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Destruction of the stem cell Niche, Pathogenesis and Promising Treatment Targets for Primary Scarring Alopecias

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Abstract

The Primary Scarring Alopecias are characterised by the irreversible destruction and fibrosis of hair follicles, leading to permanent and often disfiguring loss of hair. The pathophysiology of these diseases is not well understood. However, follicular-fibrosis and loss of the stem-cell niche appears to be a common theme. This review explores the pathogenesis of primary scarring alopecias, asking what happens to the stem cells of the hair follicle and how they may contribute to the progression of these diseases. Bulge-resident cells are lost (leading to loss of capacity for hair growth) from the follicle either by inflammatory-mediate apoptosis or through epigenetic reprogramming to assume a mesenchymal-like identity. What proportion of bulge cells is lost to which process is unknown and probably differs depending on the individual PCA and its specific inflammatory cell infiltrate. The formation of fibroblast-like cells from follicular stem cells may also mean that the cells of the bulge have a direct role in the pathogenesis. The identification of specific cells involved in the pathogenesis of these diseases could provide unique diagnostic and therapeutic opportunities to prevent disease progression by preventing EMT and specific pro-fibrotic signals.

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Funding

NK and HAA are funded by the National Research Foundation (SARChI Chair) and the South African Medical Research Council (Mid-career Scientist and Self-Initiated Research grant).

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  1. Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa

    Richard P. Halley-Stott

  2. Hair and Skin Research Laboratory, Groote Schuur Hospital, Cape Town, South Africa

    Henry A. Adeola & Nonhlanhla P. Khumalo

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  1. Richard P. Halley-Stott
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RPH-S: Design and planning, literature search, writing, figure design and construction. HAA: Literature search, writing. NPK: Design and planning, literature search, writing.

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Halley-Stott, R.P., Adeola, H.A. & Khumalo, N.P. Destruction of the stem cell Niche, Pathogenesis and Promising Treatment Targets for Primary Scarring Alopecias. Stem Cell Rev and Rep 16, 1105–1120 (2020). https://doi.org/10.1007/s12015-020-09985-6

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