1
|
Tishe ZH, Shawkat S, Popy MN, Ahmed A, Mumu SB, Apu MNH, Mostaid MS. Interleukin gene polymorphisms and alopecia areata: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e37300. [PMID: 38394507 PMCID: PMC10883625 DOI: 10.1097/md.0000000000037300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune disease which results in non-scarring hair loss on the scalp or any surface with hair. Several genetic polymorphisms of the interleukin genes have been linked with this disease but the results are inconsistent. This systematic review and meta-analysis were done to find the association between rs3118470, rs2275913, rs3212227, and rs10889677 of the IL2RA, IL17A, IL12B, and IL23R genes, respectively, of the interleukin family with alopecia areata. METHODS A comprehensive search for relevant research articles was conducted in Pubmed, Google Scholar, and Embase databases. Our search yielded 8 relevant articles with 1940 cases and 1788 controls. The odds ratio with 95% confidence intervals was calculated using fixed effect and random effect models. Heterogeneity was determined using the Q-test and I2 test. Publication bias was determined and funnel plots were used to adjust the odds ratio. RESULTS We found a significant risk effect for rs3118470 of the IL2RA gene with alopecia areata in the dominant model (CC + CT vs TT; OR = 1.54, 95% confidence interval = 1.05-2.26, P < .05, I2 = 69.03%) and homozygous model (CC vs TT; OR = 2.00, 95% confidence interval = 1.07-3.71, P < .05, I2 = 72.84%). For the other single nucleotide polymorphisms, we could not find any statistically significant association with the disease. CONCLUSION Our analysis showed that mutation of rs3118470 of IL2RA gene possesses a significant risk effect for alopecia areata. Future studies with larger sample sizes and ethnic backgrounds are warranted to confirm our findings.
Collapse
Affiliation(s)
- Zasia Hossain Tishe
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Sanjana Shawkat
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Meherun Nessa Popy
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Ashfaq Ahmed
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Sadia Biswas Mumu
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Mohd Nazmul Hasan Apu
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Md Shaki Mostaid
- Department of Pharmaceutical Sciences, Faculty of Health and Life Sciences, North South University, Dhaka, Bangladesh
| |
Collapse
|
2
|
Wang XF, Duan SB, He J, Wu X, Wu T. Causal effects of rheumatoid arthritis or ankylosing spondylitis on membranous nephropathy: a two-sample Mendelian randomization study. Clin Kidney J 2023; 16:2605-2613. [PMID: 38046019 PMCID: PMC10689137 DOI: 10.1093/ckj/sfad209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Indexed: 12/05/2023] Open
Abstract
Background Membranous nephropathy (MN) is the leading cause of adult-onset nephrotic syndrome, with primary MN of unclear cause accounting for 80% of cases. Retrospective clinical research reported that MN occurring in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients was triggered by nephrotoxic drugs or of unknown cause. However, whether RA or AS itself increases the risk of developing MN is unknown. Methods We conducted mendelian randomization (MR) analysis to evaluate the causal effects of RA or AS on MN using genome-wide association study (GWAS) statistics. The inverse variance weighted (IVW) method was the primary analysis, and several supplementary analyses and sensitivity analyses were performed to test the causal estimates. Results We obtained 30 valid instrumental variables (IVs) of RA and 16 valid IVs of AS from large-scale open-access GWASs. The genetically predicted RA significantly increased the risk of MN [IVW odds ratios (OR) = 1.327, 95% confidence interval (CI) = (1.124, 1.565), P = 8.051 × 10-4]. Three supplementary MR analyses provided the consistent positive causal effect of RA on MN (all P < 0.05). No horizontal pleiotropy was detected by MR Egger intercept analysis (P = 0.411). However, the genetically predicted AS had no causal effect on MN by IVW and supplementary analysis (all P > 0.05). Conclusions Genetically predicted RA could increase the risk of MN, but genetically predicted AS was not associated with MN. Screening for kidney involvement in RA patients should be noted, and active treatment of RA will reduce the public health burden of MN.
Collapse
Affiliation(s)
- Xiu-Fen Wang
- Department of Nephrology, The Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China
| | - Shao-Bin Duan
- Department of Nephrology, The Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China
| | - Jian He
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xi Wu
- Department of Nephrology, The Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China
| | - Ting Wu
- Department of Nephrology, The Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China
| |
Collapse
|
3
|
Luo Q, Cao Q, Guo J, Chang S, Wu Y. Genetically predicted levels of circulating cytokines and the risk of six immune skin diseases: a two-sample Mendelian randomization study. Front Immunol 2023; 14:1240714. [PMID: 37954607 PMCID: PMC10637377 DOI: 10.3389/fimmu.2023.1240714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background Circulating cytokines play a crucial role in the onset and progression of immune skin diseases. However, the causal relationships and the direction of causal effects require further investigation. Methods Two-sample Mendelian randomization (MR) analyses were conducted to assess the causal relationships between 41 circulating cytokines and six immune skin diseases including alopecia areata, chloasma, hidradenitis suppurativa (HS), lichen planus (LP), seborrheic dermatitis, and urticaria, using summary statistics from genome-wide association studies. Reverse MR analyses was performed to test for the reverse causation. Pleiotropy and heterogeneity tests were conducted to assess the robustness of the findings. Results Twelve unique cytokines showed a suggestive causal relationship with the risk of six immune skin diseases. Among them, the causal effects between 9 unique cytokines and immune skin diseases have strong statistical power. Additionally, the concentrations of six cytokines might be influenced by LP and urticaria. After Bonferroni correction, the following associations remained significant: the causal effect of beta-nerve growth factor on HS (odds ratio [OR] = 1.634, 95% confidence interval [CI] = 1.226-2.177, p = 7.97e-04), interleukin (IL)-6 on LP (OR = 0.615, 95% CI = 0.481-0.786, p = 1.04e-04), IL-4 on LP (OR = 1.099. 95% CI = 1.020-1.184, p = 1.26e-02), and IL-2 on urticaria (OR = 0.712, 95% CI = 0.531-0.955, p = 2.33e-02). Conclusion This study provides novel perspectives on the relationship between circulating cytokines and immune skin diseases, potentially providing valuable insights into their etiology, diagnostic approaches, and treatment.
