence of another possible cause of the disease. The study, “Involvement of ILC1-like innate lymphocytes in human autoimmunity, lessons from alopecia areata,” was recently published in eLife science journal.

Alopecia is a genetic autoimmune disease. Some two percent of the population, equally occurring in men and women, suffer from alopecia at some point. Cells attack the hair follicles, resulting in baldness. Until now there has been no cure for this condition. However, in June 2022, the US Food and Drug Administration (FDA) approved the first drug to treat severe alopecia – baricitinib (Olumiant®). Olumiant is an immunomodulatory medication used to treat rheumatoid arthritis, and hospitalized COVID-19 patients under certain conditions. Hair growth has been restored in 25%–35% of alopecia patients, but side effects are common.

The conventional hypothesis is that CD8 T lymphocyte cells are responsible for the disease. However, the Rambam-Technion study revealed that another group of cells is involved – innate lymphoid cells-type 1 (ILC1).

Gilhar explains, “ILC1 cells constantly secrete various proteins that usually attack and invade the tissues they are in. As part of the research experiments, our team transferred these cells to a healthy scalp and then transplanted them onto mice. Exposing hair follicles obtained from a completely healthy source to the ILC1 cells caused secretion of a high level of interferon-gamma, a material known to play a major role in the hair loss that leads to alopecia. So there is no single route in which genetics and classical immune cells play an exclusive role –there are several pathways.”

The editor’s evaluation of the paper pointed out the importance of the author’s findings, which could lead to new approaches for treating alopecia areata. Hence, the research will be of particular interest to immunologists, skin biologists, and scientists studying autoimmune disorders.

Based on an article that recently appeared in the Jerusalem Post online edition.