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Waśkiel-Burnat A, Osińska M, Salińska A, Blicharz L, Goldust M, Olszewska M, Rudnicka L. The Role of Serum Th1, Th2, and Th17 Cytokines in Patients with Alopecia Areata: Clinical Implications. Cells 2021; 10:cells10123397. [PMID: 34943905 PMCID: PMC8699846 DOI: 10.3390/cells10123397] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 02/07/2023] Open
Abstract
Alopecia areata is a type of non-scarring hair loss. The dysregulation of numerous systemic Th1 (IL-2, IFN-γ, TNF, IL-12, and IL-18), Th2 (IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17E, IL-31 and IL-33) and Th17 (IL-17, IL-17F, IL-21, IL-22, IL-23 and TGF-β) cytokines was observed in patients with alopecia areata. Positive correlations between the severity of alopecia areata and an increased serum level of various cytokines including IL-2, TNF, IL-12, IL-17, and IL-17E were reported in the literature. An increased serum level of numerous cytokines, such as IL-2, IL-6, TNF, IL-12, IL-17E, and IL-22, was described as positively correlated with the duration of the disease. Moreover, it was shown that increased pre-treatment serum level of IL-12 was a positive, while increased serum levels of IL-4 and IL-13 were negative prognostic markers for the efficacy of diphenylcyclopropenone. In conclusion, alopecia areata is associated with the dysregulation of systemic Th1, Th2 and Th17 cytokines with their role in the pathogenesis, clinical manifestations and prognosis of the disease. Available data indicate the most significant role of serum IL-2, TNF, IL-12, IL-17, and IL-17E as markers of disease activity. The serum levels IL-4, IL-12 and IL-13 may be useful as potential predictors of diphenylcyclopropenone efficacy.
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Affiliation(s)
- Anna Waśkiel-Burnat
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; (A.W.-B.); (M.O.); (A.S.); (L.B.); (M.O.)
| | - Marta Osińska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; (A.W.-B.); (M.O.); (A.S.); (L.B.); (M.O.)
| | - Anna Salińska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; (A.W.-B.); (M.O.); (A.S.); (L.B.); (M.O.)
| | - Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; (A.W.-B.); (M.O.); (A.S.); (L.B.); (M.O.)
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Małgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; (A.W.-B.); (M.O.); (A.S.); (L.B.); (M.O.)
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; (A.W.-B.); (M.O.); (A.S.); (L.B.); (M.O.)
- Correspondence: ; Tel.: +48-22-502-13-24; Fax: +48-22-824-22-00
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Pedrosa LR, Melo DF, Tortelly VD, Ribeiro NCR, Mann D, Machado CJ. A Matched Case-Control Study of Zinc Levels in Androgenetic Alopecia and Alopecia Areata: Is There a Need to Do Routine Screening? Skinmed 2020; 18:398-400. [PMID: 33397578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
| | - Daniel Fernandes Melo
- Dermatology Department, Marcílio Dias Naval Hospital, Rio de Janeiro, RJ, Brazil
- Dermatology Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Violeta Duarte Tortelly
- Dermatology Department, Marcílio Dias Naval Hospital, Rio de Janeiro, RJ, Brazil
- Dermatology Department, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Danielle Mann
- Dermatology Department, Marcílio Dias Naval Hospital, Rio de Janeiro, RJ, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Abstract
BACKGROUND Alopecia areata (AA) involves oxidative reactions in the hair follicle. Its treatment is difficult due to both the unknown etiology and the adverse drug effects. Aims: This study aimed to evaluate the effects of orally administered ginger powder on the oxidative stress markers of the plasma and blood cells in Iraqi patients with AA. SUBJECTS AND METHODS Twenty patients (9 females and 11 males), with a mean age of 26.0 ± 8.0 years, with different lesions of stable alopecia areata localized on the scalp, were enrolled in this pilot study. Exclusion criteria include the use of any medication that may influence the course of the disease. All patients were treated with 500 mg of ginger powder once daily for 60zz days. Blood samples were obtained at zero time, day-30 and day-60 and utilized for the evaluation of the erythrocytes and lymphocytes contents of reduced glutathione (GSH), malondialdehyde (MDA) and total antioxidant status (TAS), in addition to the assessment of serum zinc (Zn) and copper (Cu) levels. The results are compared with those of 20 healthy subjects served as a control group. RESULTS Treatment of the AA patients with ginger significantly improves the antioxidant/oxidant balance of the erythrocytes and lymphocytes, which is known to be impaired in the patient group as compared with healthy subjects. The ginger powder also elevates the serum concentration of zinc up to that reported in controls and associated with normalizing serum copper levels at the end of the treatment period. CONCLUSION Consumption of ginger as a supplement by the patients with AA could improve the oxidant/antioxidant balance of the erythrocytes and lymphocytes and restoring the normal level of serum zinc.
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Affiliation(s)
- A N Abbas
- Department of Pharmacology, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq
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Marahatta S, Agrawal S, Khan S. Study on Serum Vitamin D in Alopecia Areata Patients. J Nepal Health Res Counc 2019; 17:21-25. [PMID: 31110371 DOI: 10.33314/jnhrc.1475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 04/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Alopecia areata is the commonest cause of non-scarring alopecia. Few previous studies have found correlation between AA and vitamin D deficiency, suggesting that vitamin D deficiency can be a risk factor for Alopecia areata. To compare serum vitamin D level between Alopecia areata patients and healthy controls; and to assess the relation between serum vitamin D levels and AA disease severity. METHODS This case control study included 30 newly diagnosed Alopecia areata patients. Thorough history was taken, detail examination was done and relevant findings were recorded in the standardized pro-forma. Their serum vitamin D (25-hydroxyvitamin D) levels were determined by competitive chemiluminescence methods; and were compared with that of age and sex matched healthy controls. Chi square test and Spearman's rho correlation test were used for the inferential statistics using SPSS version 11.5. RESULTS There were 30 AA patients with mean age 28.37+10.07 years. Mean Severity of Alopecia Tool score was 3.56+3.50. Prevalence of 25-hydroxyvitamin D [25(OH)D] deficiency was significantly higher in AA group (83.3%) compared to the control group (53.3%) (P=0.01). Similarly, serum 25(OH)D level was reduced more in Alopecia areata group (12.84, IQR=8.87-20.47) than the control group (29.5, IQR=19.85-41.27) (P=0.06). There was inverse co-relation between serum 25(OH)D level and SALT score. CONCLUSIONS Prevalence of serum 25(OH)D deficiency was significantly higher in Alopecia areata group compared to the control, with inverse co-relation between its level and Alopecia areata disease severity.
