Dandruff is a common scalp condition, which frequently causes psychological distress in those affected. Dandruff is considered to be caused by an interplay of several factors. However, the pathogenesis of dandruff remains under-investigated, especially with respect to the contribution of the hair follicle. As the hair follicle exhibits unique immune-modulatory properties, including the creation of an immunoinhibitory, immune-privileged milieu, we propose a novel hypothesis taking into account the role of the hair follicle. We hypothesize that the changes and imbalance of yeast and bacterial species, along with increasing proinflammatory sebum by-products, leads to the activation of immune response and inflammation. Hair follicle keratinocytes may then detect these changes in scalp microbiota resulting in the recruitment of leukocytes to the inflammation site. These changes in the scalp skin immune-microenvironment may impact hair follicle immune privilege status, which opens new avenues into exploring the role of the hair follicle in dandruff pathogenesis. Also see the video abstract here: https://youtu.be/mEZEznCYtNs

中文翻译：

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头皮屑发病机制的毛囊中心观点：自然分泌机制的变化会导致麻烦的状况吗？

头皮屑是一种常见的头皮状况，经常给受影响的人造成心理困扰。头皮屑被认为是由多种因素相互作用引起的。然而，头皮屑的发病机制仍未得到充分研究，特别是在毛囊的贡献方面。由于毛囊表现出独特的免疫调节特性，包括产生免疫抑制、免疫特权环境，我们提出了一个考虑毛囊作用的新假设。我们假设酵母和细菌种类的变化和不平衡，以及促炎皮脂副产物的增加，导致免疫反应和炎症的激活。然后毛囊角质形成细胞可以检测头皮微生物群中的这些变化，导致白细胞募集到炎症部位。头皮皮肤免疫微环境的这些变化可能会影响毛囊免疫特权状态，这为探索毛囊在头皮屑发病机制中的作用开辟了新途径。另请参阅此处的视频摘要：https://youtu.be/mEZEznCYtNs