Collapse
Affiliation(s)
- Qinghua Luo
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Qiurui Cao
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Jinyan Guo
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Shuangqing Chang
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Yunxiang Wu
- Department of Anorectal Surgery, Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China
| |
Collapse
|
4
|
Englander H, Paiewonsky B, Castelo-Soccio L. Alopecia Areata: A Review of the Genetic Variants and Immunodeficiency Disorders Associated with Alopecia Areata. Skin Appendage Disord 2023; 9:325-332. [PMID: 37900769 PMCID: PMC10601931 DOI: 10.1159/000530432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/23/2023] [Indexed: 10/31/2023] Open
Abstract
Alopecia areata (AA) is an autoimmune form of non-scarring hair loss that occurs on a spectrum from patchy loss of hair on the scalp, to complete hair loss. Histology features can vary, but increased abundance of telogen hair and miniaturized hair follicles are classic hallmarks [Clin Cosmet Investig Dermatol. 2015;8:397-403]. Additionally, lymphocytic infiltration of the hair bulb is a commonly observed histology feature of AA which underscores how the disease is an autoimmune-mediated one that results from immune-mediated attack of the hair follicle. In a healthy individual, the hair follicle is one of the body's immune-privileged sites, but the breakdown of this immune privilege is thought to be an important driver in AA disease development. Diagnosis of AA is usually based on phenotypic manifestations in conjunction with biopsies which can help conclude whether the hair loss is autoimmune based. However, varied manifestation of disease both clinically and histologically makes diagnosis criteria more ambiguous and early identification of disease harder to achieve. A better understanding of genes that are associated with increased AA risk may help elucidate potential gene targets for future therapeutics.
Collapse
Affiliation(s)
- Hanna Englander
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA
| | - Briana Paiewonsky
- Charles E Schmidt College of Medicine at Florida Atlantic University, Boca Raton, FL, USA
| | - Leslie Castelo-Soccio
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA
| |
Collapse
|
5
|
Yang JS, Liu TY, Chen YC, Tsai SC, Chiu YJ, Liao CC, Tsai FJ. Genome-Wide Association Study of Alopecia Areata in Taiwan: The Conflict Between Individuals and Hair Follicles. Clin Cosmet Investig Dermatol 2023; 16:2597-2612. [PMID: 37752970 PMCID: PMC10519225 DOI: 10.2147/ccid.s428788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023]
Abstract
Purpose Alopecia areata (AA) is one of the most prevalent autoimmune diseases affecting humans. Given that hair follicles are immune-privileged, autoimmunity can result in disfiguring hair loss. However, the genetic basis for AA in the Taiwanese population remains unknown. Materials and Methods A genome-wide association study was conducted using a cohort of 408 AA cases and 8167 controls. To link variants to gene relationships, we used 882 SNPs (P<1E-05) within 74 genes that were associated with AA group to build the biological networks by IPA software. HLA diplotypes and haplotypes were analyzed using Attribute Bagging (HIBAG)-R package and chi-square analysis. Results Seven single nucleotide polymorphisms (SNPs) including LINC02006 (rs531166736, rs187306735), APC (rs112800832_C_CAT), SRP19 (rs139948960, rs144784670), EGFLAM (rs16903975) and LDLRAD3 (rs79874564) were closely associated with the AA phenotype (P<5E-08). Examination of biological networks revealed that these genomic areas are associated with antigen presentation signaling, B cell and T cell development, Th1 and Th2 activation pathways, Notch signaling, crosstalk signaling between dendritic cells and natural killer cells, and phagosome maturation. Based on human leukocyte antigen (HLA) genotype analysis, four HLA genotypes (HLA-B*15:01-*40:01, HLA-DQA1*01:02-*03:03, HLA-DQA1*01:02, and HLA-DQB1*02:01) were found to be associated with AA (adjusted p-value<0.05). HLA-DQA1*01:02 is the most significantly related gene in the Taiwanese population (adjusted p-value = 2.09E-05). Conclusion This study successfully identified susceptibility loci associated with AA in the Taiwanese population. These findings not only shed light on the origins of AA within the Taiwanese context but also contribute to a comprehensive understanding of the genetic factors influencing AA susceptibility.
Collapse
Affiliation(s)
- Jai-Sing Yang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404327, Taiwan
| | - Ting-Yuan Liu
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, 404327, Taiwan
| | - Yu-Chia Chen
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, 404327, Taiwan
| | - Shih-Chang Tsai
- Department of Biological Science and Technology, China Medical University, Taichung, 406040, Taiwan
| | - Yu-Jen Chiu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, 112201, Taiwan
- Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Chi-Chou Liao
- Million-Person Precision Medicine Initiative, Department of Medical Research, China Medical University Hospital, Taichung, 404327, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 404333, Taiwan
- China Medical University Children’s Hospital, Taichung, 404327, Taiwan
- Department of Medical Genetics, China Medical University Hospital, Taichung, 404327, Taiwan
| |
Collapse
|
6
|
Alghamdi MA, AL-Eitan LN, Aljamal HA, Shati AA, Alshehri MA. Genetic association of IL2RA, IL17RA, IL23R, and IL31RA single nucleotide polymorphisms with alopecia areata. Saudi J Biol Sci 2022; 29:103460. [PMID: 36248775 PMCID: PMC9562353 DOI: 10.1016/j.sjbs.2022.103460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 08/26/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022] Open
Abstract
The signalling of cytokine receptors plays a crucial role in regulating tolerance and immunity. Impaired immunological processes result in autoimmune inflammation that target the hair follicles, causing many hair disorders, mainly alopecia areata (AA). Therefore, polymorphisms in cytokine receptor genes are suggested to have a significant impact on the pathogenesis of AA, a disease with a multifactorial basis and uncertain etiology. In the present study, 152 AA patients of the Jordanian population were investigated for their genetic susceptibility to develop AA compared to 150 control subjects. Genomic DNA extraction and genotyping had conducted for IL17RA (rs879575, rs2229151, and rs4819554), IL2RA (rs3118470), IL23R (rs10889677), and IL31RA (rs161704) using the Sequenom MassARRAY® system. The allele frequency of IL17RA rs879575 is significantly higher in patients, while no statistical differences were found for IL2RA, IL23R, and IL31RA SNPs. Also, the recessive model of IL31RA rs161704 showing that AA genotype is significantly associated with AA development. To date, there is no published data regarding the association between AA and the selected genetic variants in our population. However, this study's findings assert that SNPs of IL17RA and IL31RA are linked to AA susceptibility in Jordanian patients.
