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4. Frontiers in Lichen Planopilaris and Frontal Fibrosing Alopecia Research: Pathobiology Progress and Translational Horizons

Author

Maryanne Makredes Senna, Erik Peterson, Ivan Jozic, Jérémy Chéret, and Ralf Paus

Subjects
Dermatology, RL1-803
Abstract

Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are primary, lymphocytic cicatricial hair loss disorders. These model epithelial stem cell (SC) diseases are thought to result from a CD8+ T-cell‒dominated immune attack on the hair follicle (HF) SC niche (bulge) after the latter has lost its immune privilege (IP) for as yet unknown reasons. This induces both apoptosis and pathological epithelial‒mesenchymal transition in epithelial SCs, thus depletes the bulge, causes fibrosis, and ultimately abrogates the HFs’ capacity to regenerate. In this paper, we synthesize recent progress in LPP and FFA pathobiology research, integrate our limited current understanding of the roles that genetic, hormonal, environmental, and other factors may play, and define major open questions. We propose that LPP and FFA share a common initial pathobiology, which then bifurcates into two distinct clinical phenotypes, with macrophages possibly playing a key role in phenotype determination. As particularly promising translational research avenues toward direly needed progress in the management of these disfiguring, deeply distressful cicatricial alopecia variants, we advocate to focus on the development of bulge IP and epithelial SC protectants such as, for example, topically effective, HF‒penetrating and immunoinhibitory preparations that contain tacrolimus, peroxisome proliferator–activated receptor-γ, and/or CB1 agonists.

Published
2022
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6. Contributors

Author

Crystal Aguh, Murad Alam, Katherine Almengo, Marc R. Avram, Sarah Benton, Wilma Fowler Bergfeld, Valerie D. Callender, Fiore Casale, Yu-Feng Chang, Maria Colavincenzo, Jeffrey S. Dover, Ronda Farah, Lynne Goldberg, Ciara Grayson, Nicole Heinen, Maria Hordinsky, Omer Ibrahim, Jared Jagdeo, Taylor A. Jamerson, Negar Kahen, Bianca Y. Kang, Shilpi Khetarpal, Alana Kurtti, Kristen Lo Sicco, Amy McMichael, Natasha Mesinkovska, Cristina Nguyen, Kelly O’Connor, Achiamah Osei-Tutu, James Thomas Pathoulas, Geraldine Cheyana Ranasinghe, Ora Raymond, Claudia M. Ricotti, Neil S. Sadick, Sara Salas, Maryanne Makredes Senna, Jerry Shapiro, Katharina Shaw, Mollly Stout, Cynthia Truong, and Frances Walocko

Published
2024
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7. Shared genetic risk variants in both male and female frontal fibrosing alopecia

Author

Tuntas Rayinda, Sheila M. McSweeney, David Fenton, Catherine M. Stefanato, Matthew Harries, Ioulios Palamaras, Alice Tidman, Susan Holmes, Anastasia Koutalopoulou, Michael Ardern-Jones, Greg Williams, Sofia Papanikou, Vasiliki Chasapi, Sergio Vañó-Galvan, David Saceda-Corralo, Ana Melián-Olivera, Carlos Azcarraga-Llobet, Alejandro Lobato-Berezo, Mariona Bustamante, Jordi Sunyer, Michela Valeria Rita Starace, Bianca Maria Piraccini, Isabel Pupo Wiss, Maryanne Makredes Senna, Rashmi Singh, Kathrin Hilmann, Varvara Kanti-Schmidt, Ulrike Blume-Peytavi, Michael Simpson, John A. McGrath, Nick Dand, and Christos Tziotzios

Subjects
Cell Biology, Dermatology, Molecular Biology, Biochemistry
Published
2023
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