Cross-sectional study of blood biomarkers of patients with moderate to severe alopecia areata reveals systemic immune and cardiovascular biomarker dysregulation.

Abstract

BACKGROUND:

Although there is increased understanding of the alopecia areata (AA) pathogenesis based on studies in scalp tissues, little is known about its systemic profile.

OBJECTIVE:

To evaluate the blood proteomic signature of AA and determine biomarkers associated with increased disease severity.

METHODS:

In a cross-sectional study, we assessed 350 inflammatory and cardiovascular proteins using OLINK high-throughput proteomics in patients with moderate to severe AA (n = 35), as compared with healthy individuals (n = 36), patients with moderate to severe psoriasis (n = 19), and those with atopic dermatitis (n = 49).

RESULTS:

Seventy-four proteins were significantly differentially expressed between AA and control individuals (false discovery rate, <.05) including innate immunity (interleukin [IL] 6/IL-8), T helper (Th) type 1 (interferon [IFN] γ/CXCL9/CXCL10/CXCL11), Th2 (CCL13/CCL17/CCL7), Th17 (CCL20/PI3/S100A12), and cardiovascular-risk proteins (OLR1/OSM/MPO/PRTN3). Eighty-six biomarkers correlated with AA clinical severity (P < .05), including Th1/Th2, and cardiovascular/atherosclerosis-related proteins, including SELP/PGLYRP1/MPO/IL-18/OSM (P < .05). Patients with AA totalis/universalis showed the highest systemic inflammatory tone, including cardiovascular risk biomarkers, compared to control individuals and even to patients with atopic dermatitis and those with psoriasis. The AA profile showed some Th1/Th2 differences in the setting of concomitant atopy.

LIMITATIONS:

Our analysis was limited to 350 proteins.

CONCLUSION:

This study defined the abnormalities of moderate to severe AA and associated circulatory biomarkers. It shows that AA has systemic immune, cardiovascular, and atherosclerosis biomarker dysregulation, suggesting the need for systemic treatment approaches.

• Authors: Jacob W Glickman, Celina Dubin, Yael Renert-Yuval, Dante Dahabreh, Grace W Kimmel, Kelsey Auyeung, Yeriel D Estrada, Giselle Singer, James G Krueger, Ana B Pavel, Emma Guttman-Yassky
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 84 Issue 2 Pg. 370-380 (Feb 2021) ISSN: 1097-6787 [Electronic] United States
• PMID: 32376430 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers

Topics

• Adult
• Alopecia Areata (blood, diagnosis, immunology)
• Biomarkers (blood)
• Cardiovascular Diseases (blood, diagnosis, immunology)
• Cross-Sectional Studies
• Female
• Healthy Volunteers
• Humans
• Inflammation (blood, diagnosis, immunology)
• Male
• Middle Aged
• Severity of Illness Index
• Young Adult