Biomarkers of alopecia areata disease activity and response to corticosteroid treatment. Issue 4 (3rd March 2016)

• Record Type: Journal Article
• Authors: Fuentes‐Duculan, Judilyn; Gulati, Nicholas; Bonifacio, Kathleen M.; Kunjravia, Norma; Zheng, Xiuzhong; Suárez‐Fariñas, Mayte; Shemer, Avner; Guttman‐Yassky, Emma; Krueger, James G.
• Is Part Of: Experimental dermatology. Volume 25:Issue 4(2016)
• Page Start: 282
• Page End: 286
• Publication Date: 2016-03-03
• Subjects: alopecia areata -- biomarkers -- hair keratins -- inflammatory cytokines; Dermatology -- Periodicals; 616.5
• DOI: 10.1111/exd.12918
• Languages: English
• ISSNs: 0906-6705

Abstract

Abstract: Alopecia areata (AA) is a common inflammatory disease targeting the anagen‐stage hair follicle. Different cytokines have been implicated in the disease profile, but their pathogenic role is not yet fully determined. We studied biopsies of pretreatment lesional and non‐lesional (NL) scalp and post‐treatment (intra‐lesional steroid injection) lesional scalp of 6 patchy patients with AA using immunohistochemistry and gene expression analysis. Immunohistochemistry showed increases in CD3 +, CD8 + T cells, CD11c + dendritic cells and CD1a + Langerhans cells within and around hair follicles of pretreatment lesional scalp, which decreased upon treatment. qRT‐PCR showed in pretreatment lesional scalp (compared to NL) significant increases ( P < 0.05) in expression of inflammatory markers (IL‐2, IL‐2RA, JAK3, IL‐15), Th1 (CXCL10 and CXCL9), Th2 (IL‐13, CCL17 and CCL18), IL‐12/IL‐23p40 and IL‐32. Among these, we observed significant downregulation with treatment in IL‐12/IL‐23p40, CCL18 and IL‐32. We also observed significant downregulation of several hair keratins in lesional scalp, with significant upregulation of KRT35, KRT75 and KRT86 in post‐treatment lesional scalp. This study shows concurrent activation of Th1 and Th2 immune axes as well as IL‐23 and IL‐32 cytokine pathways in lesional AA scalp and defined a series of response biomarkers to corticosteroid injection. Clinical trials with selective antagonists coupled with cytokine‐pathway biomarkers will be necessary to further dissect pathogenic immunity.