Collapse
Affiliation(s)
- Mansour A. Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Genomics and Personalized Medicine Unit, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Laith N. AL-Eitan
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan
- Corresponding author at: Biotechnology & Genetic Engineering Department, Faculty of Science and Arts, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
| | - Hanan A. Aljamal
- Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ayed A. Shati
- Department of Child Health, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohammed A. Alshehri
- Department of Child Health, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| |
Collapse
|
7
|
Rajabi F, Abdollahimajd F, Jabalameli N, Nassiri Kashani M, Firooz A. The Immunogenetics of Alopecia areata. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:19-59. [DOI: 10.1007/978-3-030-92616-8_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
8
|
Effect of PTPN22, FAS/FASL, IL2RA and CTLA4 genetic polymorphisms on the risk of developing alopecia areata: A systematic review of the literature and meta-analysis. PLoS One 2021; 16:e0258499. [PMID: 34735462 PMCID: PMC8568157 DOI: 10.1371/journal.pone.0258499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/28/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives Genetic association studies on alopecia areata (AA) performed in various populations have shown heterogeneous results. The aim of the current review was to synthesize the results of said studies to estimate the impact of FAS, FASL, PTPN22, CTLA4 and IL2RA gene polymorphisms on AA susceptibility. Design A systematic literature search was conducted in the Medline, Web of Science, Scopus, EMBASE and LILACS databases. Studies published up to June 2020 were included. The results available in the grey literature including the Open Grey and Google Scholar databases were also used. The texts of potentially related studies were screened by individual reviewers. Evidence of publication bias was assessed using the Newcastle-Ottawa scale and the quality of evidence was assessed using the GRADE system. The quantitative synthesis was performed using the fixed effect model. Results Out of 1784 articles, we identified 18 relevant articles for the qualitative synthesis and 16 for the quantitative synthesis. In a study of rs2476601 polymorphism of PTPN22 gene, including 1292 cases and 1832 controls, a correlation was found with the risk of developing AA in the allelic model (OR1.49 [95% C:1.13–1.95]), the heterozygous codominant (OR1.44 [95% CI:1:19–1.76]) and dominant model (OR1.43 [95% CI:1.18–1.73]). No association was found between the presence of FASL, PTPN22, CTLA and IL2RA gene polymorphisms with AA susceptibility. Conclusions The results suggest that the T allele of the single nucleoid polymorphism (SNP) rs2476601 in PTPN22 gene is a risk factor for developing alopecia areata. However, more robust studies defining the ethnic background of the population of origin are required, so that the risk identified in the present study can be validated. Additionally, a greater number of studies is necessary to evaluate the role of the FAS, FASL, PTPN22, CTLA4 and IL2RA genetic variants, given the heterogenous results found in the literature.
Collapse
|
9
|
Omar SI, Hamza AM, Eldabah N, Habiba DA. IFN-α and TNF-α serum levels and their association with disease severity in Egyptian children and adults with alopecia areata. Int J Dermatol 2021; 60:1397-1404. [PMID: 34008204 DOI: 10.1111/ijd.15658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune skin disease characterized by abnormal levels of several cytokines, such as interferon alpha (IFN-α) and tumor necrosis factor-alpha (TNF-α), which are T-helper type 1 cytokines that have important roles in the pathogenesis of AA. The aim of our study was to correlate circulating IFN-α and TNF-α levels with disease severity, activity, and clinical type in patients with AA and to evaluate the relationship between the two cytokines. METHODS We investigated serum IFN-α and TNF-α levels in 72 patients with AA (35 children and 35 adults) and 75 healthy control individuals (34 children and 41 adults) using the enzyme-linked immunosorbent assay (ELISA) technique. We evaluated AA severity using the Severity of Alopecia Tool (SALT) and determined the activity based on dermoscopic criteria of disease activity. RESULTS Serum IFN-α and TNF-α concentrations were significantly higher in the patients than in the controls. There was a significant positive correlation between serum IFN-α and TNF-α levels in all patients with alopecia areata, as well as between serum TNF-α levels and disease severity in all patients and in children. CONCLUSIONS Our results support the association between IFN-α and TNF-α levels and AA and suggest that TNF-α might be related to disease severity.
Collapse
Affiliation(s)
- Shaimaa I Omar
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ashraf M Hamza
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nermeen Eldabah
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa A Habiba
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| |
Collapse
|
10
|
Afford R, Leung AKC, Lam JM. Pediatric Alopecia Areata. Curr Pediatr Rev 2021; 17:45-54. [PMID: 32351186 DOI: 10.2174/1573396316666200430084825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/28/2020] [Accepted: 02/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a non-scarring hair loss disorder of autoimmune etiology. OBJECTIVE To familiarize physicians with the clinical presentation, diagnosis, evaluation, and management of pediatric alopecia areata. METHODS The search term "Alopecia areata" was entered into a Pubmed search. A narrow scope was applied to the categories of "epidemiology", "clinical diagnosis", "investigations", "comorbidities", and "treatment". Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. RESULTS AA is an autoimmune disease of unknown etiology. It is the third most common dermatologic presentation in children with a lifetime risk of 1-2%. Diagnosing AA can be made on the basis of the history and clinical findings. Patients will often present with patchy, non-scarring hair loss, generally affecting the scalp. History may reveal a personal or family medical history of autoimmune or atopic disease or a recent stressful event. Tricoscopic examination will classically show "exclamation point hairs" and "yellow dots". Nonspecific nail changes may be present. Other clinical variants include alopecia totalis, alopecia universalis, ophiasis, sisaipho, and Canitis subita. There are multiple treatment options for AA, including conservative treatment, and topical, oral, and injectable medications. CONCLUSION AA is an autoimmune disease with a heterogeneous presentation and unpredictable clinical course. Although there is no cure for AA, there are many current treatment options available to help manage this disfiguring disease.
