Lipid peroxidation/antioxidant activity in patients with alopecia areata

Circulating biomarkers of oxidative stress in people with acne vulgaris: a systematic review and meta-analysis

The relationship between acne vulgaris and oxidative stress biomarkers lacks a clear consensus. This study aimed to explore the potential correlation between acne vulgaris and circulating oxidative stress biomarkers (superoxide dismutase [SOD], malondialdehyde [MDA], and total antioxidant capacity [TAC]). We searched the PubMed, Embase, and Cochrane Library databases for articles published before June 26, 2023. The literature search combined free words and the medical subject headings terms related to acne vulgaris, SOD, MDA, and TAC. Data were analyzed using Stata 15 software. Additionally, we conducted a subgroup analysis stratified by the severity of acne vulgaris. A total of 14 trials involving 1191 participants were included. Overall results revealed that acne vulgaris was associated with MDA concentrations (SMD = 1.73; 95% CI 1.05, 2.4; P < 0.001). Subgroup analyses indicated that the severity of acne vulgaris was correlated with levels of circulating biomarkers of oxidative stress. TAC concentrations were significantly lower in patients with moderate acne vulgaris compared to controls (SMD =  - 1.37; 95% CI =  - 2.15, - 0.58, P = 0.001). SOD concentrations were significantly lower (SMD =  - 2.92; 95% CI =  - 5.39, - 0.46, P = 0.02) and MDA concentrations were significantly higher (SMD = 2.26; 95% CI = 0.95, 3.57, P = 0.001) in patients with severe acne vulgaris compared to controls. Our results implied that oxidative stress may exist in acne vulgaris. Furthermore, the severity of acne vulgaris was also correlated with oxidative stress.

White hair in alopecia areata: Clinical forms and proposed physiopathologic mechanisms

Alopecia areata (AA) is a common form of nonscarring hair loss. It is believed to be a consequence of an immune-mediated stimulus, probably involving autoreactive T cells against antigens present in the hair follicle. The exact antigen is still unknown; however, some authors have proposed that melanogenesis-associated molecules might trigger autoimmunity. Although transient white hair regrowth is a common and well-known situation in AA, there are other types of white hair phenomena in this context, including permanent white hair regrowth, sparing of white hair in a patchy pattern, or sparing in a diffuse pattern, giving the appearance of the so-called overnight graying phenomena or canitis subita. In this review, we aim to describe the different clinical aspects of white hair in AA, as well as the proposed pathophysiologic mechanisms involved in this phenomena.

Collagen Hydrolysate from the Scales of Mozambique Tilapia (Oreochromis mossambicus) Improve Hair and Skin Health by Alleviating Oxidative Stress and Inflammation and Promoting Hair Growth and Extracellular Matrix Factors

Fish-derived collagen hydrolysate (CH) has shown promise in improving hair and skin health. Therefore, this study sought to comprehensively assess the effects of CH extracted from Mozambique tilapia (Oreochromis mossambicus) scales on hair and skin using in vitro and in vivo models. Human dermal papilla cells (hDPCs) were used for antioxidant and gene expression analyses, while C57BL/6 mice were orally administered CH for six weeks to assess hair growth patterns. The mice were divided into four groups: negative control (NC; distilled water), positive control (PC; 1 mg/kg finasteride), CH500 (500 mg/kg BW CH), and CH1000 (1000 mg/kg BW CH). CH mitigated catalase activity reduction in hDPCs, increased IGF-1 and VEGF levels, and decreased TGF-β1, TNF-α, and IL-1β expression. In vivo, CH treatment improved hair growth index, length, diameter, weight, and density. Scanning electron microscopy revealed reduced hair damage. Moreover, CH up-regulated IGF-1, VEGF, Elastin, and HAS2 mRNA expression while down-regulating TNF-α and IL-1β. CH enhanced hair shine, growth, and skin health while alleviating inflammation. These findings demonstrate the potential of CH in alleviating oxidative stress, promoting hair growth, and enhancing skin health, both in vitro and in vivo. Fish-derived CH offers a cost-effective and bioavailable option for improving hair and skin health.

Alopecia Areata: A Review of the Role of Oxidative Stress, Possible Biomarkers, and Potential Novel Therapeutic Approaches

Alopecia areata (AA) is a dermatological condition characterized by non-scarring hair loss. Exact etiopathogenesis of AA is still unknown although it is known that several factors contribute to the collapse of the hair-follicle (HF)-immune-privileged (IP) site. Oxidative stress (OS) plays an important role in skin diseases. The aim of this review was to clarify the role of OS in AA pathogenesis and diagnosis, and to discuss potential treatment options. Oxidative-stress markers are altered in serum and skin samples of patients with AA, confirming a general pro-oxidative status in patients with AA. OS induces MHC class I chain-related A (MICA) expression in HF keratinocytes that activates the receptor NKG2D, expressed in NK cells and CD8+ T cytotoxic cells leading to destabilization of the HF immune-privileged site through the production of IFN-γ that stimulates JAK1 and JAK2 pathways. OS also activates the KEAP1-NRF2 pathway, an antioxidant system that contributes to skin homeostasis. In addition, a decrease of ATG5 and LC3B in the hair matrix and an increase in p62 levels indicates a reduction of intrafollicular autophagy during the evolution of AA. Potential biomarkers of OS in AA could be: malondialdehyde (MDA), advanced glycation end-products (AGEs), and ischemic-modified albumin (IMA). JAK inhibitors are the new frontier in treatment of AA and the use of nutraceuticals that modulate the OS balance, in combination with standard treatments, represent promising therapeutic tools.

