Serum Level of Interleukin 17 in Alopecia Areata Patients and Its Relation with the Severity of the Disease: a Case Control Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nehal Zuelfakkar ◽  
Samah Ibrahim ◽  
Hadeel Abdelwahed Mahmoud Assar
Keyword(s):  
Serum Level ◽  
Serum Concentration ◽  
Autoimmune Diseases ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Interleukin 17 ◽  
Healthy Controls ◽  
Clinical Type ◽  
Significant Difference ◽  
Severity Of The Disease

Abstract Background Alopecia Areata (AA) is one of the most common autoimmune diseases that’s characterized by hair loss on the scalp and/or body. It is an organ-specific autoimmune disease characterized by T-cell infiltrates and cytokine production. T-helper 17 (Th17) cells are crucially involved in the pathogenesis of autoimmune diseases. Objectives Our aim was to compare the serum level of interleukin-17 (IL-17) between alopecia areata patients and healthy controls to demonstrate its proposed role in the pathogenesis of alopecia areata and to correlate it with the severity of the disease. Subjects and methods The serum concentration of IL-17 was measured in 26 patients with AA and 26 healthy controls. The clinical type of AA was determined, and the severity of scalp hair loss was assessed in accordance with the Alopecia Areata Investigational Assessment Guideline criteria. Results The serum concentration of IL-17 was significantly higher in patients with AA as compared with healthy. The IL-17 concentration among cases ranged from 133.38 – 325.99 pg/ml with a median of 195.38, while among controls, the IL-17 concentration ranged from 13.59 – 225.73 pg/ml with a median of 48.42. No statistically significant difference was found in IL-17 levels regarding age, sex, clinical type, duration of disease or severity. Conclusion The significantly higher levels of serum IL-17 in patients with AA suggest a possible role of IL-17 as a proinflammatory cytokine in the pathogenesis of AA. This could point to the potential benefit of IL-17 inhibitors in recalcitrant cases of alopecia areata.

scholarly journals Adiponectin as a novel biomarker of disease severity in alopecia areata

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Stochmal ◽  
Anna Waśkiel-Burnat ◽  
Sylwia Chrostowska ◽  
Michał Zaremba ◽  
Adriana Rakowska ◽  
...  
Keyword(s):  
Serum Level ◽  
Negative Correlation ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Significant Difference ◽  
The Common ◽  
Loss Severity

AbstractThe frequent coexistence of obesity and metabolic syndrome in patients with alopecia areata may indicate the common pathogenetic pathway in these conditions with an important role of adipokines. The aim of the study was to evaluate the serum level of adiponectin, resistin and leptin in patients with alopecia areata in comparison to healthy controls. The study included 65 patients with alopecia areata and 71 healthy controls. The concentration of adipokines was determined with the enzyme-linked immunosorbent assay. The mean concentrations of adiponectin and resistin were significantly lower in the sera of patients with alopecia areata when compared to healthy controls (7966 $$\pm$$ ± 4087 vs 9947 $$\pm$$ ± 5692 ng/ml; p = 0.0312 and 11.04 $$\pm$$ ± 3.88 vs 14.11 $$\pm$$ ± 8.69 ng/ml; p = 0.0176, respectively). A negative correlation between the serum level of adiponectin and severity of alopecia tool (SALT) score was observed (r = − 0.26; p < 0.05). The concentration of adiponectin was significantly lower in patients with alopecia universalis than in patients with patchy alopecia areata (4951 $$\pm$$ ± 2499 vs 8525 $$\pm$$ ± 4085 ng/ml; p = 0.0135). No significant difference in the serum concentration of leptin was observed between patients with alopecia areata and healthy controls. The negative correlation between the serum level of adiponectin and hair loss severity indicates that adiponectin may be considered a marker of hair loss severity in alopecia areata. Further studies are needed to evaluate the role of resistin in patients with alopecia areata and its decreased level irregardless of severity or activity of the disease.

scholarly journals Comparative Study on the Efficacy of Diphenylcyclopropenone Alone and in Combination with Intralesional or Systemic Corticosteroids for the Treatment of Extensive or Refractory Alopecia Areata

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A I E Rasheed ◽  
M Y Soltan ◽  
N N Mohammed
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Combined Therapy ◽  
Age At Onset ◽  
Previous History ◽  
Autoimmune Disorder ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinical Feature ◽  
Significant Difference

