In 1996 geneticist Angela Christiano was separated from her husband, newly arrived in a strange city and looking for a research focus in her new dermatology lab at Columbia University, when her hair started falling out in patches.
A doctor diagnosed it as alopecia areata, a mysterious condition in which the body’s own immune cells attack the hair follicles. Some people see quarter-size patches of hair loss on their scalp, while others lose all of their scalp hair, or even all the hair on their bodies.
Doctors could try to treat the symptoms, Christiano learned, but there was no cure—although the hair might return on its own. Her own hair loss subsided after two years, but by then she had found her scientific calling.
Earlier this month, Christiano and her collaborators reported in the journal Nature that they had identified a set of genes that trigger the disease, which affects some 5.3 million Americans.
Christiano’s team found that alopecia areata shares key genetic pathways with other autoimmune conditions for which drug companies are developing treatments, including celiac disease, rheumatoid arthritis and type 1 (juvenile) diabetes.
“The great thing is there is going to be a lot of spillover from the clinical trial work of these other diseases that we can jump on,” says Christiano, who adds that alopecia areata sufferers are a big potential market for drugmakers. “We are the most common form of autoimmune disease and the second most common form of hair loss, after male pattern baldness.”
Alopecia areata affects males and females of all ages and races. Sufferers are often ashamed of their appearance and try to conceal evidence of the disease with wigs and tattoos, says Vicki Kalabokes, president of the National Alopecia Areata Foundation (NAAF). Actor Barry Corbin, former CNN correspondent Art Harris, Detroit Piston Charlie Villanueva and the late Christopher Reeve are among a handful of prominent people who acknowledged having the disease.
Christiano’s study compared the DNA of 1,054 alopecia areata patients with 3,200 control subjects in a genome-wide association study that identified eight suspect gene mutations. Some are known to regulate certain kinds of T cells—the white blood cells that fight infections in our bodies—while others produce chemical “danger signals” that trigger the release of the white blood cells.
Christiano’s research was partly funded by the NAAF, which also helped set up a nationwide registry of alopecia areata patients, says Kalabokes. “People are going, ‘Finally, I feel there’s hope,’ ” she says. “This validates what we’ve been doing all this time.”
Christiano next wants to look at a larger sample of patients—with as many as 10,000 people—to see whether other as-yet-undiscovered genes are involved.
“Some people have called it a labor of love,” she says of her work. “But as a geneticist it would be hard to think of a better disease to have the opportunity to work on. This is going to keep us busy for the next 20 years.”
Michael Haederle is a freelance writer whose work has appeared in People, the New York Times and the Los Angeles Times.