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Affiliation(s)
- Suchana Marahatta
- Department of Dermatology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sudha Agrawal
- Department of Dermatology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Seraj Khan
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Abstract
Background/aim Results show that oxidative stress is a pathophysiologic factor for alopecia areata (AA); however, the markers used can be confounding. Thus, we aimed to investigate the role of oxidative stress in the pathogenesis of AA through an evaluation of ischemia-modified albumin (IMA); other markers of the oxidant/antioxidant system, such as SOD, CAT, GSH-ST, and MDA; and contributing clinical risk factors. Materials and methods The usefulness of IMA as a new marker for oxidative stress was compared with that of other markers and evaluated in patients with AA. Results The mean serum level of IMA was of higher statistical significance in AA patients than in the control group (IMA: 0.57 ± 0.01 vs. 0.52 ± 0.02 ΔABSU, P < 0.0001). IMA (P = 0.03, OR = 25.8, 95% CI = 1.4–482.7) was found to be an independent predictor of oxidative stress in patients with AA. Increased severity of AA was found as an independent risk factor for IMA. Conclusion Long-lasting disease, male sex, >1 site of involvement of disease, and increased severity of disease were correlated with increased oxidation. Presence of AA, male sex, and severe disease were determined to be independent risk factors for antioxidant and oxidant systems. IMA has great potential as a biomarker of oxidative stress in AA when compared to other studied biomarkers.
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Affiliation(s)
- Hatice ATAŞ
- Department of Dermatology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Müzeyyen GÖNÜL
- Department of Dermatology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, AnkaraTurkey
| | - Yasin ÖZTÜRK
- Department of Biochemistry, Faculty of Science, Gazi University, AnkaraTurkey
| | - Mustafa KAVUTÇU
- Department of Biochemistry, Faculty of Science, Gazi University, AnkaraTurkey
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Dizen-Namdar N, Emel Kocak F, Kidir M, Sarici G, Tak H, Altuntas I. Evaluation of Serum Paraoxonase, Arylesterase, Prolidase Activities and Oxidative Stress in Patients with Alopecia Areata. Skin Pharmacol Physiol 2018; 32:59-64. [PMID: 30544126 DOI: 10.1159/000494690] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/18/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Nazli Dizen-Namdar
- Department of Dermatology, School of Medicine, University of Health Sciences, Kutahya, Turkey,
| | - Fatma Emel Kocak
- Department of Biochemistry, School of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Mehtap Kidir
- Department of Dermatology, Medical Park Hospital, Istanbul, Turkey
| | - Gulben Sarici
- Department of Dermatology, Anadolu Hospital, Kutahya, Turkey
| | - Hasan Tak
- Department of Dermatology, Akdeniz Sifa Hospital, Antalya, Turkey
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Wang EH, Santos L, Li XY, Tran A, Kim SSY, Woo K, Shapiro J, McElwee KJ. Alopecia Areata is Associated with Increased Expression of Heart Disease Biomarker Cardiac Troponin I. Acta Derm Venereol 2018; 98:776-782. [PMID: 29740659 DOI: 10.2340/00015555-2964] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The development of androgenetic alopecia is associated with a risk of developing cardiovascular diseases, but the association of alopecia areata with cardiovascular diseases in humans is largely unexplored. We measured the plasma level of two common cardiovascular disease markers, cardiac troponin I and C-reactive protein, in alopecia areata and androgenetic alopecia affected subjects. Also, we investigated the possible presence of pro-apoptotic factors in the plasma of hair loss subjects. The mean plasma cardiac troponin I level was highest in alopecia areata subjects, moderately higher in androgenetic alopecia subjects, and lowest in subjects without hair loss (p <0.05). Alopecia areata subjects not receiving treatments had highest levels of cTnI (p <0.05). Alopecia areata plasma samples with high cardiac troponin I levels also induced significantly higher rates of cardiomyocyte apoptosis in cell culture assays. The results suggest the potential for increased heart remodelling. Close monitoring of cardiovascular health in alopecia areata subjects, as well as subsets of androgenetic alopecia patients, may be appropriate.
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Affiliation(s)
- Eddy Hsi Wang
- Department of Dermatology and Skin Science, University of British Columbia, V5Z 4E8 Vancouver, BC, Canada.
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Lee S, Kim BJ, Lee CH, Lee WS. Increased prevalence of vitamin D deficiency in patients with alopecia areata: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2018; 32:1214-1221. [PMID: 29633370 DOI: 10.1111/jdv.14987] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a hair follicle-specific autoimmune disorder. Vitamin D deficiency has been associated with various autoimmune disorders for its immunomodulatory effects. However, in previous studies, there had been inconsistent association found between AA and vitamin D deficiency. OBJECTIVE To demonstrate the differences of the mean serum 25-hydroxyvitamin D level and prevalence of vitamin D deficiency between AA patients and non-AA population. METHODS A systematic review and meta-analysis of observational studies on AA and serum vitamin D levels and/or prevalence of vitamin D deficiency was performed searching MEDLINE, Cochrane, Web of Science and Google Scholar databases. RESULTS In all, 14 studies including a total of 1255 AA subjects and 784 non-AA control were analysed. The mean serum 25-hydroxyvitamin D level was significantly lower in AA subjects (-8.52 ng/dL; 95% confidential interval; -5.50 to -11.53). The AA subjects had higher odds of vitamin D deficiency (odds ratio of 3.89; 2.02 to 7.49, mean prevalence of 73.8%; 59.1 to 84.6%). However, it was difficult to find clear correlation between serum 25-hydroxyvitamin D level and extent of hair loss in AA subjects. CONCLUSION The AA subjects had lower serum 25-hydroxyvitamin D level, and vitamin D deficiency was highly prevalent compared to non-AA controls. Hence, vitamin D deficiency should be assessed in AA patients. Furthermore, nutritional supplementation of vitamin D or topical vitamin D analogues can be considered for AA patients with vitamin D deficiency. The limitation of this study is the highly heterogeneity of the included studies.
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Affiliation(s)
- S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - B J Kim
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - C H Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - W S Lee
- Department of Dermatology and Institute of Hair and Cosmetic Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Bolotnaja L, Serbina I. [ADAPTIVE REGULATORY MECHANISMS OF ALOPECIA AREATA]. Georgian Med News 2017:75-80. [PMID: 29227263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Failure of adaptive mechanisms leads to structural and functional damage at all levels and of neuroendocrinal and immune systems, which are pathogenetic basis of development of autoimmune diseases, in particular. The objective of this work was to assess the condition of adaptive hormones, such as cortisol and insulin, coefficient of stress of adaptive potential "K" and also dermatologic life quality index (DLQI) of the diseased with alopecia areata (AA). 48 patients with different forms of AA aged between 18 and 52 were examined. Correlation analysis identified positive correlation between DLQI and early age of patients, severe stage and hair loss for the period of over 12 months (p<0.01). Two types of reactions were identified - increase and decrease of content of cortisol and insulin in blood depending on the activity, severity stage and length of AA. The diseased with signs of progression of the disease, severe stage and duration of up to 3 years AA experienced increase of the coefficient "K" (p<0.05) indicates increase of tension of adaptive potential of the organism. Decrease of the coefficient "K" (p<0.05) during chronisation and duration of the disease of over 3 years indicates depletion of adaptive mechanisms of organism with possible failure of regulatory processes. Identified disorders demonstrate existence of maladaptive processes in the diseased with FF and may be considers as potential therapeutic targets.
