Increased Serum Levels of IFN-γ, IL-1β, and IL-6 in Patients with Alopecia Areata and Nonsegmental Vitiligo

Abstract

Alopecia areata (AA) and vitiligo are both common skin diseases of autoimmune origin. Both alopecia areata and vitiligo have shown to be affected by oxidative stress. The present work is aimed at evaluating and comparing the serum proinflammatory cytokine levels in AA and nonsegmental vitiligo (NSV). A cross-sectional study was conducted of 33 patients with AA, 30 patients with NSV, and 30 healthy controls. Serum levels of interferon γ (IFN-γ), interleukin- (IL-) 1β, and IL-6 were determined quantitatively by ELISA method. Our analysis identified a signature of oxidative stress associated with AA and NSV, characterized by elevated levels of IFN-γ (AA: p=0.007283; NSV: p=0.038467), IL-1β (AA; NSV: p≤0.001), and IL-6 (AA; NSV: p≤0.001). IL-6 was also significantly increased in NSV patients in comparison with AA patients (p=0.004485). Our results supported the hypothesis that oxidative stress may play a significant role in promoting and amplifying the inflammatory process both in AA and vitiligo. The complex understanding of both disease etiopathogenesis involves interrelationships between oxidative stress and autoimmunity. The clinical study registration number is RNN/266/16/KE.

Evaluation of serum levels of IL-6, IL-10, and TNF-a in alopecia areata patients: A systematic review and meta-analysis

“…There was a significant elevation of IL-6 in the serum of AA patients compared to healthy controls (SMD = 1.57, 95% CI 0.17 to 2.97). Among 5 studies that describe IL-6 levels, three studies show elevated levels of IL-6 in AA patients 11,23, 24 , and two studies show no significant difference between AA patients and healthy subjects 14, 18 . Significantly elevated levels of TNF-α in the serum of AA patients compared to healthy subjects were found (SMD = 2.05, 95% CI 0.98 to 3.13).…”

Hair Growth in a Patient with Alopecia Areata on Tocilizumab

“…IL-6-induced Th2 upregulation may contribute to the collapse of anagen hair bulb immune privilege in AA development via insufficient regulatory T-cell immunoinhibitory activity [2][3][4]17]. AA has been associated with increased serum levels of IL-6 compared to healthy controls [11]. Active PU has also been associated with increased vitreous IL-6 [8].…”

“…As a powerful immunomodulator, IL-6 is known to promote development of autoimmune disease through sustained inflammation and altered immune response [7]. This is demonstrated by elevated IL-6 serum levels and integral IL-6-dependent signal transduction pathways in numerous inflammatory diseases including noninfectious uveitis (NIU) [5,8], rheumatoid arthritis, juvenile idiopathic arthritis [5,7], vitiligo, AA [9][10][11], systemic lupus erythematosus, psoriasis, Crohn's disease, and ankylosing spondylitis [7]. IL-6 is thought to bidirectionally impact immunemediated acute and chronic inflammatory reactions including Th1 and Th2 pathways involved in AA [7,12].…”

“…IL-6 is thought to bidirectionally impact immunemediated acute and chronic inflammatory reactions including Th1 and Th2 pathways involved in AA [7,12]. IL-6 is also actively expressed in the hair follicle and modulates hair follicle growth [11]. IL-6 and oncostatin M, an IL-6 cytokine family member, are expressed in the hair follicle dermal papilla (DP) and root sheath, respectively [13].…”

The Role of Serum Th1, Th2, and Th17 Cytokines in Patients with Alopecia Areata: Clinical Implications

“…According to the majority of previously published studies, an increased serum level of IFN-γ was observed in patients with alopecia areata compared to healthy controls [ 22 , 23 , 25 , 26 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Higher IFN-γ expression was also detected in peripheral blood mononuclear cells in patients with alopecia areata in comparison with the control group [ 42 , 43 ].…”