Collapse
Affiliation(s)
- Rebecca Afford
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
11
|
Koumaki D, Koumaki V, Katoulis A, Lagoudaki E, Boumpoucheropoulos S, Stefanidou M, Miaris O, Baltaga L, Evangelou G, Zografaki K, Krueger-Krasagakis SE, Krasagakis K. Adalimumab-induced scalp psoriasis with severe alopecia as a paradoxical effect in a patient with Crohn's disease successfully treated with ustekinumab. Dermatol Ther 2020; 33:e13791. [PMID: 32510744 DOI: 10.1111/dth.13791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Vasiliki Koumaki
- Microbiology Department, Medical School of Athens, Athens, Greece
| | - Alexander Katoulis
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Eleni Lagoudaki
- Pathology Department, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | - Maria Stefanidou
- Dermatology Department, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | | | - George Evangelou
- Dermatology Department, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Kyriaki Zografaki
- Dermatology Department, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | | |
Collapse
|
12
|
Choi N, Sung JH. Udenafil Induces the Hair Growth Effect of Adipose-Derived Stem Cells. Biomol Ther (Seoul) 2019; 27:404-413. [PMID: 30971059 PMCID: PMC6609107 DOI: 10.4062/biomolther.2018.195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/01/2019] [Accepted: 02/25/2019] [Indexed: 12/25/2022] Open
Abstract
Udenafil, which is a PDE5 inhibitor, is used to treat erectile dysfunction. However, it is unclear whether udenafil induces hair growth via the stimulation of adipose-derived stem cells (ASCs). In this study, we investigated whether udenafil stimulates ASCs and whether increased growth factor secretion from ASCs to facilitate hair growth. We found that subcutaneous injection of udenafil-treated ASCs accelerated telogen-to-anagen transition in vivo. We also observed that udenafil induced proliferation, migration and tube formation of ASCs. It also increased the secretion of growth factors from ASCs, such as interleukin-4 (IL-4) and IL12B, and the phosphorylation of ERK1/2 and NFκB. Furthermore, concomitant upregulation of IL-4 and IL12B mRNA levels was attenuated by ERK inhibitor or NFκB knockdown. Application of IL-4 or IL12B enhanced anagen induction in mice and increased hair follicle length in organ culture. The results indicated that udenafil stimulates ASC motility and increases paracrine growth factor, including cytokine signaling. Udenafil-stimulated secretion of cytokine from ASCs may promote hair growth via the ERK and NFκB pathways. Therefore, udenafil can be used as an ASC-preconditioning agent for hair growth.
Collapse
Affiliation(s)
- Nahyun Choi
- College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea.,STEMORE Co. Ltd., Incheon 21984, Republic of Korea
| | - Jong-Hyuk Sung
- College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea.,STEMORE Co. Ltd., Incheon 21984, Republic of Korea
| |
Collapse
|
13
|
Lei ZX, Chen WJ, Liang JQ, Wang YJ, Jin L, Xu C, Kang XJ. The association between rs2476601 polymorphism in PTPN22 gene and risk of alopecia areata: A meta-analysis of case-control studies. Medicine (Baltimore) 2019; 98:e15448. [PMID: 31096440 PMCID: PMC6531179 DOI: 10.1097/md.0000000000015448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The single nucleotide polymorphism (SNP) rs2476601 of the protein tyrosine phosphatase, nonreceptor type 22 (PTPN22) gene has been presented to implicate in the pathogenesis of alopecia areata (AA) in a few association investigations with limited sample size and inconsistent conclusions. METHODS The aim of the current meta-analysis was to assess and synthesize the presently available data on the connection between rs2476601 and AA vulnerability. Six electronic databases, including EMBASE, PubMed, Web of Science, the Cochrane Library, Wanfang data, and the China National Knowledge Infrastructure database (CNKI), were systematically retrieved for relevant observational studies published previous to November 2018. Total odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were analyzed to evaluate the correlation between PTPN22 polymorphism and AA. Risk of bias was estimated according to the Newcastle-Ottawa Scale (NOS). Sensitivity analyses were carried out using the RevMan 5.3 software. RESULTS In general, 5 case-control studies including 1129 AA patients and 1702 healthy control individuals were obtained for this meta-analysis. The pooled results suggested that rs2476601 SNP was significantly associated with AA susceptibility under allelic model (C vs T, OR = 0.77, 95% CI, 0.64-0.92, P = .003) and recessive model (CC vs CT + TT, OR = 0.73, 95% CI, 0.60-0.88, P = .001). CONCLUSION On the basis of the results of the current research, the rs2476601 polymorphism of PTPN22 gene is significantly correlated with AA susceptibility. The C-allele and CC-genotype carriers at this locus have a lower risk of AA.
Collapse
Affiliation(s)
- Zi-Xian Lei
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
- Xinjiang Medical University, Urumqi, China
| | - Wen-Jing Chen
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
- Xinjiang Medical University, Urumqi, China
| | - Jun-Qin Liang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
| | - Yan-Jun Wang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
- Xinjiang Medical University, Urumqi, China
| | - Lan Jin
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
- Xinjiang Medical University, Urumqi, China
| | - Chen Xu
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
- Xinjiang Medical University, Urumqi, China
| | - Xiao-Jing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang
| |
Collapse
|
14
|
Sacchelli L, Magnano M, Patrizi A, Bardazzi F. Generalized hypertrichosis due to secukinumab in a patient with moderate psoriasis: A case of serendipity or zemblanity? Dermatol Ther 2019; 32:e12894. [PMID: 30963671 DOI: 10.1111/dth.12894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/05/2019] [Indexed: 12/16/2022]
Abstract
After 4 months of therapy with secukinumab, a 67-year-old man with moderate psoriasis developed generalized hypertrichosis, along with PASI 90. The patient denied any drug intake, apart from secukinumab, nor applications of any creams. Moreover, this event did not really bother the patient, thus the therapy was not discontinued and the hypertrichosis is persisting as psoriasis' control.