Abstract Background Alopecia areata (AA) is an autoimmune disorder characterized by transient, non-scarring hair loss with preservation of the hair follicle. It affects nearly 2% of the general population at some point during their lifetime. Extent of the disease can vary widely from localized hair 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. Objectives The aim of this study is to evaluate the efficacy and safety of topical diphenylcyclopropenone alone and in combination with intralesional steroids or systemic steroids for the treatment of extensive and/or refractory cases of alopecia areata. Patients and Methods The study included 21 patients suffering from alopecia areata during January 2018 till November 2018. They were recruited from the Outpatient Clinic of Dermatology, Ain Shams University Hospital and El-houd EL-marsoud Hospital. All patients gave written consent to participate in this work after explanation of the technique, expectations, possible side effects and alternative treatments. The study was approved by Research Ethical committee of Ain Shams University. Results We found that about three quarters of AA patients were males and majority were young adults aged 15 to 50 years. The duration of the disease was more than one year and mean age of first onset was 15 years. About half of the patients was of refractory type. All patients recalled previous history of AA and 90% treated by combined therapy. Scalp was affected in all patients and eyebrow in half of them while nails were affected in 10%. Mean SALT score at time of presentation was 59%. Dermoscopic examination revealed that majority of the patients (95%) had yellow dots; two third had black dots and vellous hair; while exclamation and short thin hairs were found in approximately one third of the patients. The study found that there is statistically significant difference between mean SALT scores among the three treatment modality groups at start of treatment course specifically between group II (40.6 (±20.9)) and group III (82.5 (±21.7)) (p = 0.04). Conclusion DPCP is an effective and safe treatment of extensive and refractory AA especially with intralesional steroid. Older age at onset of the disease is good indicator for a better prognosis. No statistical significant difference between treatment modalities regarding response stratified by other demographic and clinical feature of AA patients.

scholarly journals Laboratory Evaluation and Serum Level of Phenobarbital Administered by Different Pathways in Dogs

2018 ◽  
Vol 46 (1) ◽  
pp. 5
Author(s):  
Gabriela Francisco Bittar ◽  
Gleice Laine De Souza ◽  
Gabriela Haro de Melo ◽  
Dayane Aparecida Francisco Da Silva ◽  
José Sérgio Costa Júnior ◽  
...  
Keyword(s):  
Serum Level ◽  
Serum Concentration ◽  
Oral Administration ◽  
Jugular Vein ◽  
Serum Levels ◽  
Serum Biochemistry ◽  
Nasal Administration ◽  
Laboratory Evaluation ◽  
Normal Range ◽  
Significant Difference

Background: Anticonvulsants are widely used in the treatment of small animals for the remission of isolated seizures and recurrent seizures in epilepsy, including tonic-clonic seizures and in status epileticus. Phenobarbital is the drug of choice for the management of epileptic seizures, it is considered very effective, safe, low cost and with few side effects. Several routes of administration may be used, with the oral, intravenous and intramuscular routes being the most common, with rectal and nasal routes being the least common. Materials, Methods & Results: Twenty mongrel dogs were used in the present study (aged 1 to 6-year-old, males and females, weighing 6.0 to 17.0 kg). The patients were previously evaluated via physical examination, temperature, respiratory and heart rate, laboratory tests (erythrogram and leukogram), and serum biochemistry by analyzing the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (FA), and gamma-glutamyltransferase (GGT). Four experimental groups were established with five animals in each group: animals receiving intramuscular injections of phenobarbital (VIM), animals receiving nasal administration of phenobarbital (VN), animals receiving rectal administration of phenobarbital (VR), and animals receiving oral administration of phenobarbital (VO). Phenobarbital was administered every 12 h for 15 days. To determine the serum level of phenobarbital, 5 mL of jugular vein blood was collected in vacuum tubes for evaluation via hemogram. The serum level was determined after 15 days of continuous administration of phenobarbital, as stable phenobarbital serum levels can only be achieved from 10 to 15 days after the first administration. For the serum biochemistry evaluation, 10 mL of blood from the jugular vein was collected using vacuum syringes for assessing ALT, AST, GGT, and FA levels. Statistical analyses were performed with contrasted variation analysis using the Tukey method and paired t-test for comparison of time points. The level of significance was determined to be 5%. There was a significant difference (P < 0.05) among drug administration routes, and among the levels of AST and AF enzymes after the first administration of phenobarbital via the nasal and intramuscular routes. Based on the results, it was concluded that hepatic alterations secondary to the use of phenobarbital for 15 days may occur with a low incidence. The phenobarbital serum concentration in dogs varied when administered via nasal, rectal, and intramuscular routes, but was stable when administered orally.Discussion: The current results are consistent with those of previous studies, indicating that the chronic use of phenobarbital causes an increase in the serum levels of ALT and FA enzymes. It was found that phenobarbital serum levels varied greatly, particularly following nasal, rectal, and intramuscular administration. In the present study, serum phenobarbital levels were within the normal range when administered via the intramuscular, nasal, rectal, and oral routes. This result is inconsistent with that of previous studies where the serum levels were below the normal range following oral administration of phenobarbital. The serum concentration, rather than clinical criteria, should be used as a guide for treatment modification, as the distribution of this drug varies greatly among animals.