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Affiliation(s)
- L Bolotnaja
- Kharkov Medical Academy of Postgraduate Education, Ukraine
| | - I Serbina
- Kharkov Medical Academy of Postgraduate Education, Ukraine
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Abstract
Alopecia areata (AA) is a common, non-scarring form of hair loss caused by immune-mediated attack of the hair follicle. As with other immune-mediated diseases, a complex interplay between environment and genetics is thought to lead to the development of AA. Deficiency of micronutrients such as vitamins and minerals may represent a modifiable risk factor associated with development of AA. Given the role of these micronutrients in normal hair follicle development and in immune cell function, a growing number of investigations have sought to determine whether serum levels of these nutrients might differ in AA patients, and whether supplementation of these nutrients might represent a therapeutic option for AA. While current treatment often relies on invasive steroid injections or immunomodulating agents with potentially harmful side effects, therapy by micronutrient supplementation, whether as a primary modality or as adjunctive treatment, could offer a promising low-risk alternative. However, our review highlights a need for further research in this area, given that the current body of literature largely consists of small case-control studies and case reports, which preclude any definite conclusions for a role of micronutrients in AA. In this comprehensive review of the current literature, we found that serum vitamin D, zinc, and folate levels tend to be lower in patients with AA as compared to controls. Evidence is conflicting or insufficient to suggest differences in levels of iron, vitamin B12, copper, magnesium, or selenium. A small number of studies suggest that vitamin A levels may modify the disease. Though understanding of the role for micronutrients in AA is growing, definitive clinical recommendations such as routine serum level testing or therapeutic supplementation call for additional studies in larger populations and with a prospective design.
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Affiliation(s)
- Jordan M Thompson
- Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Mehwish A Mirza
- Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT, 06473, USA
| | - Min Kyung Park
- Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, USA.
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA.
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Ghafoor R, Anwar MI. Vitamin D Deficiency in Alopecia Areata. J Coll Physicians Surg Pak 2017; 27:200-202. [PMID: 28492146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To compare the mean Vitamin D level in patients with alopecia areata (AA) with age and gender controlled matched healthy controls. STUDY DESIGN Case-control study. PLACE AND DURATION OF STUDY Dermatology OPD, JPMC, from October 2014 to March 2015. METHODOLOGY All the patients diagnosed of alopecia areata by a trained dermatologist were selected. Controls were age and gender matched healthy volunteers. Venous blood was drawn and sent to hospital laboratory for 25 (OH) vitamin D by enzyme immunoassay method on chemical analyser. Data was recorded on SPSS version 16. Mann-Whitney test was applied to compare vitamin D levels of cases and controls. P-value <0.05 was taken as significant. RESULTS There are 30 cases of AA, and 30 age and gender matched controls. The mean age of our study group was 23.77 ±8.86 ng/dL in patients and 24.03 ±8.62 ng/dL in the control group. Fifteen (50%) patients presented between 3-12 months of onset of AA. Median (IQR) vitamin D level of cases was 13.5 (18.6) ng/dL and healthy controls was 22.5 (16.25) (p=0.001). CONCLUSION Serum Vitamin D levels were significantly lower in patients with alopecia areata compared to healthy controls.
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Affiliation(s)
- Rabia Ghafoor
- Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi
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Aiempanakit K, Chiratikarnwong K, Chuaprapaisilp T, Jandee S, Auepemkiate S. A Study of Plasma Zinc Levels in Thais with Alopecia Areata. J Med Assoc Thai 2016; 99:823-827. [PMID: 29901915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To study the correlation between the plasma zinc levels of Thai participants with alopecia areata (AA) and compare to the levels of Thais who do not have AA. MATERIAL AND METHOD A cross-sectional study of thirty Thais with AA (case group) and thirty gender and age-matched healthy subjects (control group). All participants underwent blood tests measuring zinc and confounding factors. RESULTS Participants in both groups were the same gender, 20 (66.7%) women and 10 (33.3%) men. The median age was 37 in the study group and 38 in the control. In the study group, the median disease duration was three months (interquartile range 1-6). Patients who had AA for more than three months had a lower mean plasma zinc level than those who had AA for less than three months without statistical significance (58.33±8.59, 62.43±13.19 μg/dL (mean ± standard deviation or SD), respectively, p-value = 0.40). The correlation between plasma zinc levels and disease duration of AA (p-value = 0.31) and the plasma zinc levels and the Severity of Alopecia Tool (SALT) score (p-value = 0.16) were not statistically significant. The mean plasma zinc level in the study group was lower than in the control group with statistical significance (61.20±12.00, 67.17±10.04 μg/dL (mean ± SD), respectively, p-value = 0.04). CONCLUSION The plasma zinc level in participants with AA is statistically significantly lower than in participants without AA. A more in depth study should be conducted to determine whether prescribing zinc supplement would be of benefit to AA patients.
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Ganzetti G, Simonetti O, Campanati A, Giuliodori K, Scocco V, Brugia M, Tocchini M, Offidani A. Osteopontin: a new facilitating factor in alopecia areata pathogenesis? Acta Dermatovenerol Croat 2015; 23:19-22. [PMID: 25969908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Osteopontin (OPN) is a multifunctional glycophosphoprotein secreted by many cell types, including osteoblasts, lymphocites, macrophages, epithelial cells, and vascular smooth muscle cells. It has been implicated in many physiological and pathological processes, such as cell-mediated immunity, inflammation, cell survival, and tumor invasion and metastasis. Osteopontin has multiple emerging roles in cutaneous biology and pathology and OPN involvement has been emphasized in Th1-mediated diseases such as psoriasis. Alopecia areata (AA) is a form of non-scarring hair loss affecting anagen stage hair follicles with a multifactorial autoimmune pathogenesis characterized by a prevalent Th1 cytokine profile. Given the role of osteopontin in Th1-mediated inflammation, we have postulated that OPN may be involved in AA pathogenesis. The aim of our study was to investigate plasma OPN level in alopecia areata before and after DPCP treatment. Our results showed that OPN plasma levels in patients with alopecia areata were higher than in healthy controls, but patients achieving complete recovery after DPCP treatment did not show a statistically significant reduction of OPN plasma levels.