Collapse
Affiliation(s)
- Lidia Sacchelli
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Michela Magnano
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Federico Bardazzi
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy
| |
Collapse
|
15
|
Serum concentrations of selected proinflammatory cytokines in children with alopecia areata. Postepy Dermatol Alergol 2019; 36:63-69. [PMID: 30858781 PMCID: PMC6409873 DOI: 10.5114/ada.2019.82826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/26/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Alopecia areata (AA) is considered an autoimmune disorder characterized by patchy loss of hair from the scalp and other body parts. Many patients develop the disease in childhood. Aim To answer the question whether abnormal production of some proinflammatory cytokines (IL-2, IL-6, IL-15, IL-17A and IFNγ) in children with AA may facilitate the development or progression of the disease. Material and methods The study group consisted of 42 children with AA, the control group – 37 healthy children. Peripheral venous blood samples were collected from patients with AA and healthy controls and the concentrations of serum cytokines, namely IL-2, IL-6, IL-15, IL-17A, IFN-γ were determined quantitatively by ELISA method. Results The serum IL-6, IL-15, IL-17A and IFNγ levels were significantly increased in patients with AA compared with control subjects (p < 0.05). The serum IL-15 level was found to be increased when the total duration of AA was increased (q = 0.30; p = 0.05). The serum cytokine level of IL-17A was found to be decreased when duration of the current episode was longer than 2 years (p < 0.05), but the correlation between IL-17A serum level and duration of the current episode was not confirmed in the Spearman test (q = –0.06; p = 0.68). The serum IL-17A level was found to be significantly decreased when the thyroiditis was present (q = –2.378; p < 0.05). Conclusions The increased levels of serum IL-6, IL-15, IL-17A and IFNγ in children suggest imbalance in the serum proinflammatory cytokines production in AA.
Collapse
|
16
|
Ostojic P, Pavlov-Dolijanovic S. Alopecia universalis in a patient with rheumatoid arthritis developed during treatment with adalimumab. Z Rheumatol 2018; 77:412-415. [PMID: 29744570 DOI: 10.1007/s00393-018-0464-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Alopecia universalis is an advanced form of alopecia areata, characterized by complete loss of hair on all hair-bearing areas. It is currently believed to be an autoimmune disorder. The development of alopecia during treatment with tumor necrosis factor alpha (TNF-α) inhibitors is a rarely observed adverse event. This case describes a 56-year-old female patient with rheumatoid arthritis (RA), who developed alopecia universalis during treatment with adalimumab. There was no improvement in alopecia despite withdrawal of adalimumab. It is believed that interferon-α is the main cytokine involved in promoting inflammation in hair loss after blocking TNF-α by TNF inhibitors. Risk/benefit ratio of maintenance and discontinuation of the drug should be weighed up when alopecia appears during treatment with TNF inhibitors.
Collapse
Affiliation(s)
- P Ostojic
- Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia.
| | - S Pavlov-Dolijanovic
- Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia
| |
Collapse
|
17
|
Abstract
Objectives: To assess the significance of thyroid autoimmune screening in alopecia areata (AA) patients in Saudi population, and to determine whether there is a difference in thyroid autoimmune susceptibility between mild and severe AA. Methods: In a prospective case-control study, we included 50 alopecia totalis (AT) and alopecia universalis (AU) patients, 50 age- and gender-matched patients with localized AA, and 50 age- and gender- matched healthy subjects between March 2015 and August 2015. Patients with AA were consecutively recruited from the hair disorders out-patient clinic of King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia. Results: Thyroid autoantibodies (TAAs) were positive in AT/AU (40%), mild AA (14%), and healthy subjects (4%). The frequency of TAAs was significantly higher in patients with AT/AU than in mild AA (p=0.001) and healthy controls (p<0.001). The frequency of thyroid peroxidase antibody (TPO-Abs) was significantly higher in patients with AT/AU than in mild AA and healthy controls (p<0.001 for both). The frequency of TG-Abs was significantly higher in patients with AT/AU (p=0.003) and mild AA (p=0.043) than in healthy controls. Serum TSH level was significantly higher in AT/AU patients than in mild AA patients (p=0.006) and healthy controls (p=0.005). Conclusion: Severe subtype of AA is associated with a high risk of autoimmune thyroid disease. This highlights the significance of screening for thyroid abnormalities and TAAs in patients with AT/AU.
Collapse
Affiliation(s)
- Ghada A Bin Saif
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
| |
Collapse
|
18
|
Wang ECE, Harris JE, Christiano AM. Topical JAK Inhibitors for the Treatment of Alopecia Areata and Vitiligo. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0163-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Dainichi T, Kabashima K. Alopecia areata: What's new in epidemiology, pathogenesis, diagnosis, and therapeutic options? J Dermatol Sci 2016; 86:3-12. [PMID: 27765435 DOI: 10.1016/j.jdermsci.2016.10.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/05/2016] [Indexed: 12/12/2022]
Abstract
Alopecia areata (AA) is a common and stressful disorder that results in hair loss, and resistant to treatment in some cases. Experimental and clinical evidence suggests that AA is caused by autoimmune attack against the hair follicles. The precise pathomechanism, however, remains unknown. Here, we focus on the recent progress in multidisciplinary approaches to the epidemiology, pathogenesis, and new treatments of AA in 996 publications from January 2010 to July 2016, and provide an overview of the current understanding in clinical management and research directions.
Collapse
Affiliation(s)
- Teruki Dainichi
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Singapore Immunology Network (SIgN) and Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore; PRESTO, Japan Science and Technology Agency, Kawaguchi, Japan
| |
Collapse
|
20
|
Pouché L, Koitka M, Stojanova J, Woillard JB, Monchaud C, Villeneuve C, Essig M, Abraham J, Le Meur Y, Rerolle JP, Kamar N, Rostaing L, Merville P, Gandia P, Bouchet S, Petersen BS, Marquet P, Picard N. A candidate gene approach of the calcineurin pathway to identify variants associated with clinical outcomes in renal transplantation. Pharmacogenomics 2016; 17:375-91. [PMID: 26894651 DOI: 10.2217/pgs.15.181] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM To investigate the potential influence of variants in genes involved in the calcineurin pathway on the efficacy and toxicity of calcineurin inhibitors in renal transplantation. MATERIALS & METHODS Twenty-three polymorphisms in thirteen genes were tested in 381 renal transplant recipients receiving ciclosporin (n = 221) or tacrolimus (n = 160) and mycophenolate mofetil. Data were collected prospectively over the first year post-transplantation. RESULTS Multivariate survival analyses revealed no genetic associations with biopsy proven acute graft rejection and serious infections. Donor-recipient Cytomegalovirus mismatch was the only variable associated with serious infection. CONCLUSION This large exploratory study casts doubts on the potential interest of genetic biomarkers related to CNI pharmacodynamics but associations with other phenotypes in transplantation deserve further studies.
