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Yao F, Yu S, Liao Z, Deng L. Good efficacy achieved by telitacicept in treatment of systemic lupus erythematosus with alopecia areata. Arch Med Sci 2024; 20:1050-1052. [PMID: 39050148 PMCID: PMC11264150 DOI: 10.5114/aoms/188860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/18/2024] [Indexed: 07/27/2024] Open
Affiliation(s)
- Fangling Yao
- Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, Hunan, China
| | - Shenyi Yu
- Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, Hunan, China
| | - Zheng Liao
- Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, Hunan, China
| | - Li Deng
- Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, Central South University, Zhuzhou, Hunan, China
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Zaaroura H, Gilding AJ, Sibbald C. Biomarkers in alopecia Areata: A systematic review and meta-analysis. Autoimmun Rev 2023; 22:103339. [PMID: 37087083 DOI: 10.1016/j.autrev.2023.103339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune non-scarring alopecia that affects the scalp or any hair-bearing areas in the body. The pathophysiology of AA is complex, but Th1, Th2, and Th17 cytokines dysregulation, as well as chemokines, immunoglobulins and other biomarkers have been shown to play a role in the pathogenesis of the disease. OBJECTIVE To conduct a systematic review and Meta-analysis to identify biomarkers that reflect AA activity and severity that could be used to better assess disease activity and response in both trials and clinical practice. METHODS A literature search was conducted using the PUBMED, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to December 2021. Articles reporting on associations between AA and serum clinical biomarkers (cytokines, chemokines, antibodies, immunoglobulins, and others) were included. Serum biomarkers were identified in patients with AA and were correlated with disease severity and patient characteristics (ex. age, sex, comorbidities). The quality of the studies was assessed using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Case-Control Studies. Meta-analysis pooling of the standardized mean differences (SMD) by the method of Cohen using the common-effect inverse-variance model was performed. For the Meta-analysis, data was pulled for all the markers with a minimum of 4 studies with means and standard deviations. Analysis of data reported as Median with range or inter-quartile range (IQR) revealed that the data was too skewed to recommend calculation and use of mean with standard deviation (SD). If the data were not skewed, mean and SD were calculated. RESULTS One thousand seven hundred fourteen studies were screened, with 91 included, reporting on a total of 52 biomarkers. Meta-analyses revealed pooled SMD that were significant for interleukin 6 (IL6), C-reactive protein (CRP) and vitamin D. CONCLUSIONS Serum IL6 and CRP levels are significantly increased in patients with AA compared to healthy age and sex matched controls. Conversely, serum vitamn D levels are significantly decreased in patients with AA compared to healthy age and sex matched controls. This data has the potenail to influence the clinical guidelines for the diagnostic workup of AA to include testing the serum levels of CRP and vitamin D.
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Affiliation(s)
- Hiba Zaaroura
- Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Anthony J Gilding
- Canadian Alopecia Areata Foundation, Toronto, ON, Canada.; Department of Chemistry & Biology, Faculty of Science, Toronto Metropolitan University, Toronto, ON, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
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The role of APRIL - A proliferation inducing ligand - In autoimmune diseases and expectations from its targeting. J Autoimmun 2018; 95:179-190. [DOI: 10.1016/j.jaut.2018.10.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/12/2022]
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Assessment of serum a proliferation-induced ligand level in patients with pemphigus vulgaris. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2018. [DOI: 10.1097/01.ewx.0000542472.35180.f9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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IL-17 inhibition: is it the long-awaited savior for alopecia areata? Arch Dermatol Res 2018; 310:383-390. [DOI: 10.1007/s00403-018-1823-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 01/24/2018] [Accepted: 02/23/2018] [Indexed: 01/13/2023]
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Wenzel J, Landmann A, Vorwerk G, Kuhn A. High expression of B lymphocyte stimulator in lesional keratinocytes of patients with cutaneous lupus erythematosus. Exp Dermatol 2017; 27:95-97. [DOI: 10.1111/exd.13419] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Joerg Wenzel
- Department of Dermatology and Allergy; University Hospital Bonn; Bonn Germany
| | - Aysche Landmann
- Division of Immunogenetics; Tumor Immunology Program; German Cancer Research Center; Heidelberg Germany
| | - Gero Vorwerk
- Department of Dermatology and Allergy; University Hospital Bonn; Bonn Germany
| | - Annegret Kuhn
- Division of Immunogenetics; Tumor Immunology Program; German Cancer Research Center; Heidelberg Germany
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Abstract
Lupus erythematosus (LE) is a multifactorial autoimmune disease with clinical manifestations of differing severity which may present with skin manifestations as primary sign of the disease (cutaneous lupus erythematosus, CLE) or as part of a disease spectrum (systemic lupus erythematosus, SLE). To date, no drugs are approved specifically for the treatment of CLE and only single agents have been applied in randomized controlled trials. Therefore, topical and systemic agents are used "off-label", primarily based on open-label studies, case series, retrospective analyses, and expert opinions. In contrast, several agents, such as hydroxychloroquine, chloroquine, cyclophosphamide, azathioprine, and belimumab, are approved for the treatment of SLE. Recent approaches in the understanding of the molecular pathogenesis of LE enabled the development of further new agents, which target molecules such as interleukin 6 (IL-6) and interferon (IFN). Only single trials, however, applied these new agents in patients with cutaneous involvement of the disease and/or included endpoints which evaluated the efficacy of these agents on skin manifestations. This article provides an updated review on new and recent approaches in the treatment of CLE.
