Evidence for neurogenic inflammation in lichen planopilaris and frontal fibrosing alopecia pathogenic mechanism
Evidence for neurogenic inflammation in lichen planopilaris and frontal fibrosing alopecia pathogenic mechanism
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DOI：
10.1111/exd.13835
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发表时间：
2020-03-01
影响因子：
3.6
通讯作者：
Hordinsky, Maria K.
中科院分区：
文献类型：
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作者：
Doche, Isabella;Wilcox, George L.;Hordinsky, Maria K.
扁平苔藓(LPP)和额叶纤维素性脱发(FFA)是主要影响头皮的淋巴细胞性疤痕脱发。虽然这两种疾病可能有一些共同的临床和组织病理学特征，但在过去的十年里，FFA已经成为一种流行病，特别是在欧洲、北美和南美洲，与LPP相比，FFA具有独特的临床表现，从而提出了这种疾病可能有不同的发病机制的想法。头皮灼热、瘙痒或疼痛等症状通常出现在这两种疾病中，这表明神经和神经肽在两种疾病的发病机制中可能起到了作用。研究表明，P物质(SP)、降钙素基因相关肽(CGRP)等神经肽与脂质代谢和多种慢性炎症性疾病密切相关。在这项研究中，我们询问这些神经肽是否与LPP和FFA头皮损伤有关。应用免疫组织化学技术和共聚焦显微镜观察两种疾病患者头皮组织中SP和CGRP的表达变化。然后，我们定量评估和比较了对照、LPP和FFA头皮活检组织中SP和CGRP的表达。虽然LPP和FFA具有相似的组织病理学结果，但在感染和未感染的头皮中发现相反的结果，提示这些疾病可能有不同的致病机制。我们还发现，与明显的临床损害无关，都存在组织病理学炎症，这增加了这两种疾病可能是影响头皮的更普遍的过程的可能性。
Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocytic scarring alopecias affecting primarily the scalp. Although both diseases may share some clinical and histopathological features, in the last decade, FFA has become an "epidemic" particularly in Europe, North and South America with unique clinical manifestations compared to LPP, thus, raising the idea that this disease may have a different pathogenesis. Symptoms such as scalp burning, pruritus or pain are usually present in both diseases, suggesting a possible role for nerves and neuropeptides in the pathogenesis of both diseases. Based on some previous studies, neuropeptides, such as substance P (SP) and calcitonin gene-related peptide (CGRP), have been associated with lipid metabolism and many chronic inflammatory disorders. In this study, we asked if these neuropeptides are associated with LPP and FFA scalp lesions. Alteration in the expression of SP and CGRP in affected and unaffected scalp skin from patients with both diseases was found with examination of sections using immunohistochemical techniques and confocal microscopy. We then quantitatively assessed and compared SP and CGRP expression from control, LPP and FFA scalp biopsies. Although LPP and FFA share similar histopathologic findings, opposite results were found in affected and unaffected scalp in the ELISA tests, suggesting that these diseases may have different pathogenic mechanisms. We also found presence of histopathological inflammation irrespective of evident clinical lesions, which raises the possibility that both diseases may be more generalized processes affecting the scalp.