Gut Dysfunction Pathogenesis in Alopecia Areata speculated
Background & Case Study
Intestinal microflora-gut dysbiosis pathogenesis in Alopecia Areata speculated; Case study: Alopecia Universalis (AU) successfully reversed with combination therapy
Swierski RJ, Dir of Research, IRC, Charlotte, NC, United States; March 2013
Alopecia areata (AA) is a frequently occurring, chronic, inflammatory disease which is expressed as varying degrees of unpredictable, non-scarring hair loss. Alopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease mediated by T cells to the hair follicles. AA is marked by autoimmune assault on the hair follicle resulting in hair loss. There is a strong association with disease severity in alopecia areata and certain other autoimmune and inflammatory diseases. Despite some progress in the last decade, alopecia areata is still poorly understood.
The role of environmental factors, including emotional stress, in triggering disease onset or exacerbation remains speculative. The increased likelihood of comorbid autoimmune disease with AA negatively impacts the severity, prognosis, and treatment possibilities of AA. Currently there is no effective or reliable treatment for AA.
There is an increasing accumulation of evidence that bacterial pathogenesis occurring in the gut mediates certain autoimmune diseases. 2011 research reported that “beneficial intestinal bacteria can activate immune cells and trigger overaction of the immune system…” Research indicates that increasing water transport and mucosal hydration function of the epithelial mucosal cells alters mucous makeup of the intestinal barrier and the composition of the intestinal microbiome providing improved intestinal immunity.
Additionally, research has shown that consumption of certain types of food can disrupt the relationship between the immune system and the beneficial mixed of bacteria in the intestine resulting in the release of strains that can set off “an unregulated tissue-damaging immune response which can be difficult to switch off” and that specifically regulated diet will alter the composition of the microbiome rapidly.
Does bacterial pathogenesis have a role in Alopecia Areata? Is dysbiosis of the human microbiome an instigating and/or complicating mechanism in the pathogenesis of autoimmune alopecia areata?
Antibiotic treatment can and has been used effectively to control or selectively eliminate gut microflora. Diet has been shown to successfully regulate the gut environment. Increasing fluid transport across the epithelial membrane has been shown to improve immune response. Diet can minimize inflammatory pathology within the body.
Further investigations are needed to confirm the role of microbiome dysbiosis and diminished epithelial cell function in the pathogenesis of AA. Further investigations are needed to confirm the role and efficacy of this combination therapy for treating Alopecia Areata.
43 year old male with Alopecia Universalis for 20 years (case A)
One informal case study of a 43 year old male patient with Alopecia Universalis (AU) for approximately 20 years is presented for evaluation. Patient initially developed AU over a period of 3-6 months and exhibited negligible regrowth throughout the 20-year duration. Concurrent onset of acute solar urticaria (SU) and widespread mild to severe arthritis was reported. Patient also reports comorbidity in the form of lifelong Atopic Dermatitis (AD) and minor Vitiligo development at approximately 15 after the onset of AU.
Patient experienced full and rapid recovery from Alopecia Universalis, solar urticaria, arthritis, and vitiligo after combination therapy treatment. Patient reports substantial improvement, but not complete remission of AD at the same time. Patient began to grow mature dark hair at approximately 10-15 days after initiation of therapy and had regrown all hair on body by day 43. No intermediate vellus hair stage was present. Patient has been recovered for a period of 33 months.
Patient further reports that continuing diet/supplement therapy does, in fact, modulate AA expression; that on 2 separate occasions, discontinuation of diet/supplement for a period of 2 & 4 weeks has resulted in relapse into patchy AA, but resumption of diet/supplement has resulted in full recovery within +/- 30 days. Patient reports that negative change in growth rate and texture of hair was noticeable within 1 week of discontinuing diet/supplement therapy. Regrowth was observed at between 7 and 30 days of resumption. Subject extensively documented self-experimentation with photos/journal.
< 20 ongoing case studies with AU, AT, and AA patients using only diet and supplementation protocol used by Case A have resulted in partial to substantial regrowth (<90%) and support the RLT dietary/supplementation premise. Comprehensive treatment with the full protocol has shown increased effectiveness and is ongoing to confirm the full potential of this combination therapy for treating Alopecia Areata.