Low dose IL-2 for treating moderate to severe alopecia areata. A 52 weeks multicenter prospective placebo-controlled study assessing its impact on T regulatory cells and natural killer populations

To the Editor, the treatment of severe Alopecia areata (AA) remains highly challenging. A breakdown of immune privilege of the hair follicle resulting in the development of an admixed immune of antigen presenting cells (APCs), CD4+ and CD8+ T lymphocytes infiltrate is hypothesized to represent an important driver of AA(Pratt et al., 2017). A deficiency in T regulatory cells (Tregs) might facilitate the occurrence of this immune privilege breakdown. A growing corpus of data in animal models but also from blood and skin in AA patients emphasized the likely key role of Tregs in AA pathomechanisms(Conteduca et al., 2014, Hamed et al., 2019, McElwee et al., 2005, Petukhova et al., 2010, Shin et al., 2013, Tembhre and Sharma, 2013).

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