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Bertolini M, Zilio F, Rossi A, Kleditzsch P, Emelianov VE, Gilhar A, Keren A, Meyer KC, Wang E, Funk W, McElwee K, Paus R. Abnormal interactions between perifollicular mast cells and CD8+ T-cells may contribute to the pathogenesis of alopecia areata. PLoS One 2014; 9:e94260. [PMID: 24832234 PMCID: PMC4022513 DOI: 10.1371/journal.pone.0094260] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/12/2014] [Indexed: 02/08/2023] Open
Abstract
Alopecia areata (AA) is a CD8+ T-cell dependent autoimmune disease of the hair follicle (HF) in which the collapse of HF immune privilege (IP) plays a key role. Mast cells (MCs) are crucial immunomodulatory cells implicated in the regulation of T cell-dependent immunity, IP, and hair growth. Therefore, we explored the role of MCs in AA pathogenesis, focusing on MC interactions with CD8+ T-cells in vivo, in both human and mouse skin with AA lesions. Quantitative (immuno-)histomorphometry revealed that the number, degranulation and proliferation of perifollicular MCs are significantly increased in human AA lesions compared to healthy or non-lesional control skin, most prominently in subacute AA. In AA patients, perifollicular MCs showed decreased TGFβ1 and IL-10 but increased tryptase immunoreactivity, suggesting that MCs switch from an immuno-inhibitory to a pro-inflammatory phenotype. This concept was supported by a decreased number of IL-10+ and PD-L1+ MCs, while OX40L+, CD30L+, 4–1BBL+ or ICAM-1+ MCs were increased in AA. Lesional AA-HFs also displayed significantly more peri- and intrafollicular- CD8+ T-cells as well as more physical MC/CD8+ T-cell contacts than healthy or non-lesional human control skin. During the interaction with CD8+ T-cells, AA MCs prominently expressed MHC class I and OX40L, and sometimes 4–1BBL or ICAM-1, suggesting that MC may present autoantigens to CD8+ T-cells and/or co-stimulatory signals. Abnormal MC numbers, activities, and interactions with CD8+ T-cells were also seen in the grafted C3H/HeJ mouse model of AA and in a new humanized mouse model for AA. These phenomenological in vivo data suggest the novel AA pathobiology concept that perifollicular MCs are skewed towards pro-inflammatory activities that facilitate cross-talk with CD8+ T-cells in this disease, thus contributing to triggering HF-IP collapse in AA. If confirmed, MCs and their CD8+ T-cell interactions could become a promising new therapeutic target in the future management of AA.
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Affiliation(s)
- Marta Bertolini
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Department of Dermatology, University of Münster, Münster, Germany
| | - Federica Zilio
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, University “La Sapienza”, Rome, Italy
| | - Patrick Kleditzsch
- Department of Gynaecology and Obstetrics, University of Rostock, Rostock, Germany
| | - Vladimir E. Emelianov
- Department of Pharmacology, Clinical Pharmacology and Biochemistry, Chuvash State University Medical School, Cheboksary, Russia
| | - Amos Gilhar
- Laboratory for Skin Research, Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Flieman Medical Center, Haifa, Israel
| | - Aviad Keren
- Laboratory for Skin Research, Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
| | - Katja C. Meyer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Eddy Wang
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kevin McElwee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ralf Paus
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Department of Dermatology, University of Münster, Münster, Germany
- Institute for Inflammation and Repair, University of Manchester, Manchester, United Kingdom
- * E-mail:
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15
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Bergfeld WF. Growth hormone deficiency in a young patient with alopecia areata. J Investig Dermatol Symp Proc 2013; 16:S54-S55. [PMID: 24326559 DOI: 10.1038/jidsymp.2013.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A young female child aged 7 years presented initially with chronic alopecia areata, which over 2 years progressed to alopecia areata universalis.
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Affiliation(s)
- Wilma F Bergfeld
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
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16
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Chne X, Chen D, Chen J, Wei J. [Serum cortisol and peripheral blood mononuclear cell glucocorticoid receptor mRNA expression in severe alopecia areata with liver-kidney deficiency syndrome]. Nan Fang Yi Ke Da Xue Xue Bao 2012; 32:230-233. [PMID: 22381765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate serum cortisol level and glucocorticoid receptors (GR) mRNA expression in peripheral blood mononuclear cells (PBMCs) in patients with severe alopecia areata and liver-kidney deficiency syndrome and their involvement in the pathogenesis of severe alopecia areata. METHODS In 32 patients with severe alopecia areata, serum cortisol levels were measured by chemiluminescence assay and GR mRNA expression in the PBMCs was detected using reverse transcription real-time fluorescence quantitative PCR before and after treatment, with 20 normal subjects serving as the controls. RESULTS Serum cortisol level showed no significant difference between the cases and the normal controls (P>0.05). The expression of GR mRNA in the PBMCs was significantly lower in the patients than in the normal controls (P<0.05). The expression of GR mRNA was even lower after treatments in patients with alopecia areata (P<0.01). CONCLUSIONS GC-GR disorder exists in severe alopecia areata. A decreased GR mRNA expression in the PBMCs can be involved in the pathogenesis of severe alopecia areata, and such pathological changes at the receptor and genetic levels might also serve as the microscopic basis of liver-kidbey deficiency syndrome in severe alopecia areata.
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Affiliation(s)
- Xiuyang Chne
- Department of Dermatology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
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17
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18
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Kasumagic-Halilovic E, Prohic A, Karamehic J. Serum concentrations of interferon-gamma (IFN-g) in patients with alopecia areata: correlation with clinical type and duration of the disease. Med Arh 2010; 64:212-214. [PMID: 21246917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Alopecia areata (AA) is a heterogeneous disease characterized by nonscarring hair loss on the scalp or other parts of the body. A wide range of clinical presentations can occur-from a single patch of hair loss (alopecia unilocularis, AUl), multiple patches (alopecia multilocularis, AM) to complete loss of hair on the scalp (alopecia totalis, AT) or the entire body (alopecia universalis, AU). The cause ofAA is unknown although most evidence supports the hypothesis that AA is a T-cell mediated autoimmune disease of the hair follicle and that cytokines play an important role. The aim of the study was to evaluate serum concentrations of interferon-gamma (IFN-g) in patients with AA and the healthy subjects and also to assess a possible association between IFN-g and clinical type and duration of the disease. Sixty patients with AA and 20 healthy controls were enrolled in the study. Serum concentrations of IFN-g were determined by ELISA method. The serum concentration of IFN-g in patients with AA was significantly higher than that in the control group (10.62 +/- 1.09 pg/mL vs 10.02 +/- 0.62 pg/mL, respectively). Significantly elevated serum IFN-g were noticed in patients with AU type (11.81 +/- 1.11 pg/mL), expecialy those suffering from AT (12.30 +/- 0.93 pg/mL), compared with both patients with AUl (10.20 +/- 0.59 pg/mL) and patients with AM clinical type (10.21 +/- 0.78 pg/mL). There was no significant difference in serum IFN-g concentration between patients with AUl and AM group, as well as between patients with AT and AU. No correlations were found between duration of disease and the serum levels of IFN-g. Our findings confirm previously published data that the Th1 type cytokine IFN-g is elevated in the serum of AA patients.
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Affiliation(s)
- Emina Kasumagic-Halilovic
- Department of Dermatovenerology, Clinical Centre of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina.
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Feizy V, Mortazavi H, Barikbin B, Yousefi M, Ranjbar A, Farshchian M. Serum selenium level in Iranian patients with alopecia areata. J Eur Acad Dermatol Venereol 2008; 22:1259-60. [PMID: 18452532 DOI: 10.1111/j.1468-3083.2008.02612.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Esfandiarpour I, Farajzadeh S, Abbaszadeh M. Evaluation of serum iron and ferritin levels in alopecia areata. Dermatol Online J 2008; 14:21. [PMID: 18627722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Although immunologic processes and hereditary factors are suggested to play an important role in alopecia areata, the specific etiology is unclear. Iron deficiency has been suggested to play a role, but its effect is controversial. In our case control study, we found a higher mean level of serum iron and ferritin and a lower mean level of TIBC in patients compared to control subjects, but the differences did not reach significance.
