Oxidative stress in alopecia areata: a systematic review and meta‐analysis

Abstract

Background Several studies have investigated the oxidative stress parameters in alopecia areata (AA) patients with variable results. This study aims to analyze the association between oxidative stress and AA based on current literature. Methods A systematic review of the existing literature was performed in PubMed, Scopus, and Cochrane databases by two authors independently. Mean and standard deviation values of oxidative stress parameters of AA patients and healthy controls were extracted for quantitative analysis. Results A total of 18 studies were included in the analysis. Patients with AA had impaired oxidative balance with elevated levels of serum malondialdehyde, nitric oxide, and total oxidant capacity and lower levels of serum superoxide dismutase, paraoxonase, glutathione peroxidase, and total antioxidant capacity. Levels of oxidative parameters were significantly higher in severe AA compared to mild/moderate AA. Heterogeneity in the baseline characteristics of the included studies and limited available data for most parameters were the limitations of this study. Conclusions Current evidence suggests that AA is associated with oxidative stress. More studies are needed to strengthen this association. Moreover, studies evaluating the role of antioxidant use in AA may be rewarding.

What Are Reactive Oxygen Species, Free Radicals, and Oxidative Stress in Skin Diseases?

“…Although the activities of SOD and GPx were increased in the skin lesions of alopecia areata, TBARS levels remained unchanged [ 86 ]. In contrast, MDA and nitrite levels and XO activity were elevated in the serum of these patients [ 87 , 88 ], whereas the activity of SOD was low [ 87 , 89 ].…”

Short Overview of Some Assays for the Measurement of Antioxidant Activity of Natural Products and Their Relevance in Dermatology

“…Skin diseases are multifactorial, and oxidative stress plays an important role in the pathophysiology of many autoimmune and inflammatory diseases, as well as in other stress- and age-dependent diseases. Accumulating evidence shows that impaired antioxidant defenses [ 39 , 40 , 58 , 59 , 60 ] and increased levels of oxidants [ 39 , 59 , 60 , 61 , 62 , 63 , 64 ] are important mediators in the pathology of a plethora of cutaneous diseases ( Table 1 ).…”

“…The SOD enzyme that accelerates the conversion of the O 2 •− to hydrogen peroxide (H 2 O 2 ), is decreased in psoriasis [ 65 ], alopecia areata [ 58 ], acne vulgaris [ 61 ], systemic sclerosis [ 62 ] and seborrheic dermatitis [ 59 ]. Alterations in the glutathione system, one of the major endogenous antioxidant defenses, were reported for alopecia areata [ 58 ], psoriasis [ 65 ], oral lichen planus [ 70 ] and atopic dermatitis [ 73 ]. In addition, vitiligo is also accompanied by decreased antioxidant defenses [ 67 ] and elevated oxidation products [ 68 , 69 ] that mediate the death of melanocytes [ 74 ].…”

Combined Diet and Supplementation Therapy Resolves Alopecia Areata in a Paediatric Patient: A Case Study

“…Genomewide association studies provide evidence for the involvement of both innate and acquired immunity in the pathogenesis of AA [3]. There is also evidence that AA is associated with oxidative stress [4].…”