斑禿治療的研究進展
發(fā)布時間：2019-04-02 07:44
【摘要】：斑禿是皮膚科常見疾病,表現(xiàn)為一種良性、局限性、非瘢痕性的脫發(fā),嚴重者可進展成全禿和普禿。該病病程經(jīng)過緩慢,部分患者可自行緩解和復(fù)發(fā)。斑禿不會危及生命,不會致殘,但會嚴重影響到患者的形象,給患者帶來較大的心理負擔。到目前為止,斑禿的發(fā)病機制尚未完全闡明,大多認為該病是一種由T細胞介導(dǎo)的自身免疫性疾病,與遺傳、精神因素、營養(yǎng)不良等相關(guān)。目前該病的治療方法多種多樣,療效不一,本文對近10來有關(guān)該病治療方法、療效及治療相關(guān)研究進展等文獻進行綜述,為進一步有效治療斑禿提供臨床參考。本論文通過在“萬方數(shù)據(jù)庫”、“中國知網(wǎng)”數(shù)據(jù)庫和“Pubmed”上輸入主題詞“斑禿”、“治療”和“進展”進行文獻檢索,根據(jù)檢索的結(jié)果,主要篩選出近10年的有關(guān)斑禿治療進展的中英文文獻,并進行仔細的閱讀、分析、整理而成。結(jié)果如下:1斑禿是皮膚科臨床上最常見的非瘢痕性脫發(fā)類的疾病之一,主要的表現(xiàn)為局限性的脫發(fā)斑。發(fā)病率為0.1%-0.2%,不同民族和種族之間略有不同,不同年齡段男女均可發(fā)病,以青年多見。其病因及發(fā)病機制尚未闡明,多數(shù)學者認為是一種T細胞介導(dǎo)的自身免疫性疾病,發(fā)病與遺傳、精神神經(jīng)因素等有關(guān)。2斑禿的治療有多種方法,療效不同,各有優(yōu)缺點。主要包括藥物、物理、皮膚外科治療等,其中糖皮質(zhì)激素、米諾地爾、復(fù)方甘草酸苷等仍是目前治療的常用藥物。單一的治療方法很難達到理想的效果,2種或2種以上的方法聯(lián)合治療顯示了較好的前景。3斑禿的發(fā)生可能是某種誘因?qū)е乱悦覟榘衅鞴俚募毎閷?dǎo)的免疫反應(yīng),影響了毛發(fā)生長周期。毛發(fā)周期性生長主要分為三個階段:生長期、退行期和休止期,毛囊上皮和間質(zhì)成分均發(fā)生周期性改變。毛囊周期的調(diào)節(jié)是一個多種因素協(xié)同作用的結(jié)果,干細胞、信號轉(zhuǎn)導(dǎo)通路等共同推動毛囊周期性生長。對于斑禿的治療可以通過基因轉(zhuǎn)染或基因敲除的方法來達到治療的效果。4隨著生物技術(shù)的不斷發(fā)展,一些新型的生物制劑不斷的被研發(fā)、應(yīng)用,并取得了一定效果,但因臨床應(yīng)用較少,還需要通過大樣本的臨床實驗研究來進一步證實其有效性和安全性。5目前對于毛囊干細胞的研究已經(jīng)成為熱點,可以把毛囊干細胞作為基因治療的介質(zhì),可通過基因轉(zhuǎn)染的方法將編碼的抗炎癥細胞或其它免疫調(diào)節(jié)劑的基因?qū)朊腋杉毎?使毛囊免受免疫攻擊從而起到治療斑禿的作用。6誘導(dǎo)式多能性干細胞(i PS)的出現(xiàn)和其能分化為各類毛囊角化細胞的能力,結(jié)合高產(chǎn)量的測序手段,使得我們在不久的將來不僅可識別與疾病有關(guān)的基因變化,也能通過移植人i PS到免疫缺陷的小鼠體內(nèi)建立疾病模型,有助于開展斑禿的病因、發(fā)病機制的進一步研究,以及開發(fā)斑禿治療方法等相關(guān)的研究。綜上所述,斑禿病因及發(fā)病機制目前尚不清楚,治療效果也不理想。對于斑禿的治療,將來需要開展多方位的研究,其中新型生物制劑被研發(fā)并取得一定效果,但是其安全性仍需進一步研究證實;毛囊干細胞可以作為基因治療的介質(zhì),通過基因轉(zhuǎn)染達到治療的目的;利用誘導(dǎo)式多能干細胞建立疾病模型,有助于進一步開展針對斑禿的病因、發(fā)病機制及治療方法的研究。
[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.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R758.71
本文編號：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.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R758.71
【參考文獻】
相關(guān)期刊論文 前3條
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2 周靜;楊勤萍;徐峰;樓瑋;盛友漁;;復(fù)方甘草酸苷治療斑禿107例臨床療效觀察[J];中國皮膚性病學雜志;2008年07期
3 孫洪棟;楊磊;劉文波;蘇湛;韓玉貞;朱玉紅;;液氮淺低溫冷凍對家兔皮膚黑素細胞組織學和超微結(jié)構(gòu)的影響[J];中國麻風皮膚病雜志;2009年12期
，本文編號：2452386
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