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Kuwano Y, Fujimoto M, Watanabe R, Ishiura N, Nakashima H, Ohno Y, Yano S, Yazawa N, Okochi H, Tamaki K. Serum chemokine profiles in patients with alopecia areata. Br J Dermatol 2007; 157:466-73. [PMID: 17489976 DOI: 10.1111/j.1365-2133.2007.07943.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although chemokines play an important role in various inflammatory diseases, there have been few studies about the role of chemokines in alopecia areata (AA). OBJECTIVES To determine serum levels of chemokines in patients with AA and their clinical correlations. METHODS Serum samples from 85 patients with AA, 20 patients with atopic dermatitis, 20 patients with psoriasis vulgaris and 28 normal controls were examined by the cytometric bead array assay assessing monokine induced by interferon (IFN)-gamma (MIG), RANTES, interleukin-8 (IL-8), IFN-inducible protein-10, monocyte chemoattractant protein-1, macrophage inflammatory protein (MIP)-1alpha, MIP-1beta and eotaxin levels. Secreted chemokine levels from peripheral blood mononuclear cells (PBMC) of patients with AA were also investigated. RESULTS Serum MIG, RANTES, IL-8 and eotaxin levels were selectively increased in patients with AA compared with normal controls. Levels of MIG, RANTES and IL-8 secreted from PBMC of patients with AA were also increased. Furthermore, elevated serum MIG and RANTES levels significantly correlated with the disease activity. RANTES levels were nonsignificantly associated with a predisposition to atopy. CONCLUSIONS These results suggest that MIG and RANTES play an important role in the development of AA and are useful as markers of disease activity and as therapeutic targets.
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Affiliation(s)
- Y Kuwano
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Kuwano Y, Fujimoto M, Watanabe R, Asashima N, Nakashima H, Ohno H, Yano S, Yazawa N, Okochi H, Tamaki K. Serum anti-Fcγ receptor autoantibodies in patients with alopecia areata. Arch Dermatol Res 2006; 298:493-8. [PMID: 17124586 DOI: 10.1007/s00403-006-0717-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2006] [Revised: 08/31/2006] [Accepted: 10/17/2006] [Indexed: 10/23/2022]
Abstract
Although anti-Fcgamma receptor antibodies (Abs) are detected in various autoimmune diseases, there have been no studies about the anti-Fcgamma receptor Abs in alopecia areata (AA). To detect the anti-Fcgamma receptor Abs in patients with AA and their clinical correlations, Serum samples from 72 patients with AA and 23 normal controls were examined by enzyme-linked immunosorbent assay assessing anti-Fcgamma receptor Ab levels. Anti-Fcgamma receptor I Abs were significantly frequently detected in patients with AA compared with normal controls. Furthermore, the detection of anti-Fcgamma receptor I Abs significantly inversely correlated with the disease duration. These results suggest that anti-Fcgamma receptor I Ab and Fcgamma receptor I play an important role in the regulation of AA, are useful for a marker of the disease prognosis and are worth intense research for the reasonable and specific therapy of AA.
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Affiliation(s)
- Yoshihiro Kuwano
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Katagiri K, Arakawa S, Hatano Y. In vivo levels of IL-4, IL-10, TGF-β1 and IFN-γ mRNA of the peripheral blood mononuclear cells in patients with alopecia areata in comparison to those in patients with atopic dermatitis. Arch Dermatol Res 2006; 298:397-401. [PMID: 17021766 DOI: 10.1007/s00403-006-0700-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 08/23/2006] [Accepted: 08/31/2006] [Indexed: 10/24/2022]
Abstract
Alopecia areata (AA) has been considered to be supported by an aberrant expression of IFN-gamma as a result of antigen dependent immune response. On the other hand, AA sometimes concurs with atopic diseases, although the mechanism of the concurrence is not clear. This study was designed to elucidate the immune status of AA and the similarity between AA and atopic dermatitis (AD) by analysis of in vivo levels of mRNA of Th1, Th2, and suppressive cytokines of peripheral blood mononuclear cells (PBMC). Using semiquantitative RT-PCR, the levels of cytokine mRNA were measured in freshly isolated PBMC of 47 patients with AA, 15 patients with AD, and 12 healthy controls (HC). The levels of IL-4, IFN-gamma, and TGF-beta1 mRNA were lower in patients with AA than those in HC. The levels of IL-10 mRNA in AA were comparable with those in HC. Decreased levels of IFN-gamma and TGF-beta1 were also shown in patients with AD. These results indicated a similarity (decreased levels of IFN-gamma and TGF-beta1) between AD and AA based on the cytokine profile. In addition, decreased levels of IL-4 mRNA in AA might also explain the experience that the severity of atopic disease coincident with AA is mild in the most of cases. Next, we compared the levels of these cytokine mRNA among the three subgroups of AA that were categorized based on the severity of the symptoms: mild, severe and totalis. Although there was no significant difference between any combinations of the subgroups, there was a tendency to increase the levels of IFN-gamma mRNA and to decrease the levels of IL-4 mRNA according to the severity of alopecia. However, the levels of IFN-gamma mRNA in any subgroups were less than those of HC. These results suggest that IFN-gamma is therefore involved in the pathogenesis of AA, although the information from PBMC is limited. In conclusion, AA might be induced by an aberrant expression of IFN-gamma in individuals whose PBMC produce low amounts of IFN-gamma and TGF-beta1. Further analysis is therefore required to investigate the phenotypes of the population in PBMC with or without reference to regulatory T cells.
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Affiliation(s)
- Kazumoto Katagiri
- Department of Anatomy, Biology and Medicine (Dermatology), Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan.
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Cserhalmi M, Hagymási K, Szentmihályi K, Fehér J. [Alopecia areata caused by extreme solar abuse]. Orv Hetil 2006; 147:1573-7. [PMID: 17037680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The Authors present a female patient who suffered from alopecia areata caused by extreme solar abuse. Biological effects of ionizing radiation, the damages by free radicals and protection against oxidative damage are summarized. The main forms and risk factors of UV-radiation, skin damages by UV-light as well as the pathogenesis of the alopecia areata are reviewed.
