Atanaska Dobreva, Ralf Paus, N.G. Cogan

Alopecia areata (AA) is an autoimmune disease, and its clinical phenotype is characterized by the formation of distinct hairless patterns on the scalp or other parts of the body. In most cases hair falls out in round patches. A well-established hypothesis for the pathogenesis of AA states that collapse of hair follicle immune privilege is one of the essential elements in disease development. To investigate the dynamics of alopecia areata, we develop a mathematical model that incorporates immune system components and hair follicle immune privilege agents whose involvement in AA has been confirmed in studies and experiments. We perform parameter sensitivity analysis in order to determine which inputs have the greatest effect on outcome variables. Our findings suggest that, among all processes reflected in the model, immune privilege guardians and the pro-inflammatory cytokine interferon-γ govern disease dynamics. These results agree with the immune privilege collapse hypothesis for the development of AA.