Protective effects of Bacillus licheniformis on growth performance, gut barrier functions, immunity and serum metabolome in lipopolysaccharide-challenged weaned piglets

Bacillus licheniformis (B. licheniformis) is a well-accepted probiotic that has many benefits on both humans and animals. This study explored the effects of B. licheniformis on growth performance, intestinal mucosal barrier functions, immunity as well as serum metabolome in the weaned piglets exposed to lipopolysaccharide (LPS). One hundred and twenty piglets weaned at four weeks of age were separated into two groups that received a basal diet (the control group, CON), and a basal diet complemented with B. licheniformis (500 mg/kg, the BL group, BL). Twenty-four piglets were chosen from the above two groups and 12 piglets were injected with LPS intraperitoneally at a concentration of 100 μg/kg and the others were injected with sterile saline solution of the same volume. All the piglets were sacrificed 4 h after LPS challenge. Results showed that B. licheniformis enhanced the ADG and final body weight and lowered the F/G and diarrhea rate. Pre-treatment with B. licheniformis markedly attenuated intestinal mucosal damage induced by LPS challenge. Supplementation with B. licheniformis strengthened immune function and suppressed inflammatory response by elevating the concentrations of serum immunoglobulin (Ig) A and jejunum mucosal IgA and IgG and decreasing serum IL-6 and jejunum mucosal IL-1β. In addition, B. licheniformis pretreatment prevented LPS-induced intestinal injury by regulating the NLRP3 inflammasome. Furthermore, pretreatment with B. licheniformis tended to reverse the reduction of acetate and propionic acids in the colonic contents that occurred due to LPS stress. B. licheniformis markedly modulated the metabolites of saccharopine and allantoin from lysine and purine metabolic pathways, respectively. Overall, these data emphasize the potentiality of B. licheniformis as a dietary supplement to overcome the challenge of bacterial LPS in the animal and to enhance the food safety.

How Our Microbiome Influences the Pathogenesis of Alopecia Areata

Alopecia areata is a multifactorial autoimmune-based disease with a complex pathogenesis. As in all autoimmune diseases, genetic predisposition is key. The collapse of the immune privilege of the hair follicle leading to scalp loss is a major pathogenic event in alopecia areata. The microbiota considered a bacterial ecosystem located in a specific area of the human body could somehow influence the pathogenesis of alopecia areata, as it occurs in other autoimmune diseases. Moreover, the Next Generation Sequencing of the 16S rRNA bacterial gene and the metagenomic methodology have provided an excellent characterization of the microbiota. The aim of this narrative review is to examine the published literature on the cutaneous and intestinal microbiota in alopecia areata to be able to establish a pathogenic link. In this review, we summarize the influence of the microbiota on the development of alopecia areata. We first introduce the general pathogenic mechanisms that cause alopecia areata to understand the influence that the microbiota may exert and then we summarize the studies that have been carried out on what type of gut and skin microbiota is found in patients with this disease.

Hair Follicle Melanocytes Initiate Autoimmunity in Alopecia Areata: a Trigger Point

Alopecia areata (AA) is characterized by common non-scarring alopecia due to autoimmune disorders. To date, the specific pathogenesis underlying AA remains unknown. Thus, AA treatment in the dermatological clinic is still a challenge. Numerous clinical observations and experimental studies have established that melanocytes may be the trigger point that causes hair follicles to be attacked by the immune system. A possible mechanism is that the impaired melanocytes, under oxidative stress, cannot be repaired in time and causes apoptosis. Melanocyte-associated autoantigens are released and presented, inducing CD8⁺ T cell attacks. Thereafter, amplification of the immune responses further spreads to the entire hair follicle (HF). The immune privilege of HF subsequently collapses, leading to AA. Herein, we present a narrative review on the roles of melanocytes in AA pathogenesis, aiming to provide a better understanding of this disease from the melanocyte's perspective.

Oxidative stress and antioxidant markers in patients with alopecia areata: A comparative cross-sectional study

Background

Alopecia areata is a chronic inflammatory skin disease. Oxidative stress may contribute to the pathogenesis of this condition.

Aim

To evaluate the serum oxidative stress markers and antioxidant capacity in patients with alopecia areata.

Methods

This cross-sectional study was performed on 40 patients with alopecia areata and 40 healthy controls. The fasting blood sugar, C-reactive protein, lipid profile, and serum oxidative markers, including advanced glycation end products and advanced oxidation protein products, were measured in this study. Also, antioxidant enzymes, including paraoxonase-1, lecithin-cholesterol acyltransferase and serum ferric-reducing antioxidant power, were determined.

