Alopecia areata, a non-contagious autoimmune disease causing hair loss, can be emotionally devastating for the estimated 5.3 million Americans who suffer from it, especially children. Celiac disease, also an autoimmune system dysfunction, is an allergy to gluten, proteins found in wheat, rye and barley. Even though people with celiac disease frequently have other autoimmune diseases, it took a scientist who had been diagnosed with alopecia areata herself to prove the genetic link between the two.
In alopecia areata, the autoimmune system attacks hair follicles. Most often, the first symptom is the appearance of one or more bald patches on the scalp but after that, the progression of the disease is highly unpredictable. Sometimes, the hair grows back on its own; other times, the condition results in alopecia totalis, the loss of all scalp hair, or alopecia universalis, the complete loss of hair everywhere on the body. Some treatments are effective in some cases, but usually only the mildest, and no treatments are effective in all cases.
When people with celiac disease eat anything containing gluten, their immune systems release antibodies that attack tiny protrusions in the small intestine called villi, necessary for the absorption of nutrients from food. The disease is often misdiagnosed because even though the inflammation starts in the digestive tract, overt symptoms may not be gastrointestinal. Celiac disease used to be considered rare but current estimates are that about 10 percent of the population may suffer from it and other forms of gluten intolerance with similarly variable symptoms.
Italian Research Findings
In October 1995, an Italian study published in "Gastroenterology" reported that some patients with alopecia areata had experienced complete hair regrowth after eliminating gluten from their diets. While the reason for the association between alopecia areata and celiac disease wasn't then clear, one theory was that intestinal inflammation interfered with absorption of food nutrients required by hair follicles. In their conclusions, the University of L'Aquila researchers suggested that doctors routinely test alopecia areata patients for CD because not only is hair loss one symptom -- it may also be the only symptom.
Genetic Links Discovered
Angela Christiano, professor of dermatology and genetics at Columbia University's School of Medicine, began researching alopecia areata in depth after she herself was diagnosed with the disease. While much had been assumed about the causes, she discovered that very little was known with scientific certainty. With the help of the National Alopecia Areata Foundation, Christiano led a study published in the July 1, 2010, "Nature Journal" and described by the NAAF as the most exciting genetic research on alopecia areata to date. Christiano and her team identified eight genes implicated in alopecia areata, three specific to hair and five involving immune response. Moreover, the same genes were responsible for other autoimmune diseases including rheumatoid arthritis, Type 1 diabetes -- and celiac disease. Because of the "overlapping genetics," drugs already approved or under development for the treatment of the other conditions may turn out to be effective for alopecia areata, Christiano told the "New York Times."
- Columbia University Medical Center; "Genetic Basis of Alopecia Areata Established for the First Time..."; June 30, 2010
- New York Times Science; "Living and Studying Alopecia"; Claudia Dreifus; Dec. 27, 2010
- PubMed; "Celiac Disease and Alopecia Areata: Report..."; Abstract; G.R. Corazza et al; October 1995
- Keratin: Celiac Disease Associated Alopecia
- CNN; "Will a Gluten-Free Diet Improve Your Health?"; Carina Storrs; April 12, 2011