Collapse
Affiliation(s)
- Lucie Pouché
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,CHU Limoges, Department of Pharmacology, Toxicology & Pharmacovigilance, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Matthias Koitka
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France
| | - Jana Stojanova
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,Laboratory of Chemical Carcinogenesis & Pharmacogenetics, University of Chile, Santiago, Chile
| | - Jean-Baptiste Woillard
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,CHU Limoges, Department of Pharmacology, Toxicology & Pharmacovigilance, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Caroline Monchaud
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,CHU Limoges, Department of Pharmacology, Toxicology & Pharmacovigilance, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Claire Villeneuve
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,CHU Limoges, Department of Pharmacology, Toxicology & Pharmacovigilance, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Marie Essig
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,CHU Limoges, Department of Nephrology, Dialysis & Transplantation, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Julie Abraham
- CHU Limoges, Department of Clinical Hematology, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Yannick Le Meur
- CHU Brest, Hôpital Cavale Blanche, Department of Nephrology, F-29609 Brest, France
| | - Jean-Phillippe Rerolle
- CHU Limoges, Department of Nephrology, Dialysis & Transplantation, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Nassim Kamar
- CHU Toulouse Rangueil, Department of Nephrology & Organ Transplantation, F-31000 Toulouse, France.,INSERM, U1043, Structure Fédérative de Recherche Bio-Médicale de Toulouse (SFR-BMT), Centre Hospitalier Universitaire (CHU) Purpan, Toulouse, France.,Université Paul Sabatier, 118 route de Narbonne, F-31062 Toulouse, France
| | - Lionel Rostaing
- CHU Toulouse Rangueil, Department of Nephrology & Organ Transplantation, F-31000 Toulouse, France.,INSERM, U1043, Structure Fédérative de Recherche Bio-Médicale de Toulouse (SFR-BMT), Centre Hospitalier Universitaire (CHU) Purpan, Toulouse, France.,Université Paul Sabatier, 118 route de Narbonne, F-31062 Toulouse, France
| | - Pierre Merville
- CHU Bordeaux, Department of Nephrology, Transplantation, Dialysis, F-33000 Bordeaux, France
| | - Peggy Gandia
- CHU Toulouse, Laboratory of Pharmacokinetics & Clinical Toxicology, F-31000 Toulouse, France
| | - Stephane Bouchet
- CHU Bordeaux, Department of Clinical Pharmacology & Toxicology, F-33000 Bordeaux, France
| | - Britt-Sabina Petersen
- Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel, Germany
| | - Pierre Marquet
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,CHU Limoges, Department of Pharmacology, Toxicology & Pharmacovigilance, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| | - Nicolas Picard
- Inserm, UMR 850, 2 Avenue Martin-Luther King, F-87042 Limoges, France.,Univ. Limoges, Faculty of Medicine & Pharmacy, 2 rue du Dr Marcland, F-87025 Limoges, France.,CHU Limoges, Department of Pharmacology, Toxicology & Pharmacovigilance, 2 Avenue Martin-Luther King, F-87042 Limoges, France
| |
Collapse
|
21
|
Salinas-Santander M, Sánchez-Domínguez C, Cantú-Salinas C, Gonzalez-Cárdenas H, Cepeda-Nieto AC, Cerda-Flores RM, Ortiz-López R, Ocampo-Candiani J. Association between PTPN22 C1858T polymorphism and alopecia areata risk. Exp Ther Med 2015; 10:1953-1958. [PMID: 26640579 DOI: 10.3892/etm.2015.2728] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 08/10/2015] [Indexed: 02/07/2023] Open
Abstract
Alopecia areata (AA) is a skin condition in which hair is lost from certain or all areas of the body. This condition has been described as an immune-mediated complex genetic disease, characterized by the presence of lymphocytes that are directed to the hair follicles in the anagen phase. The gene encoding the protein tyrosine phosphatase, non-receptor type 22 (PTPN22), which is exclusively expressed in immune cells, has been considered as a risk factor associated with a number of autoimmune diseases. In AA, the single nucleotide polymorphism, rs2476601, has been identified as a risk factor in several populations. The aim of the present study was to investigate the effect of PTPN22 C1858T inherited genetic polymorphism on the predisposition to severe forms of AA, in a case-control study on individuals. The study included 64 unrelated patients diagnosed with several types of AA, as well as 225 healthy unrelated subjects. The DNA samples were genotyped for PTPN22 C1858T polymorphism using the polymerase chain reaction-restriction fragment length polymorphism technique. Causal associations were determined by χ2 test and their respective odds ratio (OR) was assessed in a 2×2 contingency table. The results demonstrated a significant association of the T allele [P=0.040; OR=3.196; 95% confidence interval (CI), 0.094-10.279] and the CT genotype (P=0.038; OR=3.313; 95% CI, 1.008-10.892) with patchy AA. In conclusion, the results of the present study suggested the possible involvement of the T allele of the PTPN22 C1858T SNP as a genetic risk factor for this type of AA in the population studied.
