斑秃治疗的研究进展
发布时间：2019-04-02 07:44
【摘要】：斑秃是皮肤科常见疾病,表现为一种良性、局限性、非瘢痕性的脱发,严重者可进展成全秃和普秃。该病病程经过缓慢,部分患者可自行缓解和复发。斑秃不会危及生命,不会致残,但会严重影响到患者的形象,给患者带来较大的心理负担。到目前为止,斑秃的发病机制尚未完全阐明,大多认为该病是一种由T细胞介导的自身免疫性疾病,与遗传、精神因素、营养不良等相关。目前该病的治疗方法多种多样,疗效不一,本文对近10来有关该病治疗方法、疗效及治疗相关研究进展等文献进行综述,为进一步有效治疗斑秃提供临床参考。本论文通过在“万方数据库”、“中国知网”数据库和“Pubmed”上输入主题词“斑秃”、“治疗”和“进展”进行文献检索,根据检索的结果,主要筛选出近10年的有关斑秃治疗进展的中英文文献,并进行仔细的阅读、分析、整理而成。结果如下:1斑秃是皮肤科临床上最常见的非瘢痕性脱发类的疾病之一,主要的表现为局限性的脱发斑。发病率为0.1%-0.2%,不同民族和种族之间略有不同,不同年龄段男女均可发病,以青年多见。其病因及发病机制尚未阐明,多数学者认为是一种T细胞介导的自身免疫性疾病,发病与遗传、精神神经因素等有关。2斑秃的治疗有多种方法,疗效不同,各有优缺点。主要包括药物、物理、皮肤外科治疗等,其中糖皮质激素、米诺地尔、复方甘草酸苷等仍是目前治疗的常用药物。单一的治疗方法很难达到理想的效果,2种或2种以上的方法联合治疗显示了较好的前景。3斑秃的发生可能是某种诱因导致以毛囊为靶器官的细胞介导的免疫反应,影响了毛发生长周期。毛发周期性生长主要分为三个阶段:生长期、退行期和休止期,毛囊上皮和间质成分均发生周期性改变。毛囊周期的调节是一个多种因素协同作用的结果,干细胞、信号转导通路等共同推动毛囊周期性生长。对于斑秃的治疗可以通过基因转染或基因敲除的方法来达到治疗的效果。4随着生物技术的不断发展,一些新型的生物制剂不断的被研发、应用,并取得了一定效果,但因临床应用较少,还需要通过大样本的临床实验研究来进一步证实其有效性和安全性。5目前对于毛囊干细胞的研究已经成为热点,可以把毛囊干细胞作为基因治疗的介质,可通过基因转染的方法将编码的抗炎症细胞或其它免疫调节剂的基因导入毛囊干细胞,使毛囊免受免疫攻击从而起到治疗斑秃的作用。6诱导式多能性干细胞(i PS)的出现和其能分化为各类毛囊角化细胞的能力,结合高产量的测序手段,使得我们在不久的将来不仅可识别与疾病有关的基因变化,也能通过移植人i PS到免疫缺陷的小鼠体内建立疾病模型,有助于开展斑秃的病因、发病机制的进一步研究,以及开发斑秃治疗方法等相关的研究。综上所述,斑秃病因及发病机制目前尚不清楚,治疗效果也不理想。对于斑秃的治疗,将来需要开展多方位的研究,其中新型生物制剂被研发并取得一定效果,但是其安全性仍需进一步研究证实;毛囊干细胞可以作为基因治疗的介质,通过基因转染达到治疗的目的;利用诱导式多能干细胞建立疾病模型,有助于进一步开展针对斑秃的病因、发病机制及治疗方法的研究。
[Abstract]:The alopecia areata is a dermatologic disease, which is a benign, limited and non-invasive hair loss, and the severe person can be made to be bald and bald. The course of the disease is slow and some patients can self-alleviate and relapse. Alopecia is not life-threatening and will not be maimed, but will seriously affect the image of the patient and bring a greater psychological burden to the patient. So far, the mechanism of alopecia areata has not been fully set out, most of which are thought to be a T-cell-mediated autoimmune disease associated with genetic, mental and malnutrition. At present, the treatment method of the disease is varied and the curative effect is different. The article reviews the recent literature on the treatment of the disease, the curative effect and the research progress of the treatment, and provides a clinical reference for the further effective treatment of the alopecia areata. Through the search of the "alopecia areata", the "treatment" and the "make progress" of the subject words on the "Wanfang database", the "China's knowledge network" database and the "Pubmed", according to the result of the search, the Chinese and English literature on the progress of the alopecia areata in the last 10 years are mainly selected, and a careful reading and analysis are carried out, and is prepared by the following steps: The results are as follows:1. The alopecia areata is one of the most common diseases in the skin of the skin, and the main manifestation is the localized alopecia. The incidence rate is 0.1%-0.2%, the difference between the different ethnic groups and the races is slightly different. Its causes and pathogenesis have not yet been clarified, most of which are thought to be a T cell-mediated autoimmune disease, the incidence and the genetic, the mental and neurogenic factors, etc. The treatment of alopecia areata has many methods, the curative effect is different, each has its advantages and disadvantages. It mainly includes medicine, physical and skin surgical treatment and so on, in which the glucocorticoid, minoxidil, compound glycyrrhizic acid and the like are still the most commonly used drugs for the treatment. The single treatment method is difficult to achieve the desired effect, and the combination therapy of the two or more methods shows a good prospect. the occurrence of alopecia areata may be a kind of inducement which leads to the cell-mediated immune response of the hair follicle as a target organ, and the hair growth