The Role of Micronutrients in Alopecia Areata: A Review.
The Role of Micronutrients in Alopecia Areata: A Review.
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DOI：
10.1007/s40257-017-0285-x
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发表时间：
2017-10
影响因子：
7.3
通讯作者：
Cho E
中科院分区：
文献类型：
--
作者：
Thompson JM;Mirza MA;Park MK;Qureshi AA;Cho E
斑秃（AA）是一种常见的、不吓人的脱发形式，由免疫介导的毛囊攻击引起。与其他免疫介导的疾病一样，环境和遗传之间复杂的相互作用被认为导致AA的发展。维生素和矿物质等微量营养素的缺乏可能是与AA发展相关的可改变的危险因素。鉴于它们在正常毛囊发育和免疫细胞功能中的作用，越来越多的研究试图确定这些营养物质的血清水平在AA患者中是否可能不同，以及补充这些营养物质是否可能代表AA的治疗选择。虽然目前的治疗通常依赖于侵入性类固醇注射或具有潜在有害副作用的免疫调节剂，但通过微量营养素补充治疗，无论是作为主要方式还是作为辅助治疗，都可能提供一种有希望的低风险替代方案。然而，我们的综述强调了在这一领域进行进一步研究的必要性，因为目前的文献主要由小型病例对照研究和病例报告组成，这排除了微量营养素在AA中的作用的任何明确结论。在对当前文献的全面回顾中，我们发现AA患者的血清维生素D、锌和叶酸水平往往低于对照组。表明铁、维生素B12、铜、镁或硒的含量存在差异的证据相互矛盾或不足。少数研究表明，维生素A水平可能会改变这种疾病。虽然对微量营养素在AA中的作用的了解正在增加，但明确的临床建议，如常规血清水平检测或治疗性补充，需要在更大的人群中进行额外的研究，并具有前瞻性设计。
Alopecia areata (AA) is a common, non-scaring form of hair loss caused by immune-mediated attack of the hair follicle. As with other immune-mediated diseases, a complex interplay between environment and genetics is thought to lead to the development of AA. Deficiency of micronutrients such as vitamins and minerals may represent a modifiable risk factor associated with development of AA. Given their role in normal hair follicle development and in immune cell function, a growing number of investigations have sought to determine whether serum levels of these nutrients might differ in AA patients, and whether supplementation of these nutrients might represent a therapeutic option for AA. While current treatment often relies on invasive steroid injections or immunomodulating agents with potentially harmful side-effects, therapy by micronutrient supplementation, whether as a primary modality or as adjunctive treatment, could offer a promising low-risk alternative. However, our review highlights a need for further research in this area, given that the current body of literature largely consists of small case-control studies and case-reports which preclude any definite conclusions for a role of micronutrients in AA. In this comprehensive review of the current literature we found that serum vitamin D, zinc, and folate levels tend to be lower in patients with AA as compared to controls. Evidence is conflicting or insufficient to suggest differences in levels of iron, vitamin B12, copper, magnesium, or selenium. A small number of studies suggest that vitamin A levels may modify the disease. Though understanding of the role for micronutrients in AA is growing, definitive clinical recommendations such as routine serum level testing or therapeutic supplementation, call for additional studies in larger populations and with a prospective design.
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