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Affiliation(s)
- Mária Cserhalmi
- Semmelweis Egyetem, Altalános Orvostudományi Kar, II Belgyógyászati Klinika, Budapest
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26
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Kasumagić-Halilović E, Prohić A. Serum levels of total immunoglobulin e in patients with alopecia areata: relationship with clinical type of the disease. Acta Dermatovenerol Croat 2006; 14:149-52. [PMID: 17010262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Alopecia areata (AA) is a heterogeneous disease characterized by nonscarring hair loss on the scalp or any hair-bearing surface. A wide range of clinical presentations can occur, from a single patch of hair loss to complete loss of hair on the scalp (alopecia totalis, AT) or over the entire body (alopecia universalis, AU). The cause of AA is unknown although most evidence supports the hypothesis that AA is an immunologically mediated disease. The aim of the study was to compare serum levels of total immunoglobulin E (IgE) between patients with AA and healthy subjects, and to assess the difference between the localized form and extensive forms of the disease such as AT and AU. Sixty patients with AA and 50 healthy subjects were enrolled in the study. Fifty patients had localized AA (LAA), and ten patients had AT, AU or AT/AU. Serum levels of IgE were measured using fluoroenzyme immunoassay techniques. Serum levels of total IgE were significantly higher in AA patients than in controls (p<0.05). There was no significant difference in serum levels of total IgE between patients with LAA and those with extensive forms of the disease (p>0.05). The exact role of serum IgE in AA should be additionally investigated in future studies.
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Affiliation(s)
- Emina Kasumagić-Halilović
- Department of Dermatovenereology Sarajevo University Clinical Center Bolnicka 28, 71000 Sarajevo, Bosnia and Herzegovina.
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Koca R, Armutcu F, Altinyazar C, Gürel A. Evaluation of lipid peroxidation, oxidant/antioxidant status, and serum nitric oxide levels in alopecia areata. Med Sci Monit 2005; 11:CR296-299. [PMID: 15917721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2004] [Accepted: 09/15/2004] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND The pathophysiology of alopecia areata (AA) has not been clearly defined; however, it appears as a tissue-restricted autoimmune disease mediated by T lymphocytes. Immunohistochemical studies have shown peri- and infra-follicular inflammatory infiltrate which damages hair follicles. We analyzed the role of lipid peroxidation and oxidant-antioxidant enzymes in the pathogenesis of AA. MATERIAL/METHODS Twenty-four patients with AA and 20 age- and sex-matched healthy controls were enrolled in this study. We analyzed serum levels of malondialdehyde (MDA) and nitric oxide (NO) and the serum activities of superoxide dismutase (SOD) and xanthine oxidase (XO) in patients with AA and control subjects. RESULTS The levels of MDA and NO (nitrite/nitrate) and the activity of XO in serum of patients with AA (0.76+/-0.34 nmol/ml, 14.88+/-6.40 nmol/ml, and 0.34+/-0.10 U/ml, respectively) were significantly higher than those of controls (0.35+/-0.09 nmol/ml, 10.71+/-1.75 nmol/ml, 0.11+/-0.03 U/ml; p<0.001, p<0.001, p<0.05, respectively). The SOD activity (12.95+/-2.16 U/ml) in the serum of patients with AA was significantly lower than that of controls (14.89+/-2.29 U/ml, p<0.05). CONCLUSIONS Increased lipid peroxidation in AA may be related to an increase in NO level and XO activity and a decrease in SOD activity. These results suggest that lipid peroxidation and alterations in the oxidant-antioxidant enzymatic system may play a role in the pathogenesis of AA.
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Affiliation(s)
- Rafet Koca
- Departments of Dermatology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
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Lortkipanidze NT, Tevzadze MS, Kamkamidze GK. [Interferon-gamma and neopterin in alopecia areata]. Georgian Med News 2005:53-7. [PMID: 16052058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Alopecia areata (AA) is a disorder primarily affecting the hair in which associated autoimmune or atopic disease is common. The aim of the study was to compare the serum levels of interferon-gamma (INF-gamma) and neopterin (NPT) in 30 patients with AA and the control group (10 blood donors). We also investigated the difference between localized form of AA (I group), extensive form of AA (II group) and patients with family history of AA (III group). Each group consisted of 10 patients. The serum levels of INF-gamma and NPT were measured using enzyme immunoassay techniques. The mean serum INF-gamma level in control was 9,7+/-3,18 pg/mL. The mean serum INF-gamma level in AA patients (n = 30) was 14,6+/-4,81 pg/mL, whereas I group (n = 10) calculates 12,37+/-4,42 pg/mL; II group (n = 10) - 17,1+/-4,87 pg/mL and III group (n = 10) - 13,57+/-4,02 pg/mL. Serum levels of INF-gamma in patients with AA were significantly higher than those in controls (p=0,0017). Significant difference was observed in serum levels of INF-gamma between patients with extensive form and control group (p=0,0008). There was no significant difference in serum levels of INF-gamma between patients with localized form and control group (p=0,17); also between III group (with family history) and control group (p=0,057). Significant difference was observed in serum levels of INF-gamma between patients with extensive and localized forms of AA (p=0,047). There was no significant difference between patients with I and III (p=0,6); also II and III groups (p=0,1). The mean serum level NPT in control was 5,3+/-2,39 nmol/L. The mean serum NPT level in AA patients was 14,06+/-11,4 nmol/L, in I group it was equal to 10,16+/-10,06 nmol/L; II group - 21,78+/-10,8 nmol/L and III group - 10,24+/-10,12 nmol/L. Serum levels of NTP in patients with AA were significantly higher than those in controls (p=0,0003). Significant difference was observed in serum levels of NPT between patients with extensive form and control group (p=0,0001). There was no significant difference in serum levels of NPT between patients with localized form and control group (p=0,15): also between III group (with family history) and control group (p=0,15). Significant difference was observed in serum levels of INF-gamma between patients with extensive and localized form AA (p=0,02) and extensive and with family history (p=0,02) There was no significant difference between patients of I and III groups (p=0,98). Authors thank the company IBL-Hamburg and its representative in Georgia IRISE Ltd. for their support in this study.
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Zöller M, McElwee KJ, Vitacolonna M, Hoffmann R. The progressive state, in contrast to the stable or regressive state of alopecia areata, is reflected in peripheral blood mononuclear cells. Exp Dermatol 2004; 13:435-44. [PMID: 15217364 DOI: 10.1111/j.0906-6705.2004.00179.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alopecia areata (AA) is a putative autoimmune disease of the skin with an inflammatory component that can be treated by the local application of contact sensitizers. Here, we explored whether responsiveness toward diphenylcyclopropenone (DPCP) is reflected by the composition and the activation state of peripheral blood mononuclear cells (PBMCs). PBMCs of 43 AA patients, 26 treated and 17 untreated, and of 31 healthy volunteers were tested. AA patients' PBMCs differed from that of healthy donors by a slight increase in CD16- and tumor necrosis factor-alpha (TNF-alpha)-expressing cells. These features were independent of the disease state and treatment. Additional changes in the activation state of PBMCs, upregulation of the costimulatory molecules CD40 and CD80, of the accessory molecule CD154, and of interferon-gamma expression were identified only in AA patients where the disease was advancing, i.e. these changes were independent of the extent of hair loss and were not seen in patients with spontaneous or DPCP treatment-induced, regressing AA. Thus, the progressive state of AA is accompanied by a systemic activation of T cells, and the therapeutic efficacy of treatment can be estimated by restoration of the non-activated state. Furthermore, an increase in CD16(+)- and TNF-alpha-expressing cells may contribute to AA susceptibility.
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Affiliation(s)
- Margot Zöller
- Department of Tumor Progression and Tumor Defense, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany.