Collapse
Affiliation(s)
- Mauricio Salinas-Santander
- Research Department, Faculty of Medicine, Autonomous University of Coahuila, Saltillo, Coahuila 25000, México ; Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| | - Celia Sánchez-Domínguez
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| | - Cristina Cantú-Salinas
- Department of Dermatology, University Hospital 'Dr José Eleuterio González', Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| | - Hugo Gonzalez-Cárdenas
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| | - Ana Cecilia Cepeda-Nieto
- Research Department, Faculty of Medicine, Autonomous University of Coahuila, Saltillo, Coahuila 25000, México
| | - Ricardo M Cerda-Flores
- School of Nursing, Genomics and Sequencing Unit, Center for Research and Development in the Health Sciences, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| | - Rocío Ortiz-López
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México ; Department of Molecular Biology, Genomics and Sequencing Unit, Center for Research and Development in the Health Sciences, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| | - Jorge Ocampo-Candiani
- Department of Dermatology, University Hospital 'Dr José Eleuterio González', Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, México
| |
Collapse
|
22
|
Biran R, Zlotogorski A, Ramot Y. The genetics of alopecia areata: New approaches, new findings, new treatments. J Dermatol Sci 2015; 78:11-20. [DOI: 10.1016/j.jdermsci.2015.01.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 01/04/2015] [Accepted: 01/16/2015] [Indexed: 01/26/2023]
|
23
|
Immunochip-Based Analysis: High-Density Genotyping of Immune-Related Loci Sheds Further Light on the Autoimmune Genetic Architecture of Alopecia Areata. J Invest Dermatol 2015; 135:919-921. [DOI: 10.1038/jid.2014.459] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
24
|
Betz RC, Petukhova L, Ripke S, Huang H, Menelaou A, Redler S, Becker T, Heilmann S, Yamany T, Duvic M, Hordinsky M, Norris D, Price VH, Mackay-Wiggan J, de Jong A, DeStefano GM, Moebus S, Böhm M, Blume-Peytavi U, Wolff H, Lutz G, Kruse R, Bian L, Amos CI, Lee A, Gregersen PK, Blaumeiser B, Altshuler D, Clynes R, de Bakker PIW, Nöthen MM, Daly MJ, Christiano AM. Genome-wide meta-analysis in alopecia areata resolves HLA associations and reveals two new susceptibility loci. Nat Commun 2015; 6:5966. [PMID: 25608926 PMCID: PMC4451186 DOI: 10.1038/ncomms6966] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 11/25/2014] [Indexed: 12/21/2022] Open
Abstract
Alopecia areata (AA) is a prevalent autoimmune disease with 10 known susceptibility loci. Here we perform the first meta-analysis of research on AA by combining data from two genome-wide association studies (GWAS), and replication with supplemented ImmunoChip data for a total of 3,253 cases and 7,543 controls. The strongest region of association is the major histocompatibility complex, where we fine-map four independent effects, all implicating human leukocyte antigen-DR as a key aetiologic driver. Outside the major histocompatibility complex, we identify two novel loci that exceed the threshold of statistical significance, containing ACOXL/BCL2L11(BIM) (2q13); GARP (LRRC32) (11q13.5), as well as a third nominally significant region SH2B3(LNK)/ATXN2 (12q24.12). Candidate susceptibility gene expression analysis in these regions demonstrates expression in relevant immune cells and the hair follicle. We integrate our results with data from seven other autoimmune diseases and provide insight into the alignment of AA within these disorders. Our findings uncover new molecular pathways disrupted in AA, including autophagy/apoptosis, transforming growth factor beta/Tregs and JAK kinase signalling, and support the causal role of aberrant immune processes in AA.
Collapse
Affiliation(s)
- Regina C Betz
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Lynn Petukhova
- Department of Dermatology, Columbia University, NY, NY.,Department of Epidemiology, Columbia University, NY, NY
| | - Stephan Ripke
- Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Hailiang Huang
- Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Androniki Menelaou
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Silke Redler
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Tim Becker
- German Center for Neurodegenerative Diseases, Bonn, Germany.,Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn
| | - Stefanie Heilmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life&Brain Center, University Bonn, Bonn, Germany
| | - Tarek Yamany
- Department of Dermatology, Columbia University, NY, NY
| | - Madeliene Duvic
- Department of Dermatology, MD Anderson Cancer Center, Houston,TX
| | - Maria Hordinsky
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - David Norris
- Department of Dermatology, University of Colorado, Denver, CO, US
| | - Vera H Price
- Department of Dermatology, University of California, San Francisco, San Francisco CA
| | | | | | - Gina M DeStefano
- Department of Genetics & Development, Columbia University, NY, NY
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Essen, Germany
| | - Markus Böhm
- Department of Dermatology, University of Münster, Münster, Germany
| | - Ulrike Blume-Peytavi
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hans Wolff
- Department of Dermatology, University of Munich, Munich, Germany
| | - Gerhard Lutz
- Dermatological Practice, Hair and Nail, Wesseling, Germany
| | | | - Li Bian
- Department of Dermatology, Columbia University, NY, NY
| | - Christopher I Amos
- Community and Family Medicine and Genetics, Dartmouth College, Hanover, NH, US
| | - Annette Lee
- The Feinstein Institute for Medical Research, Manhasset NY
| | | | | | - David Altshuler
- Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Raphael Clynes
- Department of Dermatology, Columbia University, NY, NY.,Department of Medicine Columbia University, NY, NY
| | - Paul I W de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life&Brain Center, University Bonn, Bonn, Germany
| | - Mark J Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Angela M Christiano
- Department of Dermatology, Columbia University, NY, NY.,Department of Genetics & Development, Columbia University, NY, NY
| |
Collapse
|
25
|
Bozic Antic I, Macut D, Popovic B, Isailovic T, Petakov M, Ognjanovic S, Damjanovic S. Recurrent spontaneous abortions, Hashimoto thyroiditis and alopecia totalis: response to anticoagulation and intravenous immunoglobulin therapy. Gynecol Endocrinol 2014; 30:100-2. [PMID: 24308767 DOI: 10.3109/09513590.2013.864271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Although numerous studies indicated a link between antithyroid antibodies and recurrent spontaneous abortions (RSA), consensus on the treatment of this condition is still lacking. CASE REPORT We present a case of a 35-year-old pregnant woman (gestation week 4) with primary hypothyroidism, total alopecia, high level of positive antithyroid antibodies, and history of two recurrent spontaneous abortions in early pregnancy. Along with L-thyroxin substitution, intravenous human immunoglobulin (IVIg) combined with anticoagulation and antiaggregation therapy was introduced. During pregnancy her scalp hair completely re-grew, and following gestation week 39 she delivered healthy female child. CONCLUSION Thyroid antibodies could contribute to previous recurrent abortions in our patient. It is suggested that in older primiparas with Hashimoto thyroiditis and history of RSA, a combined treatment with IVIg, anticoagulation and antiaggregation therapy should be considered.