Results

The serum levels of advanced glycation end products and advanced oxidation protein products were significantly higher in patients with alopecia areata, compared to the controls (P < 0.001), whereas the levels of ferric-reducing antioxidant power, paraoxonase-1 and lecithin-cholesterol acyltransferase were significantly lower in patients with alopecia areata, compared to the controls (P < 0.001). The mean fasting blood sugar level was significantly higher in patients with alopecia areata, compared to the controls. The ferric reducing antioxidant power level was significantly associated with the percentage of hair loss (P = 0.01, r = 0.4) and the serum C-reactive protein level (P = 0.03, r = -0.3) in patients with alopecia areata.

Limitations

Since the current study had a cross-sectional design, no cause-effect relationship was established between alopecia areata and oxidative stress. The sample size of our study was also small.

Conclusion

Based on the present results, the oxidant-antioxidant enzymatic system is impaired in alopecia areata due to the increased oxidative products and decreased antioxidant activity.

Autoantigen Discovery in the Hair Loss Disorder, Alopecia Areata: Implication of Post-Translational Modifications

Alopecia areata (AA) is a chronic, multifactorial, polygenic, and heterogeneous disorder affecting growing hair follicles in susceptible individuals, which results in a non-scarring and reversible hair loss with a highly unpredictable course. Despite very considerable research effort, the nature of the precipitating factor(s) responsible for initiating AA in any given hair follicle remains unclear, due largely to significant gaps in our knowledge of the precise sequence of the etiopathogenic events in this dermatosis. However, disease-related changes in the immune-competence of the lower growing hair follicle, together with an active immune response (humoral and cellular) to hair follicle-associated antigens, are key associated phenomena. Confirmation of the hair follicle antigen(s) implicated in AA disease onset has remained stubbornly elusive. While it may be considered somewhat philosophical by some, it is also unclear whether immune-mediated hair loss in AA results from a) an ectopic (i.e., in an abnormal location) immune response to native (unmodified) self-antigens expressed by the healthy hair follicle, b) a normal immune response against modified self-antigens (or neoantigens), or c) a normal immune response against self-antigens (modified/non-modified) that were not previously visible to the immune system (because they were conformationally-hidden or sequestered) but become exposed and presentable in an MHC-I/-II molecule-restricted manner. While some candidate hair follicle antigen target(s) in AA are beginning to emerge, with a potential role for trichohyalin, it is not yet clear whether this represents the initial and immunodominant antigenic focus in AA or is simply one of an expanding repertoire of exposed hair follicle tissue damage-associated antigens that are secondary to the disease. Confirmation of autoantigen identity is essential for our understanding of AA etiopathogenesis, and consequently for developing a more informed therapeutic strategy. Major strides have been made in autoantigen discovery in other autoimmune conditions. In particular, some of these conditions may provide insights into how post-translational modifications (e.g., citrullination, deamidation, etc.) of hair follicle-restricted proteins may increase their antigenicity and so help drive the anti-hair follicle immune attack in AA.

Does oxidative stress correlate with disease activity and severity in alopecia areata? An analytical study

BACKGROUND

Oxidative stress (OS) has been implicated as a contributory factor in the multifactorial etiopathogenesis of alopecia areata (AA). But with the existing data, it is unclear whether OS is a cause or effect of the disease state in Alopecia areata.

AIMS

To compare the OS parameters viz.malon-di-aldehyde (MDA), superoxide dismutase (SOD), total antioxidant status (TAS) in serum of patients with alopecia areata versus age and sex matched controls, and assess their correlation with the severity of the disease.

PATIENTS/METHODS

Forty clinically diagnosed patients of alopecia areata and forty (n = 40) age and sex-matched healthy controls were recruited. ELISA was used for the evaluation of MDA, and spectrophotometric method was used to evaluate serum TAS and whole blood SOD.

RESULTS

Mean serum TAS and whole blood SOD levels of cases were significantly lower than controls (p = 0.005 and p = 0.002, respectively). Mean serum MDA level of patients was significantly higher compared to controls (p = 0.001). While levels of serum TAS and whole blood SOD were found to decrease from mild to severe grades of disease (p = 0.003, p < 0.001 respectively), levels of MDA increased with increasing disease severity (p < 0.001).

CONCLUSION

The OS parameters were deranged in all subsets of AA, with the greatest derangement seen with whole blood SOD levels.

The role of oxidative stress in onychomycosis: Thiol/disulphide homeostasis

OBJECTIVES

Onychomycosis is the general term to define fungal nail infections that arise from dermatophytes, non-dermatophytic moulds and yeasts. Thiol/disulphide homeostasis is a new indicator of oxidative stress. In this study, we aimed to investigate the role of thiol/disulphide balance in the pathogenesis of onychomycosis.

METHODS

This cross-sectional study included adult patients with onychomycosis who were admitted to the dermatology department and healthy adult volunteers without any dermatologic or systemic condition. The patients and controls were evaluated in terms of native thiol, total thiol, and disulphide levels, and disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios. The possible association between these parameters and clinical subtypes of onychomycosis and demographic characteristics was also investigated.

RESULTS

A total of 52 patients with onychomycosis and 50 healthy subjects were enrolled in the study. The patient group showed lower levels of total thiol, native thiol and native thiol/total thiol ratio, and higher ratios of disulphide/native thiol and disulphide/total thiol. No statistically significant relationship was found between the parameters, clinical subtypes of onychomycosis and demographic characteristics (p > .05).