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Tobin DJ, Gardner SH, Lindsey NJ, Hoffmann R, Happle R, Freyschmidt-Paul P. Diphencyprone immunotherapy alters anti-hair follicle antibody status in patients with alopecia areata. Eur J Dermatol 2002; 12:327-34. [PMID: 12095876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Alopecia areata (AA) is a relatively common reversible hair loss disorder usually manifesting as patchy areas of complete hair loss on the scalp and other body parts that can progress to complete loss of all body hair. This condition is now generally assumed to be an autoimmune disease with the hair follicle (HF) as the principal target tissue. AA may be passively transferred by T cells and there is some evidence that serum IgG may also disturb hair cycling. Here, we examine whether the status of anti-HF antibody reactivity is altered during hair regrowth associated with topical immunotherapy using the contact sensitizer diphencyprone. Eleven patients with severe AA of the scalp were treated with diphencyprone on one side of the scalp and serum was obtained from each patient before the start of therapy, after unilateral hair regrowth, during continuing hair regrowth and in some cases after complete and sustained regrowth. The presence and titer of circulating antibodies to HF was assessed by indirect immunofluorescence and immunoblotting analysis. A striking reduction was detected in both the titer and range of HF components/antigens targeted by anti-hair follicle IgG antibodies in those patients that exhibited complete and sustained hair regrowth after DCP-treatment. By contrast, unilateral hair regrowth was associated with no change, or even an increase, in anti-HF antibody titer and reactivity. Therefore we can conclude that the down-regulation of antibody reactivity is likely to be a result rather than the cause of hair regrowth induction by topical immunotherapy. As this immunotherapy is associated with a reduction in the titer/pattern of anti-HF antibodies, these may hold the key to the identity of the HF antigen targets in AA. Moreover, the presence/titer of anti-HF antibodies may be a marker of clinical disease activity or opportunity for spontaneous regrowth.
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Affiliation(s)
- Desmond J Tobin
- Department of Biomedical Sciences, University of Bradford, Bradford, West Yorkshire, BD7 1DP, England.
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Shimizu T, Mizue Y, Abe R, Watanabe H, Shimizu H. Increased macrophage migration inhibitory factor (MIF) in the sera of patients with extensive alopecia areata. J Invest Dermatol 2002; 118:555-7. [PMID: 11874501 DOI: 10.1046/j.0022-202x.2001.01669.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
We have previously described spontaneous but reversible hair loss that clinically and histologically resembles human alopecia areata in a colony of C3H/HeJ mice. Alopecia areata in humans is associated with antibodies to hair follicles. This study was conducted to determine whether C3H/HeJ mice with hair loss have a similar abnormal antibody response to hair follicles. Eighteen C3H/HeJ mice with alopecia, 12 unaffected littermates, and 15 control mice were examined for circulating antibodies to C3H/HeJ anagen hair follicles by indirect immunofluorescence and against extracts of isolated C3H/HeJ and human anagen hair follicles by immunoblotting. Using both procedures, antibodies to anagen hair follicles were present in all C3H/HeJ mice with alopecia but in none of the control mice. The antibodies were also present in some unaffected C3H/HeJ littermates but were absent in mice of an unrelated strain with inflammatory skin disease and alopecia, indicating that their appearance did not result from the hair loss. These antibodies reacted to hair follicle-specific antigens of 40-60 kDa present in murine and human anagen hair follicles. These antigens were also reactive with human alopecia areata antibodies. Some of the antibodies in both C3H/HeJ mice and humans with alopecia areata reacted to antigens of 44 and 46 kDa, which were identified as hair follicle-specific keratins. This study indicates that C3H/HeJ mice with hair loss have circulating antibodies to hair follicles similar to those present in humans with alopecia areata. These findings confirm that these mice are an appropriate model for human alopecia areata and support the hypothesis that alopecia areata results from an abnormal autoimmune response to hair follicles.
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Affiliation(s)
- D J Tobin
- The Ronald O. Perelman Department of Dermatology, New York University Medical School, New York 10016, U.S.A
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35
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Tobin DJ, Hann SK, Song MS, Bystryn JC. Hair follicle structures targeted by antibodies in patients with alopecia areata. Arch Dermatol 1997; 133:57-61. [PMID: 9006373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To identify the structures in hair follicles (HFs) targeted by alopecia areata (AA) antibodies and the role of antigen expression in the development or localization of AA lesions. DESIGN The identity of HF structures targeted by AA antibodies was determined by indirect immunofluorescence and the level of antigen expression from the intensity of the staining. SETTING A university medical center. PATIENTS Ten patients with active AA and 8 control individuals. RESULTS Antibodies to anagen HFs were present in up to 90% of patients with AA but in less than 37% of controls. The antibodies in patients with AA reacted to antigens present only in HFs. The structures most commonly targeted were the outer root sheath and, less often, the inner root sheath, matrix, and hair shaft. The same HF structure contained several immunologically distinct antigens reactive with AA antibodies. The expression of some AA antigens was much greater in the scalp of patients with AA than in normal individuals. CONCLUSIONS These findings indicate that the autoantibody responses to HFs in patients with AA are heterogeneous and target multiple structures in anagen HFs. The expression of some as-yet-unidentified HF antigens is increased in many patients with AA, suggesting that the initiation, localization, severity, and persistence of the disease may be related to the level of expression of some HF antigens.
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Affiliation(s)
- D J Tobin
- Department of Dermatology, New York University Medical Center, New York, USA
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Teraki Y, Imanishi K, Shiohara T. Cytokines in alopecia areata: contrasting cytokine profiles in localized form and extensive form (alopecia universalis). Acta Derm Venereol 1996; 76:421-3. [PMID: 8982401 DOI: 10.2340/0001555576421423] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Recent studies have suggested that cytokines play a critical role in the pathophysiology of alopecia areata; however, no information is available regarding the difference in cytokine profiles in these patients. Serum levels of cytokines, including interferon gamma (IFN-gamma), tumor necrosis factor alpha, interleukin 1 alpha (IL-1 alpha), IL-2, IL-4, and IL-6, were measured using radioimmunoassay or enzyme-linked immunosorbent assay techniques in patients with the localized form and the extensive form (alopecia universalis). The serum levels of IL-1 alpha and IL-4 were significantly elevated in patients with the localized form. In contrast, the serum levels of IFN-gamma and IL-2 were significantly elevated in patients with the extensive form. These results indicate that immune responses in the localized form and the extensive form of alopecia areata are regulated by Th2 cytokines and Th1 cytokines, respectively.
