Wouldn't the T-lymphocytes around the hair follicle die?

Hello,

I receive a question that what if the excessive T-lymphocytes around the hair follicles of a patient with Alopecia areata dies or will they live forever?

We're alive today because our body is alive, our tissues are alive and so does our cells (We're living organism because we're composed of living cells)

Yes, eventually all cells have to die however the life span of each type of cell varies. (Normally our red blood cells live about 120 days, they lost their membrane integrity due to wear and tear, and eventually destroyed by the spleen.)

T-lymphocytes also have its life-span. In human, the T-lymphocytes (Special/ specific Soldier) can survive between 3 to 6 months (The more wear and tear, the shorter the life-span) and B-Lymphocytes can survive between 1 to 2 months).

In my previous blog, I talked on the functions of T-lymphocytyes (the Cytotoxic and Helper cells), I was merely talking about effector Lymphocytes (Special/ specific Soldier). The second type of lymphocytes by function is memory Lymphocytes (Special/ specific Messenger). Memory lymphocytes stayed in the periphery tissues and blood circulation for an extended period, responding quicker upon the same specific exposure of antigen by providing instant information to the effector Lymphocytes (In this case, we're talking about the self-antigen of the hair-follicle).

Memory lymphocytes (T & B cells) live somewhere between 3 months to 5 years with 1% of the memory lymphocytes living up to 20 years (Vaccination that we get annually? or once every five years i.e. hepatitis A, B as booster?...much related to memory lymphocytes).

With the word memory alone, the dysfunctional T-lymphocytes found around the hair follicle or an Alopecia areata patient, kept on producing a specific dysfunctional response against the hair follicle.

Theoratically, (Memory Cells with the time element) we can now basically explain why some Alopecia areata patients:

1. Experience little regrowth but then fall off again...

2. Have a very long duration of disease...

3. Believed to be of genetic basis...

More details...(Wait for the next blog or post me a question)

Joshua

A letter response to Jon's ex-school

Hi everyone, I am brought to the attention that a highschool kid with alopecia areata has quit school due to the school/ district authority refused to allow him to wear a head gear even with official writing from dermatologists.

Below is my written response to the school's authority (sent on early February 2009) based on the kid's mom letter/discussion on an alopecia forum.

__________________________________________________________________________

5^th February 2009

Our Ref. No.: aasc/asia/oletter/01FEB09-01

Mrs. A., Principal
West Seneca East Senior High School

UNITED STATES

Mrs. A.,

Hello. It is brought to my attention (from a letter written by Sharon Lesakowski- attached for our reference) that a student has quit your school due to the school authority’s refusal to allow him to wear a head covering even though he is diagnosed with alopecia areata (Hairloss due to a medical condition).

The excuse given by the school authority is almost absurd, laughable and mostly unprofessional as per the context given by Mr. Wiley, Assistant Superintendent on a return phone call to Sharon Lesakowski that Jonathan’s way of dealing with his affliction (wearing a bandana) was not acceptable.

This may not be a perfect analogy but it is good enough to reflect a medically illiterate faux pas. It provides an impression that as if the school will penalize a student for flashing gang signs where as the student is actually deaf and communicating in sign language. In this case, it is a student being penalized for promoting gang image where as the student is actually suffering alopecia and requires a head covering to protect his scalp. I believe that you are aware or at least read about alopecia areata. Even though alopecia areata is not a life-threatening or infectious disease itself, covering the hairless area especially the scalp is more than just a psychological comfort to the alopecia patient. Technically, Jonathan’s option of wearing a bandana has physiological reasons behind it. The physiological aspects, a bandana:

1. Keep the head warm during winter.

2. Keep the head (skin) from over exposed with UV during summer.

3. Keep the sweat from going into the eyes due to the loss of eyebrows and eyelashes.

As long as the attire does not offend others in the school, a bandana (with no offensive symbols or design) is not a violation a dress code or district policy given a medically certified condition as what Jonathan has. The school’s policy in Jonathan’s case (his rights) is itself a violation of the United States Constitution’s Bills of Right. In addition, the school’s policy discriminate alopecia patients (in general) of the right to protect their scalp with a bandana. About 2% of the human population and up to 5 million peoples in the United States are affected by alopecia areata (Sources by National Alopecia Areata Foundation, NAAF and National Institute of Arthritis, Musculo skeletal and Skin diseases, NIAMS).

As an education institution, the school has failed to provide a comfortable environment where knowledge is to be imparted without partiality and favour, in this case to Jonathan (for wearing a bandana to protect his head). As an alopecia patient myself, I felt insulted and discriminated by the excuse given by the school authority. Equating bandana wearing in general to promote gang image itself is an unacceptable reason and an insult to community of alopecia patients and patients suffering hair loss due to secondary effect (like hormonal problems, burnt victims, cancer patients).