CONCLUSION

Patients with onychomycosis showed a shifted thiol/disulphide homeostasis towards oxidative stress with a reduction in thiols and an increase in disulphide/native thiol, and disulphide/total thiol ratios. These findings may indicate the role of oxidative stress in the pathogenesis of onychomycosis.

Malondialdehyde on postoperative day 1 predicts postoperative cognitive dysfunction in elderly patients after hip fracture surgery

Background: Postoperative cognitive dysfunction (POCD) is a great problem for anesthetized subjects and is associated with poor short- and long-term outcomes. We explored promising predictors for POCD in elderly patients after hip fracture surgery.Methods: Elderly subjects (aged ≥65 years) undergoing surgery for hip fracture were consecutively recruited. Neuropsychological assessments were performed 1 day preoperatively (baseline) and 7 days postoperatively, and POCD was defined using the 'Z scores' method. Clinical data and laboratory tests were compared between patients with and without POCD development. Binary univariate and multivariate logistic regression analyses were conducted for risk factor assessment. Receiver operating characteristic (ROC) curve analysis was performed to investigate the predictive value of malondialdehyde (MDA) on postoperative day 1 (POD1) for POCD.Results: A total of 198 patients were finally enrolled in the analysis and 51 patients exhibited POCD within 7 postoperative days, with an incidence rate of 25.8%. MDA expression on POD1 (OR: 1.12, 95%CI: 1.03-1.23, P=0.017) was the only independent risk factor for POCD according to the final multivariate logistic regression analysis. ROC curve analysis indicated that MDA on POD1 was a predictor for POCD, with an area under the curve (AUC) of 0.683 and 95%CI of 0.590-0.775 (P<0.001).Conclusions: In conclusion, we demonstrated that MDA on POD1 was an independent risk factor for POCD in elderly subjects undergoing hip fracture surgery.

Effects of anxiety and depression symptoms on oxidative stress in patients with alopecia areata

Introduction

Increased oxidative stress (OXS) and a high prevalence of psychiatric disorders are seen in alopecia areata (AA). However, OXS and psychiatric disorders have been studied separately in AA patients.

Aim

To determine the effects of anxiety and depression symptoms on OXS in AA patients.

Material and methods

The anxiety and depression levels of 33 AA patients and 33 normal controls (NC) were determined using the Hospital Anxiety and Depression Scale. The oxidative stress index (OSI) was calculated by measuring serum total antioxidant status (TAS) and total oxidant status (TOS) levels in AA patients and NC.

Results

The AA patients had higher anxiety and depression scores than NC (p < 0.001 for both). Total oxidant status (p = 0.002) and OSI (p < 0.001) values were higher, and TAS (p < 0.001) levels were lower, in patients with AA compared to NC. However, patients’ anxiety and depression scores were not correlated with the TAS, TOS, or OSI values (p > 0.05). There was no significant difference in TAS, TOS, or OSI values between patients with high and low anxiety or depression scores (p > 0.05).

Conclusions

These results show that OXS, anxiety, and depression scores were higher in patients with AA compared to NC. However, anxiety and depression scores were not associated with OXS in AA patients. More extensive studies should be performed to investigate the relationship between psychological status and OXS in patients with AA.

Alopecia Areata Different View; Heavy Metals

Background:

Alopecia areata (AA) is a noncicatricial alopecia affecting any hair-bearing area. Although AA is considered to be an autoimmune disease, oxidative stress has been shown to be an important factor in the etiology of AA. Trace elements are highly essential for humans since they form the building blocks of large molecules, function as the cofactors of enzymes, and have some key biological functions. The aim of this study was to investigate serum levels of heavy metals like iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), magnesium (Mg), cobalt (Co), cadmium (Cd), and lead (Pb) in patients with AA.

Materials and Methods:

The study included a patient group of 30 with AA and a control group of 31 healthy individuals. Serum levels of heavy metals were measured using atomic absorption spectrophotometry.

Results:

The 30 patients included 17 (56.7%) men and 13 (43.3%) women with a mean age of 33.8 (range, 19–48) years. Serum Zn and Mn levels were significantly lower and serum Cd, Fe, Mg, Pb, Co, and Cu levels were significantly higher in the patient group compared to that of the control group (P<0.05 for all).

Conclusion:

The results indicated that low levels of Zn and Mn are associated with AA while other metals were normal. So Zn supplementation may have some beneficial effect in AA while Fe prescription is fruitless.

Ischemic modified albumin as a new biomarker in predicting oxidative stress in alopecia areata

Background/aim

Results show that oxidative stress is a pathophysiologic factor for alopecia areata (AA); however, the markers used can be confounding. Thus, we aimed to investigate the role of oxidative stress in the pathogenesis of AA through an evaluation of ischemia-modified albumin (IMA); other markers of the oxidant/antioxidant system, such as SOD, CAT, GSH-ST, and MDA; and contributing clinical risk factors.

Materials and methods

The usefulness of IMA as a new marker for oxidative stress was compared with that of other markers and evaluated in patients with AA.

Results

The mean serum level of IMA was of higher statistical significance in AA patients than in the control group (IMA: 0.57 ± 0.01 vs. 0.52 ± 0.02 ΔABSU, P < 0.0001). IMA (P = 0.03, OR = 25.8, 95% CI = 1.4–482.7) was found to be an independent predictor of oxidative stress in patients with AA. Increased severity of AA was found as an independent risk factor for IMA.