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Affiliation(s)
- A Kuhn
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center Mainz, Germany Division of Immunogenetics, Tumor Immunology Program, German Cancer Research Center, Heidelberg, Germany
| | - A Landmann
- Division of Immunogenetics, Tumor Immunology Program, German Cancer Research Center, Heidelberg, Germany
| | - J Wenzel
- Department of Dermatology, University of Bonn, Germany
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Salem SA, Asaad MK, Elsayed SB, Sehsah HM. Evaluation of macrophage migration inhibitory factor (MIF) levels in serum and lesional skin of patients with alopecia areata. Int J Dermatol 2016; 55:1357-1361. [DOI: 10.1111/ijd.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/06/2016] [Accepted: 03/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Samar A. Salem
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Marwa K. Asaad
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Sherin B. Elsayed
- Department of Medical Microbiology and Immunology; Faculty of Medicine; Ain Shams University; Cairo Egypt
| | - Hend M. Sehsah
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Ain Shams University; Cairo Egypt
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Elela MA, Gawdat HI, Hegazy RA, Fawzy MM, Abdel Hay RM, Saadi D, Shaker O. B cell activating factor and T-helper 17 cells: possible synergistic culprits in the pathogenesis of Alopecia Areata. Arch Dermatol Res 2016; 308:115-21. [PMID: 26796544 DOI: 10.1007/s00403-016-1617-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 11/18/2015] [Accepted: 01/06/2016] [Indexed: 12/21/2022]
Abstract
The role of T-helper 17 cells (Th17) and regulatory T-cells (Tregs) in the pathogenesis of alopecia areata (AA) has not been clearly elucidated. B cell activating factor (BAFF) being a regulator of T cell activation could be involved in this pathologic process as well. The current study evaluated the expression of IL-17, IL-22, Foxp3 and BAFF in tissue and sera of AA patients. Forty AA patients and 40 age and sex matched healthy controls were included. Tissue and serum levels of IL-17, IL-22, BAFF as well as serum level of Foxp3 were measured by enzyme-linked immunosorbent assay (ELISA). Immunohistochemical staining was used for assessment of tissue level of Foxp3. Tissue and serum levels of IL-17, tissue levels of IL-22 and BAFF were significantly higher in patients. Serum levels of IL-22, Foxp3 and BAFF were non-significantly higher in patients. Foxp3 immunostaining showed negativity in tissue of patients and controls. A significant positive correlation was found between both tissue levels of IL-17 and BAFF (r = 0.474, P = 0.035) and tissue level of IL-22 and disease duration (r = 0.766, P < 0.001) in AA patients. Th17 cells and BAFF are synergistically involved in the pathogenesis of AA. BAFF represents a promising therapeutic target for such a challenging disease. Defective Tregs number and/or function in AA warrants further studies.