Personally, I hope that the school authority and responsible personnel to provide a full public apology to Jonathan and his family, nothing short of a personal apology and also issue a public apology via local media. I strongly believe that being in the education profession, one should be courageous enough to admit and apologize for the mistake done whether by moral obligation or work ethics.

I am also affected by alopecia areata and have lost all my hair on my scalp. If I were to come to your school to seek education and I chose not to wear anything to cover up my baldness, would I later be “accused” or “penalized” for promoting the skinhead gang because I appeared bald at school? Therefore, I urge the school’s policies/ school district policies in particular the out-dated attire policy to be reviewed immediately in line with proper sensitivity to the medically unwell and needy patients, upholding the Bill of Rights as enshrined in the United States Constitution and finally to function as a school to provide education and conducive environment for students to receive education to avoid unacceptable mistakes like Jonathan’s situation in the future. All kind of responses is most welcome. Thank you.

Yours sincerely,

_________________

A Note of about hair follicle (Alopecia areata patients)

A NOTE ABOUT THE HAIR FOLLICLE:

Hair follicles are extremely tough and robust. They are able to take multiple insults and despite being disrupted by the immune cells, the hair follicle are capable to regenerate given the right conditions (subject of research), even after many years of insults/punishment.

The fact about hair follicle mentioned above has been a driving force for the search of a cure for Alopecia areata and it is also an explanation why some patients will have their hair back after many years of being afflicted by Alopecia areata.

So, do not be discouraged and keep your head high!

Joshua

My previous series of blog about Alopecia:

1. Explaining Alopcia areata and the immune system.

2. Understanding the Lymphocytes found around the hair follicle.

3. Alopecia areata as auto-immune condition.

...etc.

Should Alopecia areata patients strengthen their immune system?

Basically, the ultimate cure for Alopecia Areata would be to "tell" or "inform" the T-lymphocytes of our body (Specifically those who are targeting our hair follicles) that the "social security number" of hair follicle tissues are of our own body and NOT foreign.

So, should we strengthen our immune system?

Yes, the T-lymphocytes still plays a great role in our well being and defense mechanism against specific bacteria, viruses and prevent rapid proliferation of mutated cells (cancerous).

Therefore, systemic steroidal treatments are not encouraged to treat Alopecia Areata in long term, as it would "weaken" the ENTIRE Immune System. Its like, SHUTTING off the COUNTRY's entire police force because a few police made a mistake and arrested THE COUNTRY's own citizens as illegal immigrants.

Joshua

Alopecia Areata as Auto-immune disease

In my previous blogs, I talked about the immune system in relation to alopecia areata and then I talked about the normal functions of T-lymphocytes.

Why is Alopecia areata considered as an autoimmune disease?

Each different cells/tissue of the body has their own "social security number" / receptors (non antigenic) and the T-lymphocytes normally identify the "social security numbers" that does not belong to the normal tissues found in one own's body and attack them. For example, the immune system, including lymphocytes is triggered to attack the foreign infectious agents and abnormal proteins found in the normal body. (Different "social security numbers" of the various pathogenic bacteria, viruses...etc)

In Alopecia Areata, the T-lymphocytes somehow identify the specific "social security number" (self antigen) of the hair follicles as foreign infectious agents/ non self and could not distinguish it for being of the part of own body and start "arresting and attacking" the hair follicles....and now the person suffers from Alopecia Areata.

Medical definition for:

Antigen- Any substances which is capable, under appropriate conditions, of inducing a specific immune response..

Self antigen- Any constituents of body's own tissue capable of stimulating a specific immune response/ autoimmunity.

(Its like the police arrest you as for being an illegal immigrant when you're actually a citizen of the country)

Joshua

(For information on Alopecia & Support, pls visit AASC-i or join Alopecia Areata Support Community)

Understanding T-Cytotoxic & T-Helper Lymphocytes

Hello everyone,

From my previous blog (Explaining Alopecia Areata & Autoimmune Disease), I talked briefly about Alopecia Areata and then proceed to the discussion of the Immune System.

I have touched on the microscopic presence of T-Cytotoxic and T-Helper lymphocytes excessively on the hair follicles of a skin biopsy taken from a patient with Alopecia Areata.

Before I go on further to explain why Alopecia Areata is recognized to be an autoimmune condition. Let us watch the videos below to understand the normal function of T-Cytotoxic and T-Helper lymphocytes in our body's immune system.