Conclusion

Long-lasting disease, male sex, >1 site of involvement of disease, and increased severity of disease were correlated with increased oxidation. Presence of AA, male sex, and severe disease were determined to be independent risk factors for antioxidant and oxidant systems. IMA has great potential as a biomarker of oxidative stress in AA when compared to other studied biomarkers.

Assessment of Metabolic Profile and Ischemia-modified Albumin Level in Patients with Alopecia Areata: A Case-Control Study

Background:

Alopecia areata (AA) is an autoimmune-mediated hair follicle disorder. In the literature, there is no study evaluating metabolic syndrome and levels of ischemia-modified albumin (IMA) which is proposed as an oxidative stress biomarker in patients with AA.

Aims:

The aim was to investigate the presence of metabolic syndrome and the levels of IMA, small dense low-density lipoprotein (sd-LDL), and visfatin levels in AA patients.

Settings and Design:

A hospital-based cross-sectional study was undertaken among AA patients and controls.

Subjects and Methods:

Thirty-five patients with AA and 35 sex-, age-, and body mass index-matched healthy controls were enrolled. Clinical and laboratory parameters of metabolic syndrome were examined in all participants. Furthermore, IMA, sd-LDL, and visfatin levels were assessed and analyzed with regard to disease pattern, severity and extent, severity of alopecia tool score, duration, and recurrence.

Results:

The median IMA and adjusted IMA levels were significantly increased compared with controls (P<0.05 and P=0.002, respectively). Patients with pull test positivity displayed higher levels of adjusted IMA levels (P<0.05). In AA group, there was a positive correlation between adjusted IMA and waist circumference (r=0.443, P=0.008), adjusted IMA and triglyceride levels (r=0.535, P=0.001), and adjusted IMA and sd-LDL levels (r=0.46, P<0.05). We observed no statistically significant difference in fasting blood glucose and lipid profile, sd-LDL, and visfatin levels of the patients and healthy controls.

Conclusions:

AA patients and controls have similar metabolic profile. Raised levels of adjusted IMA levels may be associated with antioxidant/oxidant imbalance and with risk of cardiovascular disease.

Alopecia areata: A multifactorial autoimmune condition

Alopecia areata is an autoimmune disease that results in non-scarring hair loss, and it is clinically characterised by small patches of baldness on the scalp and/or around the body. It can later progress to total loss of scalp hair (Alopecia totalis) and/or total loss of all body hair (Alopecia universalis). The rapid rate of hair loss and disfiguration caused by the condition causes anxiety on patients and increases the risks of developing psychological and psychiatric complications. Hair loss in alopecia areata is caused by lymphocytic infiltrations around the hair follicles and IFN-γ. IgG antibodies against the hair follicle cells are also found in alopecia areata sufferers. In addition, the disease coexists with other autoimmune disorders and can come secondary to infections or inflammation. However, despite the growing knowledge about alopecia areata, the aetiology and pathophysiology of disease are not well defined. In this review we discuss various genetic and environmental factors that cause autoimmunity and describe the immune mechanisms that lead to hair loss in alopecia areata patients.

Investigation of oxidative stress in patients with alopecia areata by measuring the levels of malondialdehyde and ceruloplasmin in the blood

INTRODUCTION

Alopecia areata (AA) is a chronic, inflammatory and autoimmune disease, presenting with non-scarring hair loss. Although the precise etiopathogenesis of AA remains unknown, oxidative stress is thought to play a role.

AIM

To investigate the role of oxidative stress in AA by measuring the levels of plasma and erythrocyte malondialdehyde (MDA) and the ceruloplasmin (CER) in serum.

MATERIAL AND METHODS

The study included 24 AA patients and a control group consisting of 24 age- and sex-matched healthy volunteers. The levels of MDA and CER were measured and compared between groups.

RESULTS

Plasma MDA levels were significantly higher (p < 0.05) in patients with AA compared with controls. No significant difference was observed in MDA erythrocyte levels (p = 0.990) between the study group and the control group. Ceruloplasmin level was higher in the AA group, but this increase was not statistically significant (p = 0.156).

CONCLUSIONS

Patients with AA displayed significant plasma MDA levels, which could lead to damage in erythrocytes exposed to high concentrations of free radicals. These results demonstrate the presence of an imbalance in the oxidant-antioxidant system and support the concept of a possible role of oxidative stress in AA etiopathogenesis.

Tocotrienol-rich fraction supplementation prevents foetal loss in females mated with corticosterone-treated male Sprague-Dawley rats

This study examined whether tocotrienol supplementation to corticosterone-treated male rats could prevent foetal loss in females upon their mating. Epididymides of adult male Sprague-Dawley (SD) rats with proven fertility were surgically separated at the testis-caput junction. Twenty-four hours post-surgery, these animals received for 7 days either: tocopherol-stripped corn oil (Control), corticosterone 25 mg/kg s.c. (CORT), CORT 25 mg/kg s.c. and tocotrienol-rich fraction (TRF) 100 mg/kg orally (CORT + TRF) or TRF 100 mg/kg orally (TRF). On day 8, males were cohabited with proestrus females. A spermatozoa-positive vaginal smear indicated pregnancy. Males were euthanised for analysis of testosterone and antioxidant activities. Reproductive organs were weighed. On day 8 of pregnancy, females were laparotomised to count the number of implantation sites. Pregnancy was continued until term. Number of pups delivered and their weights were determined. Data were analysed using ANOVA. Malondialdehyde levels were significantly lower in CORT + TRF group compared with CORT group. Enzymatic antioxidant activities, testosterone level and reproductive organ weights were significantly higher in CORT + TRF group compared with CORT group. Number of implantation sites and live pups delivered, and their birth weights from females mated with CORT + TRF males were significantly higher compared to CORT group. Therefore, TRF prevents foetal loss in females mated with CORT + TRF-treated males.

Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress

Conventionally, the medical focus has been either on hair loss or the condition of the scalp in terms of specific dermatological diseases. Indeed, the proximate structural arrangement of the scalp and hair leads to an interdependent relationship between the two. While protective benefits of the hair to the scalp are obvious, the role of the scalp as an incubatory environment for the preemergent hair fiber has largely been ignored. In fact, there is a wealth of observational data on specific dermatological conditions of the scalp providing evidence for the role of the scalp condition in supporting the production of healthy hair. Oxidative stress, the inability of the body to sufficiently counteract the sources of oxidation, is prevalent in many skin conditions, including normal skin aging. On the scalp, the hair appears to be impacted prior to emergence, and oxidative stress appears to play a role in premature hair loss. The scalp commensal organism, Malassezia, has been recognized to be a source of oxidative damage. Therefore, hair care products, specifically shampoos, with active Malassezia inhibitory agents, such as zinc pyrithione, tend to reduce premature hair loss, besides the known benefits in treating specific dermatologic scalp pathologies, and therefore should represent an integral part of every treatment regimen for hair loss, even in individuals not showing symptoms of scalp pathologies.

Prostaglandin D2 Uses Components of ROS Signaling to Enhance Testosterone Production in Keratinocytes

Elevated levels of prostaglandin D2 (PGD2) have been shown to be present in the bald scalp of androgenic alopecia (AGA) patients and to functionally inhibit hair growth. However, its precise mechanism in AGA has yet to be clearly defined. Although testosterone plays a critical role in the initiation and progression of AGA, the existence of a possible link between PGD2 and testosterone in skin has not been investigated. Here we show that human keratinocytes treated with PGD2 show enhanced capacity to convert the weak androgen, androstenedione, to testosterone. At the same time, treatment with PGD2 induced reactive oxygen species as indicated by generation of the lipid peroxidation product, 4-hydroxynonenal. To determine whether these two events are linked, we used the reactive oxygen species scavenger N-acetyl-cysteine, which blocked the enhanced testosterone production from PGD2-treated keratinocytes. Our study suggests the existence of a possible crosstalk between the PGD2-reactive oxygen species axis and testosterone metabolism in keratinocytes. Thus, we propose that AGA patients might benefit from the use of N-acetyl-cysteine or other antioxidants as a supplement to currently available or emerging AGA therapies such as finasteride, minoxidil, and PGD2 receptor blockers.

Alopecia areata

Alopecia areata is an autoimmune disorder characterized by transient, non-scarring hair loss and preservation of the hair follicle. Hair loss can take many forms ranging from loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime. Skin biopsies of affected skin show a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in the anagen (hair growth) phase. A breakdown of immune privilege of the hair follicle is thought to be an important driver of alopecia areata. Genetic studies in patients and mouse models have shown that alopecia areata is a complex, polygenic disease. Several genetic susceptibility loci were identified to be associated with signalling pathways that are important to hair follicle cycling and development. Alopecia areata is usually diagnosed based on clinical manifestations, but dermoscopy and histopathology can be helpful. Alopecia areata is difficult to manage medically, but recent advances in understanding the molecular mechanisms have revealed new treatments and the possibility of remission in the near future.

Oxidative Stress Biomarkers and Adenosine Deaminase over the Alopecic Area of the Patients with Alopecia Areata

BACKGROUND

Alopecia areata (AA) is an autoimmune, T-cell mediated, and chronic inflammatory disorder. The pathological mechanisms of disease are unclear, but oxidative stress may be involved. To our knowledge, no studies have examined the oxidative stress levels or biomarkers within the lesional area and skin surface in patients with AA. Similarly, adenosine deaminase (ADA) has not been characterized in AA.

AIMS

Therefore, we aimed to define ADA levels and the factors involved in oxidative stress from scalp-scrapes of patients with AA.

STUDY DESIGN

Case-control study.

METHOD

A total of 60 patients (30 diagnosed AA patients and 30 healthy controls) were included in the study. ADA as well as oxidative stress factors, including malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) were analyzed from scalp-scrapes in both groups and quantified by spectrophotometry.

RESULTS

Activities of SOD (p=0.000), CAT (p=0.033), and ADA (p=0.004) as well as levels of GSH (p=0.000) and MDA (p=0.032) in patients with AA were higher than the controls statistically significant.

CONCLUSION

Based on these results, factors associated with oxidative stress were elevated in AA patient scalp-scrapes compared to controls and may have a defined role the disease pathogenesis. Alterations in the activities of antioxidant enzymes from AA patient scraping samples may be a local effect of elevated oxidative stress levels. In this disease, oxidative stress may affect not only hair follicle but also any layers of the skin.

