Report on key points of discussion from Genetics, Immunology and Therapeutic Targets breakout group.

1. Genetics, Immunology, and
Therapeutic Targets
Breakout Group Report

2. What has already been done and how is it related?
• Identification of new targets…but there must be more
• Are we looking in the right places? Hair follicle..? ECM..?
• Are we looking for the right signals…? Other cytokines…?
• Are we looking at the right cells…? NK? Other regulatory cells?
• Efforts toward antigen discovery progress being made and needs
to keep going
• What can we learn from patients who don’t respond to JAK
inhibitors?
• How can we better define those who will respond to JAK
inhibitors?

3. What questions still need to be answered?
• Need to understand how to stratify/select patients
• What defines a JAK responder vs a JAK non-responder?
• Are all non-responders not responding for same reason(s)? Different
reason(s)?
• Are there confounding diagnoses in JAK treated patients (AGA, other
alopecias?)
• Can we define a set of markers to select/stratify JAK responders, and
group the non-responders for further studies?
• What is the mechanism of longstanding disease? Is there burnout?
• Correlation of clinical status with research efforts – new onset patients,
longstanding disease, pediatric populations, etc.

4. What resources are needed?
• Additional funding for immunological studies
• Exploration to other immune mechanisms – NK cells, gammadelta
T cells, Tregs, B cells, DCs, mast cells, monocytes, others
• Further genetic studies – only 14 confirmed genes so far…there
are likely many more. Defining complete architecture to find
more pathways, potentially the ‘minor’ ones
• Biology of the end organ – hair follicle, cycle, pigmentation- and
its role in disease
• Consideration of environmental factors that interact with genetics
• Biomarkers and tools to monitor response to treatments

5. What can NAAF do to help?
• Liaise with other autoimmune disease groups to leverage research
findings, funding schemes, research priorities, shared disease
mechanisms (T1D, RA, thyroiditis, vitiligo, etc)
• Continued funding of exploratory ideas, to advance new concepts
and young investigators
• Continue to drive drug development pathway
• Continued emphasis on developing new outcome measures
• Continue with Research Summit to help define priorities and set
the agenda for the coming years!