scholarly journals Characterizing the Skin and Gut Microbiome of Alopecia Areata Patients

2020 ◽  
Vol 4 (1) ◽  
pp. 23-30
Author(s):  
Margit Juhasz ◽  
Siwei Chen ◽  
Arash Khosrovi-Eghbal ◽  
Chloe Ekelem ◽  
Yessica Landaverde ◽  
...  
Keyword(s):  
Alopecia Areata ◽  
Gut Microbiome ◽  
Healthy Controls ◽  
Healthy Individuals ◽  
Microbial Composition ◽  
Future Directions ◽  
Fecal Microbiome ◽  
Autoimmune Attack ◽  
Significant Difference ◽  
Control Study

Background: Alopecia areata (AA) is caused by autoimmune attack of the hair follicle. The exact pathogenesis is unknown, but hypotheses include innate immunity imbalance, environmental exposures, genetic predisposition, and possibly the microbiome. The objective of this study was to characterize the skin and gut microbiome of AA patients, and compare microbial composition to healthy individuals. Methods: This was a pilot, case-control study. Scalp and fecal microbiome samples were collected from 25 AA patients, and 25 age, gender, and race-matched healthy controls in Southern California with no significant difference in demographic characteristics. After library preparation and identification of bacterial and fungal taxonomy, multivariant analysis was performed to compare AA and healthy microbiomes. Results: The AA scalp microbiome was significant for decreased Clostridia and Malasseziomycetes, and the gut microbiome was significant for decreased Bacteroidia and increased Bacilli (p<0.05) compared to healthy controls. Conclusions: The composition of the AA bacterial and fungal, scalp and gut microbiome is significantly different than healthy individuals. Future directions include using this data to characterize microbial changes associated with AA patient diet, relating to disease severity, and predicting disease progression, prognosis and/or therapeutic response.

scholarly journals SLAM/SAP Decreased Follicular Regulatory T Cells in Patients with Graves’ Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Lina Geng ◽  
Jun Yang ◽  
Xinyi Tang ◽  
Huiyong Peng ◽  
Jie Tian ◽  
...  
Keyword(s):  
T Cells ◽  
B Cells ◽  
Regulatory T Cells ◽  
Autoimmune Diseases ◽  
Negative Correlation ◽  
Graves Disease ◽  
Healthy Controls ◽  
Significant Difference ◽  
Ifn Γ ◽  
Signaling Lymphocytic Activation Molecule

Signaling lymphocytic activation molecule (SLAM) and SLAM-associated protein (SAP) play important role in inflammatory and autoimmune diseases. Our study is aimed at detecting the expression of SLAM and SAP in patients with Graves’ disease (GD) and analyzing the effect of SLAM/SAP on circulating blood CD4+CXCR5+Foxp3+ follicular regulatory T (Tfr) cells. The level of SAP in CD4+CXCR5+ T cells and the level of SLAM on CD19+ B cells were significantly increased in the patients with GD, but no significant difference in the level of SLAM on CD4+CXCR5+ T cells was observed between the patients with GD and the healthy controls. A decrease in the percentage of Foxp3+ cells in CD4+CXCR5+ T cells was observed following anti-SLAM treatment, but the percentages of IFN-γ+ cells, IL-4+ cells, and IL-17+ cells showed no obvious differences. The proportion of circulating Tfr cells was decreased in the patients with GD, and the proportion of circulating Tfr cells had a negative correlation with the level of SAP in CD4+CXCR5+ T cells and the levels of autoantibodies in the serum of the patients with GD. Our results suggested that the SLAM/SAP signaling pathway is involved in the decrease of circulating Tfr cells in Graves’ disease.