Increased oxidative stress in pemphigus vulgaris is related to disease activity and HLA-association

Pemphigus vulgaris (PV) is a rare blistering skin disorder characterized by the disadhesion of keratinocytes due to autoantibody attack against epidermal targets including desmoglein (Dsg) 3, Dsg 1 and possibly other adhesion and non-adhesion molecules. The mechanisms leading to immune-mediated pathology in PV are multifactorial and not fully understood. Recently, oxidative stress (antioxidant/oxidant disequilibrium) has been proposed as a contributory mechanism of autoimmune skin diseases, including PV. In this study, we directly assessed oxidative stress via measurement of total antioxidant capacity (TAC) using ELISA in 47 PV patients, 25 healthy controls and 18 bullous pemphigoid (BP) patients. We also performed microarray gene expression analysis on a separate set of 21 PV patients and 10 healthy controls to evaluate transcriptional dysregulation in oxidative stress-related pathways. Our data indicate that there is a significant reduction in TAC levels in PV patients compared with healthy controls, as well as BP patients. Furthermore, PV patients with active disease have significantly lower TAC levels than PV patients in remission. We also find that HLA allele status has a significant influence on oxidative stress. These findings are corroborated by microarray analysis showing differentially expressed genes involved in oxidative stress between the aforementioned groups. Collectively, our findings provide support for a role of oxidative stress in PV. Whether increased oxidative stress leads to disease manifestation and/or activity, or if disease activity leads to increased oxidative stress remains unknown. Future longitudinal studies may help to further elucidate the relationship between PV and oxidative stress.

Telogen elongation in the hair cycle of ob/ob mice

Alopecia impairs the physical and mental health of patients. We have previously shown that 8-week-old ob/ob mice have no reactivity to depilation, which is a stimulus that induces anagen transition in normal mice, while no hair cycle abnormalities have been reported in other studies until mice reach 7 weeks of age. Therefore, we hypothesized that ob/ob mice have abnormalities in hair cycle progression beyond 7 weeks of age. We examined 6- to 24-week-old ob/ob and 6- to 10-week-old normal mice. After acclimation, the dorsal skin was harvested and the hair cycle phase was identified histologically and immunohistochemically. Normal mice showed catagen–telogen and telogen–anagen transitions at 6 and 8–9 weeks old, respectively. In contrast, the anagen–catagen transition was observed in 7-week-old mice and the telogen phase was maintained from 10 to 24 weeks in most ob/ob mice. These results suggests that ob/ob mice are a possible model animal for telogen effluvium.

Investigation of oxidative stress in patients with alopecia areata and its relationship with disease severity, duration, recurrence and pattern

BACKGROUND

Alopecia areata (AA) is an inflammatory autoimmune disease that causes hair loss on the scalp or trunk without scarring. Although the precise aetiopathogenesis of alopecia areata remains unknown, oxidative stress is thought to play a role.

AIM

To investigate the relationship between severity and the role of oxidative stress in AA, by measuring plasma oxidant levels and antioxidant enzyme activities in erythrocytes.

METHODS

In total, 62 patients with AA (24 males and 38 females), and 62 sex- and age-matched healthy controls (HCs) were enrolled in the study. We investigated the levels of plasma malondialdehyde (MDA) and the activities of erythrocyte catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). The relationship between oxidative stress and AA was also investigated with regard to disease pattern, severity, duration and recurrence.

RESULTS

The mean erythrocyte GSH-Px and SOD activities were significantly reduced (P < 0.001 and P < 0.001 respectively) compared with the control group. Plasma MDA levels were increased but statistically insignificant (P = 0.08) in patients with AA compared with controls. No significant difference between erythrocyte CAT activities was observed between patients and controls (P = 0.2). In addition, we observed no statistically significant difference in patient plasma MDA levels or erythrocyte CAT, GSH-Px or SOD activities with regard to AA severity, duration, recurrence or pattern (P > 0.05).

CONCLUSIONS

Patients with AA displayed reduced erythrocyte SOD and GSH-Px activities and enhanced plasma MDA levels. These findings support the possible role of oxidative stress in the pathogenesis of AA.

Preferential recognition of hydroxyl radical-modified superoxide dismutase by circulating autoantibodies in patients with alopecia areata

Background

Alopecia areata (AA) is a common form of localized, non-scarring hair loss. The cause of AA is unknown but reports suggest an autoimmune etiology, where oxygen free radicals play an important role.

Objective

The aim of this study was to investigate the role of a hydroxyl radicals (·OH)-modified antioxidant enzyme, superoxide dismutase (SOD), in AA autoimmunity.

Methods

SOD was modified by ·OH radicals. Binding characteristics of autoantibodies in AA patients (n=26) against ·OH-modified SOD (·OH-SOD) were evaluated by immunoassays and the results were compared with those of healthy, age-matched controls (n=30). The effects of ·OH radicals on immunoglobulin G (IgG) isolated from AA patients were studied.

