NIHR | Manchester Biomedical Research Centre

Dermatology researchers at Manchester BRC awarded first ever Alopecia UK PhD bursary

The first ever Alopecia UK PhD bursary has been awarded to a team at the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC).

In 2022, national charity Alopecia UK invited researchers to apply for the bursary of £107,470, made possible by a generous legacy donation. The donation specified that it needed to be used for research into the causes and cures for alopecia areata.

The winner of the bursary is the team led by Dr Matthew Harries at the Centre for Dermatology Research at The University of Manchester, who work in collaboration with Salford Royal Hospital – part of Northern Care Alliance NHS Foundation Trust. Their work will be part of the Inflammatory Hair Disease research programme at NIHR Manchester BRC and will start in October 2023.

The bursary will be awarded over a period of three years and will support the research student and cost of materials used on the project.

Dr Matthew Harries, Deputy Lead of Manchester BRC’s Inflammatory Hair Diseases research programme and Consultant Dermatologist at Salford Royal Hospital, said: “We are very grateful to Alopecia UK for allowing us this unique opportunity to study alopecia areata (AA) at such an early stage in disease development. We hope the insights gained will shed new light on early pathogenic processes in this disease, potentially leading to identification of new prognostic markers and treatment targets.”

Alopecia areata (AA)

AA is one of the most common types of hair loss. It is an autoimmune condition, whereby the immune system – which normally protects the body from viruses and bacteria – mistakenly attacks the hair follicles. This causes patchy hair loss, which in some people can progress to complete loss of all scalp and body hair.

Dr Matthew Harries

What will the PhD project involve?

The project is titled: The Alopecia Areata Rapid Access Clinic: Can early access improve outcomes in patients with recent-onset alopecia areata?

The Alopecia Areata Rapid Access Clinic (AA-RAC) will recruit people with newly diagnosed alopecia areata to study the early stages of AA. Typically, people who are in this early stage are not offered treatment and told to see if hair grows back naturally or come back if it progresses to a severe state. By the time people do reach a specialist, their disease is chronic and established. In the meantime, their psychological well-being and quality of life have suffered significantly.

Dr Harries’ team will recruit people within 12 months of AA onset (and ideally within three to six months) and aim to offer appropriate treatments options alongside a personalised management plan.

Patients will speak to a nurse, health psychologist and dermatologist at the start of treatment, and again after four and 24 weeks. After this period, they will be referred to hospital dermatology or back to their GP with a care plan.

As part of the study, blood samples will be collected to allow the researchers to study risk factors for developing AA, and whether there are any relationships with other diseases. They will also study the levels of certain minerals, vitamins, and other nutrients to establish whether these may be related to the hair loss. In addition, they will collect hair and skin biopsy samples to investigate the activity of molecules and cells involved in immune processes.

By thoroughly screening the participants they also hope to establish whether there are different types of AA:

  • Autoimmune AA – people who have a personal or family history of other autoimmune disease, and is therefore the result of immune cells attacking specific ‘autoantigen’ targets in our own hair follicles; or
  • Non-autoimmune AA – those with no personal or family history of AA or other autoimmune disease, but with a clear identifiable trigger.

Following participation in the study, people will also be asked questions about the status of their hair loss 12 and 18 months later to get an understanding of how the disease progresses in different people. This will also allow them to work out if any of the markers they measured early on were predictors for the severity of AA and the risk of AA returning in the future.

The researchers aim to work with GPs and use the lessons from this research to create a successful model for rapid access to appropriate care for people with new onset AA.

In research, it is also important to include participants representative of the population as a whole, so that any results and recommendations can be applied to and improve outcomes for everyone. The epidemiology paper published by Dr Harries and others in 2021 has shown that AA is more common in people of non-white ethnicity (and of Asian ethnicity in particular) and of low socio-economic status. These groups may also be less likely to have access to specialist care. To reduce this inequality, part of the project will see the researchers work with the Salford Health Improvement Team to improve access for these groups.

Niels Bootsma, Alopecia UK Research Manager, said: “We are very grateful for the exceptional legacy donation that has made it possible for us to invest into this PhD studentship. The Alopecia UK Research Committee and Lay Research Panel were very enthusiastic about this project as it aims to address some of the most pressing concerns that people with AA face.

“Capturing what is happening in people with early-stage AA is such an important piece of the puzzle that we are still missing. It will go a long way in our understanding of how AA progresses in different people and will hopefully show us if treating it early can stop it in its tracks.”

Please note, although Dr Harries is a member of the Alopecia UK Research Committee, he was not involved in the decision to award this funding, in accordance with Alopecia UK’s Conflict of Interest Policy.