T-Cytotoxic (Lymphocytes)
*Note: Antigens are proteins that are able to produce an immune response (E.g. proteins of bacteria, viruses)

-function to eliminate antigens by releasing cytoxic properties/substances.

T-Helper (Lymphocytes)

-function to eliminate antigens by signalling other immune cells.

Thats all for today, I shall talk about Alopecia Areata as an Autoimmune Disease at a later date. (I shall continue our discussion in about a week from now)

At the end of this series of blog, if the people who read and learned about Alopecia areata still behaved rudely and even jeer at people suffering from Alopecia areata. I shall make an official declaration on this kind of people.

As for the rest, thank you very much for your support, patience and interest in Alopecia areata.

Joshua

Explaning Alopecia areata & Autoimmune disease.

I would like to begin my first official blog by posting a subject that is not life-threatening but life-altering. The subject is Alopecia Areata (Widely believed to be an autoimmune disease).

As an Alopecia areata patient, I have been laughed, stared, commented rudely and even be labelled as a member of the skinhead gang in the public multiple times. I've even heard from the public calling women with alopecia totalis, alopecia universalis, crazy womens, Alopecia universalis patients as freaks who shaved their eyebrows and pulled off their eyelashes.

Children are being laughed and jeered as baldy, alien or even hairless monsters! Enough is enough! If we are not bound by the Rule of Law but rather the Law of the jungle, I would have given a smack or two slaps on the faces on people who laughed at children with Alopecia areata.

• So, to whoever (on condition that you're civilized, with brains in the body, I don't care where your brains is, as long as you have one in your body) want or have showed rudeness, ignorance to children and women with alopecia especially and also to my fellow brothers. You are welcome to read my blog.

To those who live with Alopecia areata or live with/know someone you loved with Alopecia areata, you are most welcome to read my blog.

• First of all, Immune system and Autoimmune system does not exist separately. The term "Autoimmune System" does not even exist whether in scientific or medical definition. There is only Immune system and Autoimmune disease/condition (One of many ways the immune system can breakdown).

• However, "Autoimmune disorder, Autoimmune conditions, Autoimmune diseases" are often used interchangeably and Autoimmune disorder/conditions/diseases is merely the failure of the body Immune system to recognize one own self (cells and tissues) and therefore "attack" (produce an immune response against) the host's (e.g human) own cells and tissues that makes up the normal structure of the physical body.

• Let us not discuss in depth into scientific terms but rather an explanation based on basic science.

The immune system in general, works in two general pathways:

1. Non-specific immunity (innate pathway)- eg. the physical barrier of skin, acid in the stomach, phagocytics cells in blood that eats up bacteria in general...etc
2. Specific immunity (pathway)

Alopecia areata falls into the minor malfunction of the Specific immunity (pathway).Under Specific Immunity, it further subdivides into two components:

1. Passive immunity- (e.g transfer of antibodies from mother's milk to baby)
   and Alopecia Areata (Autoimmnue condition) is narrowed down to the minor malfunction of the Active immunity.
2. Active immunity- response upon stimulation (e.g vaccination, exposure of disease, infection)

Under Active immunity, it further divides into two categories:

1. Humoral immunity ( produced by B-lymphocytes)- e.g production of antibodies like Immunoglobulins, IgM, IgG, IgE...etc.
2. Cell-mediated immunity (T-lymphocytes)

* Another type of lymphocytes besides B and T-lymphocytes is Natural Killer Cells (NK) which is part of the Non-specific (Innate pathway) immune system.

and the identified culprit (agreed by most) for Alopecia areata is the T-lymphocyte cells (T-Cytotoxic cells which destroys cells) and (T-Helper cell which tells the other white blood cells to destroy cells and enhance the B-lymphocytes to produce antibodies specifically)

Under the microscope: a skin biopsy of a patient with Alopecia Areata shows

• Extensive T-Cytotoxic and T-Helper cells are present surrounding the hair follicles, "attacking" them, so in laymen term the hair follicle is "under siege". Hence, the hair follicle cannot produce any hair, and the nutrients supplied for hair growth is BLOCKED by these T-lymphocytes cells and their allies.

So, above the surface of the skin, no hair is present (Alopecia= a clinical symptom of absence of hair on skin where they normally are/ should be).

Why is Alopecia Areata often starts as circular patches extending outwardly? What's wrong with the presence lymphocytes around the hair follicle and why Autoimmune disease?

I will discuss that in my next blog. Thank you for reading.

Joshua

p/s: You may want to visit Alopecia Areata Support Community or read about Alopecia Areata at AASC-i if you find my blog interesting.