Immune Regulation in Hair Follicle Protection and Hair Regeneration: Insights from the Collapse of Immune Privilege in Alopecia Areata and Targeted Immunotherapy

The review article discusses the role of immune regulation in protecting hair follicles and promoting hair regeneration, particularly in the context of alopecia areata. Under normal conditions, hair follicle immune privilege is maintained through spatial isolation and immune regulators, which are crucial for hair cycle regulation and wound-induced hair neogenesis. In alopecia areata, stress can lead to the collapse of this immune privilege, triggering an inflammatory response. The review, which includes approximately 120 studies, highlights recent advances in understanding these processes and explores current and emerging therapies. While current treatments like corticosteroids and Janus Kinase inhibitors offer symptomatic relief, they do not prevent relapse. New targeted immunotherapies that inhibit inflammatory pathways and modulate regulatory T cells show promise for more effective treatment of alopecia areata.