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Affiliation(s)
- Y Teraki
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
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Affiliation(s)
- S Somos
- Department of Dermatology of Medical University of Pécs, Hungary
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Affiliation(s)
- D A Fenton
- St John's Dermatology Centre, St Thomas' Hospital, London, U.K
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Affiliation(s)
- V A Randall
- Department of Biomedical Sciences, University of Bradford, West Yorkshire, UK
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Affiliation(s)
- K J McElwee
- Department of Biological Sciences, University of Dundee, Scotland, United Kingdom
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Imai R, Takamori K, Ogawa H. Changes in populations of HLA-DR+CD3+ cells and CD57-CD16+ cells in alopecia areata after corticosteroid therapy. Dermatology 1994; 188:103-7. [PMID: 7511010 DOI: 10.1159/000247111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
We investigated the populations of activated T (HLA-DR+CD3+) cells and natural killer (CD57-CD16+) cells in the peripheral blood of patients with various types of alopecia areata (AA) and noted any changes that occurred in the said populations after administration of local and systemic corticosteroid therapy. In type 2 (severe multiple AA and alopecia totalis) and type 3 (alopecia universalis), the mean percentages of HLA-DR+CD3+ cells and CD57-CD16+ cells were significantly higher when compared with those of the normal controls. The percentages of both subsets in type 1 (mild AA) and the normal controls were consistent. Twenty-four patients in types 2 and 3 had received corticosteroid treatment, and all patients experienced new hair growth. With the changes in disease activity, the populations of HLA-DR+CD3+ cells in these patients after corticosteroid therapy significantly decreased when compared with those recorded prior to treatment. Subsequent to treatment, the mean percentages of CD57-CD16+ cells decreased to levels that were not significant relative to that of the normal controls. These findings indicate that HLA-DR+CD3+ and CD57-CD16+ cells in the peripheral blood of patients with AA may be correlated with the disease activity of AA.
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Affiliation(s)
- R Imai
- Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan
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Kalish RS, Johnson KL, Hordinsky MK. Alopecia areata. Autoreactive T cells are variably enriched in scalp lesions relative to peripheral blood. Arch Dermatol 1992; 128:1072-7. [PMID: 1497361 DOI: 10.1001/archderm.128.8.1072] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND DESIGN Alopecia areata is a condition characterized by hair loss in association with perifollicular infiltration of T cells and antigen-presenting cells. Autoreactive T cells are postulated to amplify this abnormality by interacting with DR+ follicular epithelium. These cells may recognize either autologous major histocompatibility complex class II antigen or an autoantigen restricted by major histocompatibility complex class II. Limiting dilution analysis was used to determine the frequency of autoreactive lymphocytes in scalp biopsy specimens and peripheral blood from seven adult patients with alopecia areata. Autoreactive T cells are defined for this study as those that proliferate in response to autologous irradiated peripheral blood mononuclear cells. RESULTS Autoreactive lymphocytes were enriched in scalp biopsy specimens relative to peripheral blood in five of seven patients. This enrichment was statistically significant in four of five patients. Five autoreactive T-cell clones derived from lesional scalp were characterized. Four of these clones were CD3+CD4+CD8- and one clone was CD3+CD4-CD8+. CONCLUSIONS Enrichment of autoreactive cells in lesions of alopecia areata supports a role for these cells in the pathogenesis of this condition. Enrichment of autoreactive lymphocytes is also found in allergic contact dermatitis. Thus, these autoreactive lymphocytes may have a general role in inflammation.
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Affiliation(s)
- R S Kalish
- Department of Dermatology, University of Minnesota, Minneapolis
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Abstract
Interleukin-2 (IL-2) is a lymphokine produced by activated T cells and its receptor (IL-2R) is expressed on T cells; one of the IL-2R components can be measured as a soluble serum protein (sIL-2R). Levels of sIL-2R were measured as a sign of T cell activation in serum of 12 patients suffering from alopecia areata (totalis or universalis) and in a group of healthy control subjects. An enzyme-linked immunosorbent assay was used to determine the levels of sIL-2R in blood samples drawn during both the active and resting phase of the disease. In patients with alopecia areata in active phase the sIL-2R concentrations were significantly higher than in stable phase and in controls. The biologic role of sIL-2R is still unknown, but one could speculate that T lymphocyte activation with subsequent secretion of IL-2 and IL-2R expression may contribute to the immune inflammatory mechanism of alopecia areata.
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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Broniarczyk-Dyła G. [Alopecia areata--clinical and immunological characteristics]. Przegl Dermatol 1990; 77:363-6. [PMID: 2270299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Lutz G, Stefan J, Niedecken H, Kreysel HW. [The value of serologic inflammatory parameters in the diagnosis of alopecia areata]. Z Hautkr 1989; 64:1075-82. [PMID: 2483785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Even recently, focal processes or inflammatory diseases have repeatedly been discussed as the possible causes of alopecia areata (AA) and corresponding diagnostic measures are still recommended. Therefore, we initially attempted to find definite indications of processes like these in AA patients by means of serologic parameters of inflammation and ESR as well as supplementary clinical focal diagnostics. The data obtained revealed increased titers of antistreptolysin in 2.9% and antistreptococcal DNase B in 25.7%, positive C-reactive protein in 8.6%, positive rheumatoid factor in 4.3%, and elevated ESR in 11.7% of the cases. After these data had carefully been compared to those in healthy persons, only the titer of antistreptococcal DNase B and the ESR were found to be increased. In the majority of the cases, these elevations correlated with concomitant bacterial infections detected by clinical focal diagnostics. Antistreptococcal DNase B titer and ESR seem to be the most appropriate of all our test parameters to provide some indications of a focal process or concomitant inflammatory diseases. The remaining parameters are not indicated in AA.
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Affiliation(s)
- G Lutz
- Haut- und Poliklinik der Rheinischen Friedrich-Wilhelms-Universität Bonn
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Cipriani R, Bordin A, Veller Fornasa C, Coghi P, Costantini G, Peserico A. [Alopecia areata: appropriateness of various laboratory parameters]. GIORN ITAL DERMAT V 1989; 124:265-6. [PMID: 2630433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Over the past four years 190 patients with alopecia areata have been examined: hematochemical parameters have been assessed in each patient and the possible presence of organ-and non-organ-specific circulating antibodies has been assayed. No significant alterations were found with regard to the different hematochemical parameters examined. On the other hand, a highly significant increase of anti-gastric parietal cell autoantibodies was observed in patients with alopecia areata and alopecia universalis in comparison to normal control subjects; in addition, patients with alopecia universalis showed a significant increase of anti-thyroid antibodies.
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Imai R, Miura J, Takamori K. [Increase in Leu7- Leu11+ cells in the peripheral blood lymphocytes of patients with alopecia areata]. Nihon Hifuka Gakkai Zasshi 1989; 99:503-5. [PMID: 2482377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Natural killer (NK) cell subsets in the peripheral blood lymphocytes of patients with alopecia areata (AA) were investigated by FACStar-I using NK cell specific monoclonal antibodies. The patients were classified into one of 2 types (Type A: single AA in regrowth phase; Type B: multiple AA, alopecia totalis and alopecia universalis in non-regrowth phase). The percentages of Leu7- Leu11+ cells in Type B were significantly higher than those of the normal control. The increase in Leu7- Leu11+ cells in Type B suggests that NK cells may play an important role in the pathogenesis of AA in the non-regrowth phase.
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Trevisan G, Cisilin MP. [Alopecia areata. Hemorheological study and treatment with pentoxifylline]. GIORN ITAL DERMAT V 1988; 123:211-4. [PMID: 3209239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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