period is affected. The periodic growth of the hair is divided into three stages: the growth phase, the destage and the rest period, and the hair follicle epithelium and the interstitial component are periodically changed. The adjustment of the cycle of the hair follicle is a result of a variety of factors, such as stem cells, signal transduction pathways, and the like to promote the periodic growth of the hair follicle. For the treatment of alopecia areata, the treatment effect can be achieved through the method of gene transfection or gene knockout. it is also necessary to further confirm the effectiveness and safety of the hair follicle stem cells by a clinical trial study of large samples.5. Current research on hair follicle stem cells has become a hot spot, and the hair follicle stem cells can be used as a medium for gene therapy, a gene encoding an anti-inflammatory cell or other immunomodulator can be introduced into the hair follicle stem cell by a gene transfection method, the hair follicle is protected from the immune attack to play the role of treating alopecia areata, the appearance of the 6-type multi-functional stem cell (i PS) and the ability of the hair follicle to differentiate into various hair follicle keratinocytes, and combined with a high-yield sequencing method, so that not only the gene change related to the disease can be identified in the near future, but also the disease model can be established in the mouse body of the transplanted human i PS to the immune defect, so that the cause of the alopecia areata and the further research of the pathogenesis are facilitated, And the development of a alopecia areata treatment method and the like. In conclusion, the etiology and pathogenesis of alopecia areunknown, and the therapeutic effect is not ideal. For the treatment of alopecia areata, multi-direction research will be needed in the future, in which the new biological preparation has been developed and has a certain effect, but its safety still needs to be further studied and confirmed; the hair follicle stem cells can be used as a medium for gene therapy, and the purpose of treatment can be achieved by gene transfection; The disease model is set up by using the multipotent stem cells, which is helpful for further research on the causes, pathogenesis and treatment of alopecia areata.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.71
本文编号：2452386
[Abstract]:The alopecia areata is a dermatologic disease, which is a benign, limited and non-invasive hair loss, and the severe person can be made to be bald and bald. The course of the disease is slow and some patients can self-alleviate and relapse. Alopecia is not life-threatening and will not be maimed, but will seriously affect the image of the patient and bring a greater psychological burden to the patient. So far, the mechanism of alopecia areata has not been fully set out, most of which are thought to be a T-cell-mediated autoimmune disease associated with genetic, mental and malnutrition. At present, the treatment method of the disease is varied and the curative effect is different. The article reviews the recent literature on the treatment of the disease, the curative effect and the research progress of the treatment, and provides a clinical reference for the further effective treatment of the alopecia areata. Through the search of the "alopecia areata", the "treatment" and the "make progress" of the subject words on the "Wanfang database", the "China's knowledge network" database and the "Pubmed", according to the result of the search, the Chinese and English literature on the progress of the alopecia areata in the last 10 years are mainly selected, and a careful reading and analysis are carried out, and is prepared by the following steps: The results are as