Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations

Wang, Chuang‐Wei; Wu, Ming-Ying; Chen, Chun‐Bing; Lin, Wei‐Chen; Wu, Jennifer D.; Lu, Chun‐Wei; Chen, Wei‐Ti; Wang, Fang-Ying; Hui, Rosaline Chung‐Yee; Chi, Min‐Hui; Chiu, Tsu‐Man; Chang, Ya‐Ching; Lin, Jingyi; Yang, Lin; Tsai, Wan-Ting; Chung, Wen‐Hung

doi:10.1016/j.clim.2023.109737

Cited by 3 publications

(5 citation statements)

References 62 publications

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“…Additionally, polyethylene glycol 2000 (PEG 2000) and polysorbate 80, present in mRNA COVID-19 vaccines and the AZD1222/MVCCOV1901 vaccine, are major allergens. T cells from patients with AA associated with mRNA COVID-19 vaccines are significantly activated by PEG 2000 or spike protein, whereas those associated with the AstraZeneca COVID-19 vaccine are activated by polysorbate 80 or spike protein ( 60 ).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, studies have found that autoantibodies such as ANA (antinuclear antibodies), IgG-anti-MX1, and IgG-anti-METTL3 are elevated in patients with autoimmune diseases related to the COVID-19 vaccine ( 60 ). However, a direct link between AA induced by COVID-19 or vaccination and autoantibodies like anti-spike protein has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

“…There are reports of patients completely recovering from severe AA using PRP (platelet-rich plasma) therapy, which is more convenient and less toxic than other treatments ( 32 ). In addition, studies have shown that tofacitinib and baricitinib can successfully treat AA related to the COVID-19 vaccine ( 60 ). However, larger sample size studies are still needed to assess the efficacy of JAK inhibitors in treating AA related to the COVID-19 vaccine.…”

Section: Discussionmentioning

confidence: 99%

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The correlation between corona virus disease 2019 and alopecia areata: a literature review

Xie,

Lv,

Luo

et al. 2024

Front. Immunol.

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Corona virus disease 2019(COVID-19) is one of the most serious respiratory pandemic diseases threatening human health for centuries. Alopecia areata (AA) is a sudden patchy hair loss, an autoimmune disease, which seriously affects the image and mental health of patients. Evidence shows that the risk of autoimmune diseases significantly increases after COVID-19, and is positively correlated with the severity, with a significant increase in the risk of alopecia in those over 40 years old. The relationship between COVID-19 and AA has become a hot topic of current research. Strengthening the research on the correlation between COVID-19 and AA can help to identify and protect susceptible populations at an early stage. This article reviews the research progress on the epidemiological background of COVID-19 and AA, the situation and possible mechanisms of AA induced by COVID-19 or COVID-19 vaccination, and potential treatment methods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The correlation between corona virus disease 2019 and alopecia areata: a literature review

Xie,

Lv,

Luo

et al. 2024

Front. Immunol.

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“…Various environmental triggers have been identified as potential catalysts for the onset or exacerbation of AA. Infections with human papillomavirus (HPV), Epstein–Barr virus (EBV), human immunodeficiency virus (HIV), hepatitis B and C viruses, and SARS-CoV-2 have been documented to precede AA development [ 6 , 46 , 47 , 48 , 49 ]. Vaccinations against hepatitis B or COVID-19 infection and certain drug regimens, including highly active antiretroviral therapy (HAART) or amphetamines, are also described as inducible factors [ 49 , 50 , 51 ].…”

Section: Environmental Factors In the Development Of Aamentioning

confidence: 99%

“…Infections with human papillomavirus (HPV), Epstein–Barr virus (EBV), human immunodeficiency virus (HIV), hepatitis B and C viruses, and SARS-CoV-2 have been documented to precede AA development [ 6 , 46 , 47 , 48 , 49 ]. Vaccinations against hepatitis B or COVID-19 infection and certain drug regimens, including highly active antiretroviral therapy (HAART) or amphetamines, are also described as inducible factors [ 49 , 50 , 51 ]. Additionally, metabolic deficiencies, such as low serum levels of ferritin, folate, zinc, selenium, and vitamin D, have been associated with AA onset and changes in its course and severity [ 8 , 52 , 53 , 54 , 55 , 56 , 57 ].…”

Section: Environmental Factors In the Development Of Aamentioning

confidence: 99%

Deciphering the Complex Immunopathogenesis of Alopecia Areata

Šutić Udović,

Hlača,

Massari

et al. 2024

IJMS

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Alopecia areata (AA) is an autoimmune-mediated disorder in which the proximal hair follicle (HF) attack results in non-scarring partial to total scalp or body hair loss. Despite the growing knowledge about AA, its exact cause still needs to be understood. However, immunity and genetic factors are affirmed to be critical in AA development. While the genome-wide association studies proved the innate and acquired immunity involvement, AA mouse models implicated the IFN-γ- and cytotoxic CD8+ T-cell-mediated immune response as the main drivers of disease pathogenesis. The AA hair loss is caused by T-cell-mediated inflammation in the HF area, disturbing its function and disrupting the hair growth cycle without destroying the follicle. Thus, the loss of HF immune privilege, autoimmune HF destruction mediated by cytotoxic mechanisms, and the upregulation of inflammatory pathways play a crucial role. AA is associated with concurrent systemic and autoimmune disorders such as atopic dermatitis, vitiligo, psoriasis, and thyroiditis. Likewise, the patient’s quality of life (QoL) is significantly impaired by morphologic disfigurement caused by the illness. The patients experience a negative impact on psychological well-being and self-esteem and may be more likely to suffer from psychiatric comorbidities. This manuscript aims to present the latest knowledge on the pathogenesis of AA, which involves genetic, epigenetic, immunological, and environmental factors, with a particular emphasis on immunopathogenesis.

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A scoping review of alopecia areata and its relationship to COVID-19 vaccinations

Konisky,

Choi,

Valada

et al. 2024

Arch Dermatol Res

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In response to the COVID-19 pandemic several vaccines were produced, including novel mRNA and viral vector-based vaccines. Though COVID-19 had its own associated dermatological sequelae, the vaccines were associated with a new set of cutaneous side effects, including hypersensitivity reactions, vasculitis, and autoimmune-mediated reactions. Notably, alopecia areata (AA) was reported in several patients closely following a COVID-19 vaccine, especially in those with a personal or family history of AA. A PubMed and Google Scholar search was conducted in July 2024 which resulted in 26 case reports/case series, 1 prospective study, and 3 cross-sectional retrospective chart reviews. Based on our holistic literature review, there is no evidence to support an increased association between COVID-19 vaccination and AA. Despite recent literature highlighting the incidence of de novo and recurrent AA after COVID-19 vaccines, several large retrospective analyses have shown that the overall incidence of AA in vaccinated individuals does not differ from that of historical controls. The potential for de novo AA after COVID-19 vaccine is low and the benefit of being vaccinated far outweighed the risks, especially within the first few years of COVID-19 vaccine rollout. While the decision to get vaccinated is a personal choice, the threat of developing AA secondary to vaccination should not be a deterrent.

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Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations

Cited by 3 publications

References 62 publications

The correlation between corona virus disease 2019 and alopecia areata: a literature review

The correlation between corona virus disease 2019 and alopecia areata: a literature review

Deciphering the Complex Immunopathogenesis of Alopecia Areata

A scoping review of alopecia areata and its relationship to COVID-19 vaccinations

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