The Serum Level of Agalactosyl IgG in Rheumatoid Arthritis Patients Treated with Methotrexate

1996 ◽  
Vol 9 (1) ◽  
pp. 19-22
Author(s):  
J. K. Lacki ◽  
U. Mackiewicz ◽  
S. Mackiewicz ◽  
W. Muller
Keyword(s):  
Rheumatoid Arthritis ◽  
Serum Level ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Healthy Controls ◽  
Disease Course ◽  
Antiinflammatory Drugs ◽  
Significant Difference ◽  
One Year ◽  
Agalactosyl Igg

To verify the hypothesis that methotrexate may affect the serum level of agalactosyl IgG (IgG[0]) we followed the changes in IgG galactosylation patterns in a cohort of rheumatoid arthritis patients treated with either methotrexate (MTX) or nonsteroidal antiinflammatory drugs (NSAID). The average values of IgG[0] in RA patients at the beginning of the observation were significantly higher as compared to healthy controls (0.45 ± 0.39 vs. −0.03 ± 0.09, p<0.05). The findings of IgG[0] after one-year follow-up were also higher as compared to healthy controls (0.38 ± 0.39 vs. −0.03 ± 0.09, p<0.05). We did not notice any statistically significant difference in IgG[0] between MTX and NSAID treated patients at the beginning of the study (0.49 ± 0.42 vs. 0.42 ± 0.38, NS). However, during one-year MTX treatment IgG[0] significantly dropped (0.49 ± 0.42 vs. 0.25 ± 0.24, p<0.01). We did not establish any fluctuation in IgG[0] in the group of patients treated with NSAID (0.42 ± 0.38 vs. 0.46 ± 0.45, NS). The data thus far obtained suggest that IgG[0] may serve as an indicator for the disease course in patients with RA. Secondly, the clinical improvement and IgG[0] decrease after methotrexate implies, that the immunoregulatory abnormality in RA may be susceptible to correction by immunotherapy.

Serum Interleukin-15 in Alopecia Areata and its correlation with dermoscopic findings

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Naziha Hafez Khafagy ◽  
Marwa Salah El Din Zaki ◽  
Aya Mahmoud Hussein
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Serum Levels ◽  
Common Finding ◽  
Control Group ◽  
University Hospitals ◽  
Exclamation Mark ◽  
Significant Difference ◽  
Initial Onset ◽  
And Control

Abstract Background Alopecia areata is an autoimmune hair loss which frequently starts in childhood. Its presentation had an extreme variability not only in the time of initial onset but also in the duration, extent, and pattern of hair loss during any given episode of active loss. Moreover, the course of disease is unpredictable, with spontaneous regrowth of hair occurring in 80% of patients within the first year and sudden relapse at any given time. Due to the clinical variability and unpredictable nature of spontaneous regrowth, diagnosis and management may be difficult and challenging. Objective The aim of this study is to evaluate the serum levels of IL-15 in active alopecia areata and correlate them with disease severity and activity according to dermoscopic findings. Methods This case-control study were conducted in Dermatology, Venereology and Andrology department, Ain Shams University Hospitals included 30 patients with different clinical variants of AA, the diagnosis was made via clinical examination and dermoscopic findings. In addition, 30 apparently healthy individuals of matched age and sex as a control group were included in the study. Results Dermoscopic examination among cases showed that the most common dermoscopic findings in patients were vellus hair and yellow dots, while the least common finding was exclamation mark hairs. On comparing serum IL-15 in patients and control groups, it was found that serum levels of IL-15 in patients were significantly higher than those in the control group. There was no statistically significant difference in serum IL-15 levels between patients with negative and positive pull test, nail involvement, or body involvement. Similarly, no statistically significant difference in serum IL-15 levels in patients with various subjective disease activity was detected. However, there was a highly significant difference between serum IL-15 levels in different SALT score groups, with the highest levels being in the S3 group. There was a highly significant difference between IL-15 levels in patients with and without black dots. Also, there was significant difference between IL-15 in patients with and without broken hair, and exclamation mark hair. There was no significant difference in level of IL-15 among patients with and without yellow dots, and with and without vellus hair. Conclusion On the basis of the current study, we can conclude that IL-15 is significantly elevated in AA patients when compared to the control subjects. It is also a possible marker of AA severity. It is positively correlated with dermoscopic findings in AA patients, so dermoscopic findings can be useful in evaluating severity of alopecia areata.

scholarly journals Increased Serum Level and High Tissue Immunoexpression of Interleukin 17 in Cutaneous Lichen Planus: A Novel Therapeutic Target for Recalcitrant Cases?