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Affiliation(s)
- Mostafa A Elela
- Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Heba I Gawdat
- Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
| | - Rehab A Hegazy
- Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Marwa M Fawzy
- Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Rania M Abdel Hay
- Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Dina Saadi
- Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Olfat Shaker
- Department of Biochemistry, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
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Bakry OA, El Shazly RMA, Basha MA, Mostafa H. Total serum immunoglobulin E in patients with alopecia areata. Indian Dermatol Online J 2014; 5:122-7. [PMID: 24860742 PMCID: PMC4030335 DOI: 10.4103/2229-5178.131076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Context: Alopecia areata (AA) is a common form of localized, non-scarring hair loss. The pathogenesis of the disease is unknown. Previous evidence suggested the involvement of Th2 cytokines in disease pathogenesis. Aim: To determine serum level of total IgE, this is mainly influenced by Th2 cytokines, in Egyptian patients with AA. Materials and Methods: Fifty subjects with AA (28 males and 22 females) were selected from Dermatology Outpatient Clinic, Menoufiya University Hospital from February 2012 to December 2012. Subjects with other conditions that might elevate serum IgE were excluded from the study. Fifty age- and sex-matched healthy subjects were selected as a control group. Venous blood samples were taken from cases and controls for measurement of total serum IgE by enzyme-linked immunosorbent assay. Skin biopsy was taken from every case from an active area of hair loss. Results: Total serum IgE was elevated in 27 (54%) cases. Its values among patients ranged from 13.5 IU/ml to 780 IU/ml. There was a statistically significant difference between cases and controls with regard to mean value of serum IgE (P < 0.05). Mean value of IgE did not vary significantly with disease severity, patients’ age, patients’ gender, disease duration, site of lesions, and positive family history of AA. No correlation was found between serum IgE levels and histopathological changes detected in examined cases. Conclusions: Total serum IgE is elevated in AA. This elevation is not related to age, gender, disease duration, disease severity, site of affection or family history of AA.
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Affiliation(s)
- Ola Ahmed Bakry
- Departments of Dermatology, Andrology and STDs, Menoufiya University, Menoufiya, Egypt
| | | | - Mohamed Ahmed Basha
- Departments of Dermatology, Andrology and STDs, Menoufiya University, Menoufiya, Egypt
| | - Hanan Mostafa
- Departments of Dermatology, Andrology and STDs, Menoufiya University, Menoufiya, Egypt
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Karadag AS, Ertugrul DT, Bilgili SG, Takci Z, Tutal E, Yilmaz H. Insulin resistance is increased in alopecia areata patients. Cutan Ocul Toxicol 2012; 32:102-6. [PMID: 22916967 DOI: 10.3109/15569527.2012.713418] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Increased insulin resistance (IR) has been found in androgenetic alopecia in several studies. However, IR has not been investigated in alopecia areata (AA). We aimed to investigate IR in AA patients and the controls. Anthropometric and demographic data were obtained from 51 AA patients and 36 controls. We measured insulin, c-peptide and blood glucose and HOMA-IR. Demographic characteristics of the two groups were similar. AA group had higher insulin [12.5 ± 7.01 vs. 8.3 ± 3.9 µIU/mL, p = 0.001], c-peptide [2.7 ± 1.07 vs. 2. ± 0.6 ng/mL, p = 0.007] and HOMA-IR levels [2.8 ± 1.6 vs. 1.9 ± 0.9, p = .004] than the controls. Patient and control groups were also similar regarding lipid profiles. In this study, we found increased IR in AA patients for the first time in literature. Increased inflammatory cytokines and hypothalamic-pituitary-adrenal axis activation may be responsible for this finding. Further studies with larger sample sizes may give additional information for IR in AA.
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Affiliation(s)
- Ayse Serap Karadag
- Faculty of Medicine, Department of Dermatology, Yuzuncu Yil University, Van, Turkey.
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Ohmatsu H, Sugaya M, Miyagaki T, Suga H, Fujita H, Asano Y, Tada Y, Kadono T, Sato S. BAFF levels are increased in lesional skin and sera in patients with cutaneous T-cell lymphoma. Br J Dermatol 2012; 167:359-67. [DOI: 10.1111/j.1365-2133.2012.10998.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gregoriou S, Papafragkaki D, Kontochristopoulos G, Rallis E, Kalogeromitros D, Rigopoulos D. Cytokines and other mediators in alopecia areata. Mediators Inflamm 2010; 2010:928030. [PMID: 20300578 PMCID: PMC2837895 DOI: 10.1155/2010/928030] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2009] [Revised: 01/28/2010] [Accepted: 01/28/2010] [Indexed: 11/17/2022] Open
Abstract
Alopecia areata, a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin, has been extensively studied as far as the role of several cytokines is concerned. So far, IFN-gamma, interleukins, TNF-alpha, are cytokines that are well known to play a major role in the pathogenesis of the disease, while several studies have shown that many more pathways exist. Among them, MIG, IP-10, BAFF, HLA antigens, MIG, as well as stress hormones are implicated in disease onset and activity. Within the scope of this paper, the authors attempt to shed light upon the complexity of alopecia areata underlying mechanisms and indicate pathways that may suggest future treatments.
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Affiliation(s)
- Stamatis Gregoriou
- Andreas Sygros Hospital, University of Athens Medical School, 5 Ionos Dragoumi Street, 16121 Athens, Greece.
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Current world literature. Curr Opin Pediatr 2009; 21:553-60. [PMID: 19622920 DOI: 10.1097/mop.0b013e3283300b10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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