The pathogenesis of alopecia areata in rodent models.
Rodent models of human disease provide an important tool in the investigation of genetic and environmental activation factors, disease pathogenesis, and the development of new and improved treatments. Up to 20% of aged C3H/HeJ mice and 70% of Dundee Experimental Bald Rats (DEBR) develop alopecia areata (AA), a nonscarring, inflammatory hair loss disease with a suspected autoimmune pathogenesis. These rodent models are currently employed in determining the genetic basis of AA, understanding the mechanisms of disease initiation and progression, and defining potential endogenous and environmental influences. Induction of AA by skin graft transfer between affected and unaffected mice has been employed to examine skin and immune system changes during AA pathogenesis. Manipulation of inflammatory cells in vivo indicates AA is primarily a cell mediated disease with auto-antibody production as a secondary event. Whether the AA activating factors are exogenous or endogenous antigens, or involve normal or aberrant epitope expression remains to be elucidated. However, current research suggests a self contained disease cycle involving four key events: (1) Failure of the putative anagen stage hair follicle immune privilege and exposure of hair follicle located AA inciting epitopes to the immune system; (2) Antigen presentation, costimulation, and activation of responsive lymphocytes by antigen presenting cells; (3) Activated inflammatory cell migration to, and infiltration of, hair follicles; (4) The subsequent disruptive actions of the inflammatory cell infiltrate on the hair follicles. Each of these events is vulnerable to therapeutic intervention, and rodent models will be fundamentally involved in developing new treatments for AA.