Pathobiology of chemotherapy-induced hair loss.
Hair loss can be a psychologically devastating adverse effect of chemotherapy, but satisfactory management strategies for chemotherapy-induced alopecia remain elusive. In this Review we focus on the complex pathobiology of this side-effect. We discuss the clinical features and current management approaches, then draw upon evidence from mouse models and human hair-follicle organ-culture studies to explore the main pathobiology principles and explain why chemotherapy-induced alopecia is so challenging to manage. P53-dependent apoptosis of hair-matrix keratinocytes and chemotherapy-induced hair-cycle abnormalities, driven by the dystrophic anagen or dystrophic catagen pathway, play important parts in the degree of hair-follicle damage, alopecia phenotype, and hair-regrowth pattern. Additionally, the degree of hair-follicle stem-cell damage determines whether chemotherapy-induced alopecia is reversible. We highlight the need for carefully designed preclinical research models to generate novel, clinically relevant pointers to how this condition may be overcome.
Department of Dermatology, University of Lübeck, Lübeck D-23538, Germany. ralf.paus@manchester.ac.uk
Ralf
R
Paus
Iain S
IS
Haslam
Andrey A
AA
Sharov
Vladimir A
VA
Botchkarev
D000505:Alopecia / Q000139:chemically induced* / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018859:Hair Follicle / Q000187:drug effects / Q000254:growth & development; D006801:Humans
D000970:Antineoplastic Agents