Collapse
Affiliation(s)
- Ivana Bozic Antic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia and
| | | | | | | | | | | | | |
Collapse
|
26
|
Miao Y, Kang Z, Xu F, Qi S, Sheng Y, Han Y, Hu R, Guo X, Yang Q. Association analysis of the IL2RA gene with alopecia areata in a Chinese population. Dermatology 2013; 227:299-304. [PMID: 24280705 DOI: 10.1159/000351555] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 04/12/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Interleukin-2 receptor subunit alpha (IL2RA) is highly expressed on CD4+CD25+ regulatory T cells and is important for immune homeostasis and the suppression of autoimmune responses. It has been suggested that the single nucleotide polymorphism in IL2RA may affect the pathogenesis of alopecia areata (AA). OBJECTIVE Our aim was to investigate the link between IL2RA polymorphism and AA in a Chinese population. METHODS We examined 427 patients and 430 controls in this study. The rs3118470 polymorphism was evaluated using high-resolution melting analysis and direct sequencing. RESULTS The prevalence of the C/C, T/C and T/T genotypes was 16.2, 48.2 and 35.6%, respectively. The genotype distribution and allele frequencies were significantly different between AA and control subjects (p < 0.0001). The C allele frequency was significantly higher in the AA group (p < 0.0001), and the frequencies of C allele and C/C genotype were higher in the patients with family history (p = 0.034; p < 0.0001). CONCLUSIONS The rs3118470 single nucleotide polymorphism of IL2RA may be a genetic marker to assess the risk of AA in a Chinese population.
Collapse
Affiliation(s)
- Y Miao
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
McElwee KJ, Gilhar A, Tobin DJ, Ramot Y, Sundberg JP, Nakamura M, Bertolini M, Inui S, Tokura Y, Jr LEK, Duque-Estrada B, Tosti A, Keren A, Itami S, Shoenfeld Y, Zlotogorski A, Paus R. What causes alopecia areata? Exp Dermatol 2013; 22:609-26. [PMID: 23947678 PMCID: PMC4094373 DOI: 10.1111/exd.12209] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The pathobiology of alopecia areata (AA), one of the most frequent autoimmune diseases and a major unsolved clinical problem, has intrigued dermatologists, hair biologists and immunologists for decades. Simultaneously, both affected patients and the physicians who take care of them are increasingly frustrated that there is still no fully satisfactory treatment. Much of this frustration results from the fact that the pathobiology of AA remains unclear, and no single AA pathogenesis concept can claim to be universally accepted. In fact, some investigators still harbour doubts whether this even is an autoimmune disease, and the relative importance of CD8(+) T cells, CD4(+) T cells and NKGD2(+) NK or NKT cells and the exact role of genetic factors in AA pathogenesis remain bones of contention. Also, is AA one disease, a spectrum of distinct disease entities or only a response pattern of normal hair follicles to immunologically mediated damage? During the past decade, substantial progress has been made in basic AA-related research, in the development of new models for translationally relevant AA research and in the identification of new therapeutic agents and targets for future AA management. This calls for a re-evaluation and public debate of currently prevalent AA pathobiology concepts. The present Controversies feature takes on this challenge, hoping to attract more skin biologists, immunologists and professional autoimmunity experts to this biologically fascinating and clinically important model disease.
Collapse
Affiliation(s)
- K. J. McElwee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - A. Gilhar
- Laboratory for Skin, Research, Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel Marta Bertolini
| | - D. J. Tobin
- Centre for Skin Sciences, School of Life Sciences, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK
| | - Y. Ramot
- Department of Dermatology, Hadassah- Hebrew University Medical Center, Jerusalem 91120, Israel
| | - J. P. Sundberg
- The Jackson Laboratory, Bar Harbor, ME, USA; Division of Dermatology, Skin Disease Research Center, Vanderbilt University, Nashville, TN, USA
| | - M. Nakamura
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan Yoshiki Tokura
| | - M. Bertolini
- Department of Dermatology, University of Lübeck, Germany Yehuda Shoenfeld
| | - S. Inui
- Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Y. Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - L. E. King Jr
- The Jackson Laboratory, Bar Harbor, ME, USA; Division of Dermatology, Skin Disease Research Center, Vanderbilt University, Nashville, TN, USA
| | - B. Duque-Estrada
- Instituto de Dermatologia Prof. Rubem David Azulay, Rio de Janeiro, Brazil Antonella Tosti
| | - A Tosti
- Department of Dermatology, University of Miami, Miami, FL, USA
| | - A. Keren
- Laboratory for Skin, Research, Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel Marta Bertolini
| | - S. Itami
- Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Y. Shoenfeld
- Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - A. Zlotogorski
- Department of Dermatology, Hadassah- Hebrew University Medical Center, Jerusalem 91120, Israel
| | - R. Paus
- Department of Dermatology, University of Lübeck, Germany; Institute of Inflammation and Repair, University of Manchester, Manchester, UK ,
| |
Collapse
|
28
|
The association between Interleukin (IL)-4 gene intron 3 VNTR polymorphism and alopecia areata (AA) in Turkish population. Gene 2013; 527:565-9. [DOI: 10.1016/j.gene.2013.05.086] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/17/2013] [Accepted: 05/29/2013] [Indexed: 01/23/2023]
|
29
|
Rudnicka L, Lukomska M. Alternaria scalp infection in a patient with alopecia areata. Coexistence or causative relationship? J Dermatol Case Rep 2013; 6:120-4. [PMID: 23329992 DOI: 10.3315/jdcr.2012.1120] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 12/26/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Alopecia areata is an autoimmune disease that is affecting anagen hair follicles. The triggers of autoimmunity in patients with alopecia areata remain unknown. MAIN OBSERVATION A 13-year-old boy developed multiple hairless patches of focal hair loss with typical clinical and trichoscopy features of alopecia areata. Mycology examination of the scalp hair and epidermal scrapings reveled massive growth of Alternaria chlamydospora. CONCLUSION We hypothesize that fungal antigens (e.g. antigens involved in fungal melanin synthesis) may be possible triggers, contributing to autoimmune reactions in patients with alopecia areata. We discuss research data, which may indirectly support this hypothesis, however the concept has yet to be verified.
Collapse
Affiliation(s)
- Lidia Rudnicka
- Department of Dermatology CSK MSW, Warsaw, Poland ; Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland ; Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | | |
Collapse
|