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Magdalena Żychowska ◽  
Aleksandra Batycka-Baran ◽  
Wojciech Baran
Keyword(s):  
Serum Level ◽  
Serum Concentration ◽  
Healthy Volunteers ◽  
Lichen Planus ◽  
Elevated Serum ◽  
Tissue Expression ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Interleukin 17 ◽  
Tissue Samples

Background. Interleukin-17 is supposed to play an important role in the pathogenesis of oral lichen planus (OLP). However, there is scarce data in the literature on its significance in the cutaneous variant of the disease. Objectives. To determine the serum level and tissue immunoexpression of IL-17 in cutaneous lichen planus (CLP). Methods. Fifty-two adult patients with CLP, without any significant autoimmune or inflammatory conditions, were included in the first part of the study. The control group consisted of 27 age- and sex-matched healthy volunteers. Serum concentration of IL-17 was quantified using enzyme-linked immunosorbent assay (ELISA) kit. In the second part of the study, the tissue expression of IL-17 was assessed in archival paraffin-embedded biopsy specimens from CLP (n=14) against normal control tissues (n=11) using immunohistochemical assays. The expression was evaluated using Zeiss Axio Imager A2 light microscope. Positively stained cells were counted in 10 fields of view for biopsy specimen at 200x magnification, and the mean value was calculated. Results. The serum level of IL-17 was significantly elevated in patients with CLP, compared with healthy volunteers (0.218±0.221 ng/ml versus 0.126±0.058 ng/ml, respectively; p=0.025). No correlation was found between the serum concentration of IL-17 and patient age, gender, disease duration, extent of skin involvement, the presence or intensity of pruritus, and coexistence of mucosal lesions. In tissue samples from CLP lesions, significantly higher numbers of cells expressing IL-17 were found when compared to a healthy skin (p<0.001). Conclusion. Elevated serum concentration of IL-17 and high expression in a lesional skin support the hypothesis that IL-17 is implicated in the immunopathogenesis of CLP. These findings may constitute a premise for the future use of anti-IL-17 monoclonal antibodies in the treatment of severe and recalcitrant forms of CLP.

scholarly journals A Study of Serum Ferritin Level in Female Patient with Alopecia

2018 ◽  
Vol 14 (2) ◽  
pp. 116-120
Author(s):  
Manish Pradhan ◽  
Dipa Rai ◽  
Sagar Paudel
Keyword(s):  
Serum Ferritin ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Mean Value ◽  
Androgenetic Alopecia ◽  
Iron Store ◽  
Body Iron ◽  
Body Iron Store ◽  
Significant Difference ◽  
Total Body

 ABSTRACTIntroduction: Total body iron store is an integral factor in the development of hair follicle. Numerous studies have been done seeking for the relationship between body iron store and various forms of chronic diffuse hair loss, with relatively contradictory findings in various reports in these studies. The main objective of this study is to find out if there is any association between total body iron store and various types of chronic diffuse hair loss in females in reproductive age.Materials and Methods: This is a hospital based case control study conducted in Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Sixty female patients of age group 15-50 years with chronic diffuse hair loss with equal number of age- and sex- matched controls were studied. Both of the study groups were evaluated for various parameters of iron status. Results: The mean value of serum ferritin in cases was significantly lower as compared to controls (p=0.018). Patients with alopecia areata (p=0.008) and androgenetic alopecia (p=0.021) had significantly lower serum ferritin, whereas there was no statistically significant difference in telogen effluvium and controls (p=0.857).The mean value of hemoglobin, hematocrit and mean corpuscular hemoglobin was found to be significantly lower in alopecia areata and androgenetic alopecia. However, there was no statistically significant difference in RBC indices of patients of telogen effluvium and controls.Conclusion: Diffuse chronic hair loss shows definite association with serum ferritin and various RBC indices in female of reproductive age group. Alopecia areata and androgenetic alopecia show major association with total body iron stores. Keywords: alopecia areata; androgenetic alopecia; serum ferritin; telogen effluvium.    

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