follows:1. The alopecia areata is one of the most common diseases in the skin of the skin, and the main manifestation is the localized alopecia. The incidence rate is 0.1%-0.2%, the difference between the different ethnic groups and the races is slightly different. Its causes and pathogenesis have not yet been clarified, most of which are thought to be a T cell-mediated autoimmune disease, the incidence and the genetic, the mental and neurogenic factors, etc. The treatment of alopecia areata has many methods, the curative effect is different, each has its advantages and disadvantages. It mainly includes medicine, physical and skin surgical treatment and so on, in which the glucocorticoid, minoxidil, compound glycyrrhizic acid and the like are still the most commonly used drugs for the treatment. The single treatment method is difficult to achieve the desired effect, and the combination therapy of the two or more methods shows a good prospect. the occurrence of alopecia areata may be a kind of inducement which leads to the cell-mediated immune response of the hair follicle as a target organ, and the hair growth period is affected. The periodic growth of the hair is divided into three stages: the growth phase, the destage and the rest period, and the hair follicle epithelium and the interstitial component are periodically changed. The adjustment of the cycle of the hair follicle is a result of a variety of factors, such as stem cells, signal transduction pathways, and the like to promote the periodic growth of the hair follicle. For the treatment of alopecia areata, the treatment effect can be achieved through the method of gene transfection or gene knockout. it is also necessary to further confirm the effectiveness and safety of the hair follicle stem cells by a clinical trial study of large samples.5. Current research on hair follicle stem cells has become a hot spot, and the hair follicle stem cells can be used as a medium for gene therapy, a gene encoding an anti-inflammatory cell or other immunomodulator can be introduced into the hair follicle stem cell by a gene transfection method, the hair follicle is protected from the immune attack to play the role of treating alopecia areata, the appearance of the 6-type multi-functional stem cell (i PS) and the ability of the hair follicle to differentiate into various hair follicle keratinocytes, and combined with a high-yield sequencing method, so that not only the gene change related to the disease can be identified in the near future, but also the disease model can be established in the mouse body of the transplanted human i PS to the immune defect, so that the cause of the alopecia areata and the further research of the pathogenesis are facilitated, And the development of a alopecia areata treatment method and the like. In conclusion, the etiology and pathogenesis of alopecia areunknown, and the therapeutic effect is not ideal. For the treatment of alopecia areata, multi-direction research will be needed in the future, in which the new biological preparation has been developed and has a certain effect, but its safety still needs to be further studied and confirmed; the hair follicle stem cells can be used as a medium for gene therapy, and the purpose of treatment can be achieved by gene transfection; The disease model is set up by using the multipotent stem cells, which is helpful for further research on the causes, pathogenesis and treatment of alopecia areata.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.71
【参考文献】
相关期刊论文 前3条
1 周静;丁杨峰;杨勤萍;徐峰;;T细胞因子在斑秃发病中的作用[J];中国皮肤性病学杂志;2010年01期
2 周静;杨勤萍;徐峰;楼玮;盛友渔;;复方甘草酸苷治疗斑秃107例临床疗效观察[J];中国皮肤性病学杂志;2008年07期
3 孙洪栋;杨磊;刘文波;苏湛;韩玉贞;朱玉红;;液氮浅低温冷冻对家兔皮肤黑素细胞组织学和超微结构的影响[J];中国麻风皮肤病杂志;2009年12期
，本文编号：2452386
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