Food allergies and alopecia
Food allergies and alopecia

COULD A FOOD ALLERGY BE LINKED TO ALOPECIA AREATA?

Food allergies have been considered to be a facilitating factor in triggering alopecia areata.  Previous studies of women with alopecia areata have shown subsets of patients that can have one or more of the following: seasonal relapses, hay fever, asthma and dermatitis, high levels of circulating immune cells, high levels of immune cells specific to house dust mites and disrupted skin barrier function.

Allergies and alopecia areata share a very similar genetic background that both contribute to an immune reaction imbalance.  Allergies and alopecia areata can both be treated successfully with antihistamines.   Allergies may contribute to the onset and relapse of alopecia areata.

FOOD ALLERGY SYMPTOMS AND ALOPECIA AREATA MAY IMPROVE WITH SIMILAR TREATMENT

There are several factors suspected as alopecia areata disease onset triggers.  The modulators that are thought to provoke the immune system include viruses, stress, bacterial infection, pathogenic gut bacteria, and diet [1-5].  Alopecia areata has a complex pattern of clinical presentation which indicates multiple contributing pathogenic factors are involved.

These factors come together in a way that induce an autoimmune response that results in hair follicle specifically antigens [6,7].

Alopecia areata and food allergy response are both relieved by antihistamines.  Ebastine, an antihistamine, has shown positive results in patients with extensive alopecia areata. Ebastine is a second-generation histamine H1 receptor antagonist that is used to attenuate allergic inflammation. Most pharmacological studies of antihistamines have focused on cellular aspects of allergic responses and immune regulation. Though some clinical observations have suggested favourable effects of antihistamines on alopecia areata.

Nori et al. showed that ebastine suppresses the production of Th2 and pro-inflammatory cytokines and inhibits T cell migration.  It is the migration of T-cells to the hair follicle that instigates the immune response in the scalp area.  T-cell infiltration was hardly detected in alopecia areata patches of ebastine-treated mice. This observation suggested that ebastine plays some roles in the suppression of the T-cell-mediated immune response in alopecia areata lesions.

Alopecia areata with antihistamine treatment

At the start of treatment patient had been on corticosteroids (diphenylcyclopropenone) for 12 weeks.

Alopecia areata with antihistamine treatment

The second picture shows regrowth after the addition of antihistamines (ebastine).  The alopecic patch is nearly fully regrown.

Credit: Openviento.org

REFERENCES

  1. C. T. Richardson, M. S. Hayden, E. S. Gilmore, B. Poligone. Am J Clin Dermatol. 2018, 19, 119.
  2. C. H. Chu, Y. P. Cheng, J. Y. Chan. Pediatr Dermatol. 2016, 33, e218.
  3. R. P. Wise, K. P. Kiminyo, M. E. Salive. JAMA. 1997, 278, 1176.
  4. K. J. McElwee, S. Niiyama, P. Freyschmidt-Paul, E. Wenzel, S. Kissling, J. P. Sundberg, R.Hoffmann. Exp Dermatol. 2003, 12, 30.
  5. K. J. McElwee, K. Silva, W. G. Beamer, L. E. King, Jr., J. P. Sundberg. Exp Dermatol. 2001,10, 420.
  6. H. Guo, Y. Cheng, J. Shapiro, K. McElwee. Expert Rev Clin Immunol. 2015, 11, 1335.
  7. K. McElwee, P. Freyschmidt-Paul, A. Ziegler, R. Happle, R. Hoffmann. Eur J Dermatol. 2001,11, 11.

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