What are the reason of spreading alopecia occur
Alopecia areata (AA) is an inflammatory, non-scarring, or non-permanent, hair loss that is the second most common hair loss disease worldwide. According to statistics, there are about 147 million patients in the world, of which 4 million are in China.
On June 13, the US FDA announced the approval of a new indication of baricitinib for the treatment of severe alopecia areata in adults. This is not only the first FDA-approved oral therapy for alopecia areata, but also a major breakthrough in the field of JAK inhibitor therapy for alopecia areata.How i cured my alopecia areata
Why does alopecia areata occur
Alopecia areata is a kind of sudden benign, recurrent, non-scarring hair loss, mostly asymptomatic, and can occur anywhere in the body. Alopecia totalis occurs when the entire scalp is affected, while alopecia universalis occurs when the scalp and other parts of the body are affected at the same time.
Unlike other diseases, alopecia areata is not a viral disease, but an autoimmune disease. The immune system of normal people is good and evil, and only attacks viruses; while the immune system of alopecia areata patients is not pleasing to everyone. Because the immune system attacks the hair follicles, it will cause hair on the skin, face or other parts of the body. or fall off completely.
What is a JAK inhibitor
Compared with traditional immunosuppressive drugs, targeted small molecule inhibitors work with narrower targets and fewer side effects. The difference from previous cytokine biologics is that JAK inhibitors can inhibit a series of cytokines, while the former can only inhibit a single cytokine, so the latter has a stronger effect.
The JAK-STAT pathway is an important signaling pathway in the body, especially playing a key role in the inflammatory response. The activation and regulation relationship between cytokines and the JAK-STAT pathway is complex. Usually, one JAK kinase can be activated by multiple cytokines, and one cytokine may also affect the activities of multiple STAT enzymes. JAK inhibitors can inhibit these pathways, thereby treating a variety of inflammatory diseases due to dysregulation of functional proteins in the JAK-STAT pathway.
Mechanism of action of baricitinib in the treatment of alopecia areata
Baricitinib is the most common structure of JAK inhibitors and belongs to the pyrrolopyrimidine class. Its mechanism of action in the treatment of alopecia areata mainly has two aspects: ① Eliminate the effect of T cell-mediated immune response on hair follicle epithelial cells, this step is by blocking the downstream signaling of γc family cytokines and receptors, and interfering with Th17 , Th1 and Th2 cell differentiation.
Reduced production of cytokines such as IFN-γ, which induces the entry and maintenance of hair follicles in the telogen phase; hair follicles in areas of alopecia areata are freed from the repressive negative effects of cytokines on the follicle cycle and enter the anagen phase, leading to hair regrowth. ② Directly acts on hair follicles, promotes the occurrence of growth period, prolongs the growth period of hair follicles, proliferates blood vessels and regenerates hair.
The therapeutic effect of baricitinib
In fact, baricitinib was originally developed to treat rheumatoid arthritis. In recent years, scientists have discovered that the drug can prevent the immune system from attacking hair follicles, thereby allowing patients to regrow hair.
The reason why baricitinib can be added for the treatment of severe alopecia areata in adults is mainly based on two clinical studies on baricitinib. In order to understand the efficacy and safety of baricitinib, researchers conducted two phase 3 clinical trials in patients with alopecia areata. The results of the trial showed that after 36 weeks of treatment, about one-third of patients received a dose of 4 mg of baricitinib. Ritinib-treated patients achieved more than 80% scalp hair coverage.
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