Interferon‐gamma serum level and immunohistochemical expression of CD8 cells in tissue biopsies in patients with alopecia areata in correlation with trichoscopic findings

Abstract

Alopecia areata (AA) is an autoimmune form of nonscarring hair loss. The aim of the study was to assess the serum concentration of interferon gamma (IFN‐γ) and CD8 cell expression in lesional skin biopsies in correlation with the disease severity, activity, duration, and trichoscopic findings in patients with AA. The study included 30 patients with AA and 15 age‐ and sex‐matched healthy controls. Trichoscopy was performed and photographs were captured for the alopecic areas, and the enzyme‐linked immunosorbent assay technique was used for serum level of IFN‐γ assessment and immunohistochemistry for CD8 cells. The results obtained indicate that IFN‐γ serum level in patients was significantly higher than that of control subjects, and significantly correlated with the activity status and the duration of the disease. CD8+ T cells infiltrate intensity significantly correlated with severity. Yellow dots (YDs), vellus hair, black dot, and exclamation marks were the most common trichoscopic findings. The presence of black dots significantly correlated to the disease activity, duration, serum IFN‐γ, and CD8+ infiltrate intensity. The presence of YDs significantly correlated with the mean serum IFN‐γ level. Exclamation marks significantly correlated with the disease activity and the degree of CD8+ infiltrate. In conclusion, trichoscopy could be a reliable indicator of the IFN‐γ serum level and CD8+ T cell infiltrate intensity in AA patient.

Altered T cell subpopulations and serum anti-TYRP2 and tyrosinase antibodies in the acute and chronic phase of alopecia areata in the C3H/HeJ mouse model

“…3C). These alterations between the phases correlated with the clinical observations that the Tc1 cell percentages among PBMCs were higher in the chronic phase and that Tc1 cells infiltrated hair follicles in both the acute and chronic phase [27], finally, that the serum IFN-g levels correlated with AA activity and disease duration [28]. These data suggest a systemically-enhanced cytotoxic activity but also a CTL localization in the lesions in acute-AA mice, and in the non-lesions as well as the lesions in chronic-AA mice.…”

Aberrant inflammasome activation as a driving force of human autoimmune skin disease

“…There is a spectrum of inflammatory skin diseases that are characterized by strong upregulation of IFN and recruitment of effector T cells ( 83 , 84 ). This spectrum includes, but is not limited to, CLE ( 85 ), LP ( 86 , 87 ), vitiligo ( 88 ) and AA ( 89 – 91 ), which are considered autoimmune diseases ( 92 – 94 ). These diseases come along with a predisposing genetic background, particularly gene polymorphisms of components of the innate and adaptive immune system.…”

“…CXCL chemokines are known to recruit CXCR3+ effector T cells, which accumulate around hair bulbs and exhibit autoreactivity to follicular epithelial cells. These inflammatory events lead to loss of hair follicle immune privilege with anagen arrest ( 89 – 91 , 100 , 173 , 174 ).…”

Alopecia areata: What's new in the diagnosis and treatment with JAK inhibitors?

“…8 A study including 30 patients with AA and 15 matched controls indicated that serum interferon (IFN)γ levels were significantly higher in patients than in controls and were significantly correlated with disease activity status and duration. 9 A study including 65 patients with AA and 71 healthy controls demonstrated that serum levels of adiponectin were significantly lower in patients with AA than in controls and were negatively correlated with the SALT score. 10 In a study that included 42 patients with AA and 17 control subjects, serum levels of lipocalin-2, insulin, C-peptide, and homeostasis model assessment for insulin resistance were significantly higher in patients with AA than in controls.…”

“…A study including 40 patients with AA and 40 matched controls revealed that the serum levels of interleukin (IL)‐15 in patients were significantly higher than those in the control group and positively correlated with the Severity of Alopecia Tool (SALT) score 8 . A study including 30 patients with AA and 15 matched controls indicated that serum interferon (IFN)‐γ levels were significantly higher in patients than in controls and were significantly correlated with disease activity status and duration 9 . A study including 65 patients with AA and 71 healthy controls demonstrated that serum levels of adiponectin were significantly lower in patients with AA than in controls and were negatively correlated with the SALT score 10 .…”