Results

Highly specific binding to ·OH-SOD was observed in 32% of the samples of patient sera, whereas normal human sera showed negligible binding with either antigen. Competitive inhibition immunoassays reiterated the results from direct binding. Protein-A-purified IgG from AA patients (AA-IgG) also showed strong binding to ·OH-SOD as compared to IgG from normal human controls (p<0.001). In addition, AA-IgG from patients with alopecia universalis recognized ·OH-SOD to a greater extent than did AA-IgG from patients with the patchy, persistent type of alopecia. Furthermore, sera from AA patients had lower levels of SOD activity as compared to control sera.

Conclusion

This is the first report showing an association between ·OH-modified SOD and AA. These novel results demonstrate that ·OH radical-mediated changes in SOD present unique neo-epitopes that might contribute to antigen-driven antibody induction in AA.

Biochemical and immunological studies on erythrocytes superoxide dismutase modified by nitric oxide in patients with alopecia areata: Implications in alopecia patchy persistent and alopecia universalis

Alopecia areata (AA) is a non-scarring hair loss disorder that ranges in severity from patchy loss of scalp hair (AA patchy persistent; AAP) to loss of all scalp and body hair (alopecia universalis; AU). The cause of AA is unknown but most evidences support that AA has an autoimmune etiology, where free radicals play an important role. This study was undertaken to investigate the role of nitric oxide (NO) modified erythrocytes superoxide dismutase (eSOD) in AA. Data revealed that NO-induced damage in eSOD caused alteration in hydrophobic or aromatic amino acids and protein carbonyl contents. NO-specific quencher, carboxyl-PTIO further reiterates NO-modifications. Specificity of antibodies from AA patients (n=26) was analyzed toward NO-modified eSOD (NO-eSOD) and their results were compared with healthy controls (n=30). Protein-A purified IgG of AA patients (AA-IgG) showed strong binding to NO-eSOD in comparison with IgG from controls. In addition, AA-IgG from patients with AU recognized NO-eSOD in a greater extent as compared to AA-IgG from patients with AAP. Furthermore, AU patients' sera contained higher levels of NO or carbonyl contents and lower levels of SOD activity compared with AAP patients' or control sera. In conclusion, this is the first study to demonstrate the role of NO-modified-eSOD in AA. Our novel results conclude that perturbations in SOD by NO presenting unique neo-epitopes that might be one of the factors for the antigen driven antibodies induction in AA. Preferential binding of NO-eSOD by AA-IgG pointed out the likely role of NO-eSOD in the initiation/progression of AA.

Serum paraoxonase activity and oxidative status in subjects with alopecia areata

INTRODUCTION

Previous studies have suggested that oxidative stress may play an important role in the pathogenesis of alopecia areata (AA) but these reports are limited and conflicting.

OBJECTIVES

The aim of this study was to investigate serum paraoxonase-1 (PON1) activity and oxidative status in subjects with AA.

MATERIALS AND METHODS

Thirty-nine subjects with AA and 39 healthy controls were enrolled. Serum PON1 activity, total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined.

RESULTS

Serum TAC levels and PON1 activity were significantly lower in the subjects with AA than controls (p = 0.038, p = 0.001, respectively), whereas TOS levels and OSI were significantly higher (both, p = 0.001) in the subjects with AA.

CONCLUSIONS

Our results suggest that reduced PON1 activity may be related to increased oxidant and decreased antioxidant levels. These data indicated that oxidant/antioxidant imbalance may play a role in the etiopathogenesis of AA.

Selenium and psoriasis

Psoriasis is a chronic, immune-mediated skin disease characterized by production of reactive oxygen species due to the activation of tumor necrosis factor alpha (TNF-α), which is thought to be an important factor in inducing and maintaining psoriatic lesions. As an external factor, ultraviolet B (UVB) radiation stimulates TNF-α production and secretion by human keratinocytes in vitro and can also reach the upper dermis and suppress endothelial cells in vitro. The selenium level in psoriatic patients has been found to be lower than expected, but studies on its role in the pathogenesis of the disease are scarce. Selenium can influence immune response by changing the expression of cytokines and their receptors or by making immune cells more resistant to oxidative stress. It was reported that selenium supplementation had inhibitory effects on TNF-α levels in patients with psoriasis, but the details are not completely elucidated. Selenium compounds are also known to prevent the in vitro release of UVB-induced proinflammatory cytokines by inhibition of mRNA in human keratinocytes. In the present review, the protective role of selenium in oxidative stress, lesions, and immune system regulation in patients with psoriasis is summarized.

The antioxidant role of paraoxonase 1 and vitamin E in three autoimmune diseases

PURPOSE OF THE STUDY

To investigate the role of paraoxonase 1 (PON1) and vitamin E in the pathogenesis of some autoimmune diseases, and to correlate their levels with the disease activity.

PROCEDURES

This randomized case control study was performed on 60 subjects: 45 patients [suffering from psoriasis, vitiligo and alopecia areata (AA) 15 patients each group] and 15 healthy controls. Venous blood and tissue biopsy were collected from each subject to estimate the levels of vitamin E and PON1.

RESULTS

All patients showed significantly lower levels of both PON1 and vitamin E in tissue and serum than the controls (p < 0.001).

CONCLUSION

An association between oxidative stress and pathogenesis of these autoimmune diseases is identified. Attenuation of oxidative stress might be a relevant therapeutic approach and it would be useful to recommend additional drugs with antioxidant effects in the treatment of these conditions.