title: Mediation of alopecia areata by cooperation between CD4+ and CD8+ T lymphocytes: transfer to human scalp explants on Prkdc(scid) mice.
abstract: OBJECTIVE
  To determine the role of CD4+ and CD8+ T lymphocytes in the pathogenesis of alopecia areata.
  
  
  METHODS
  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.
  
  
  METHODS
  University-based dermatology practice.
  
  
  METHODS
  Eleven patients with either alopecia totalis or severe alopecia areata.
  
  
  METHODS
  Hair regrowth, hair loss, and immunohistochemical findings of scalp explants.
  
  
  METHODS
  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 (P<.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.
authors.affiliation: Research Laboratories, Flieman Medical Center and B. Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
authors.forename: Amos
authors.initials: A
authors.lastname: Gilhar
authors.forename: Marina
authors.initials: M
authors.lastname: Landau
authors.forename: Bedia
authors.initials: B
authors.lastname: Assy
authors.forename: Raya
authors.initials: R
authors.lastname: Shalaginov
authors.forename: Sima
authors.initials: S
authors.lastname: Serafimovich
authors.forename: Richard S
authors.initials: RS
authors.lastname: Kalish
mesh_terms: D000328:Adult; D000506:Alopecia Areata / Q000276:immunology* / Q000473:pathology; D000818:Animals; D001706:Biopsy; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002478:Cells, Cultured; D005260:Female; D018859:Hair Follicle / Q000276:immunology / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D008211:Lymphocyte Cooperation / Q000276:immunology*; D008297:Male; D051379:Mice; D016513:Mice, SCID; D008875:Middle Aged; D019737:Transplants