IFN‐α and TNF‐α serum levels and their association with disease severity in Egyptian children and adults with alopecia areata

Abstract

Background Alopecia areata (AA) is an autoimmune skin disease characterized by abnormal levels of several cytokines, such as interferon alpha (IFN-a) and tumor necrosis factor-alpha (TNF-a), which are T-helper type 1 cytokines that have important roles in the pathogenesis of AA. The aim of our study was to correlate circulating IFN-a and TNF-a levels with disease severity, activity, and clinical type in patients with AA and to evaluate the relationship between the two cytokines.Methods We investigated serum IFN-a and TNF-a levels in 72 patients with AA (35 children and 35 adults) and 75 healthy control individuals (34 children and 41 adults) using the enzyme-linked immunosorbent assay (ELISA) technique. We evaluated AA severity using the Severity of Alopecia Tool (SALT) and determined the activity based on dermoscopic criteria of disease activity.Results Serum IFN-a and TNF-a concentrations were significantly higher in the patients than in the controls. There was a significant positive correlation between serum IFN-a and TNF-a levels in all patients with alopecia areata, as well as between serum TNF-a levels and disease severity in all patients and in children.Conclusions Our results support the association between IFN-a and TNF-a levels and AA and suggest that TNF-a might be related to disease severity.

The Role of Serum Th1, Th2, and Th17 Cytokines in Patients with Alopecia Areata: Clinical Implications

“…A positive correlation between the serum level of TNF and disease severity was reported in the literature [ 40 , 47 ]. Indeed, a study performed by Alzolibani et al [ 24 ] showed the serum level of TNF to be higher in patients with alopecia areata with the severity SALT score ≥ 25% compared to patients with the SALT score < 25%.…”

“…According to the literature, a positive correlation was reported between the severity of alopecia areata and the serum level of various cytokines including IL-2 [ 25 ], TNF [ 40 ], IL-12 [ 50 ], IL-17 [ 25 , 28 , 48 ], and IL-17E [ 49 ] ( Table 4 ).…”

“…According to the majority of previously published studies, an increased serum level of IFN-γ was observed in patients with alopecia areata compared to healthy controls [ 22 , 23 , 25 , 26 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Higher IFN-γ expression was also detected in peripheral blood mononuclear cells in patients with alopecia areata in comparison with the control group [ 42 , 43 ].…”

“…Numerous studies demonstrated an increased serum level of TNF in patients with alopecia areata compared to healthy controls [ 24 , 28 , 40 , 46 , 47 , 48 , 49 ]. Moreover, an increased expression of TNF mRNA was reported in peripheral blood mononuclear cells in patients with alopecia areata compared to healthy individuals [ 24 , 43 ].…”

Evaluation of serum levels of IL-6, IL-10, and TNF-a in alopecia areata patients: A systematic review and meta-analysis

“…Significantly elevated levels of TNF-α in the serum of AA patients compared to healthy subjects were found (SMD = 2.05, 95% CI 0.98 to 3.13). Among 11 studies that describe TNF-α levels in AA patients and healthy controls, eight studies describe higher levels of TNF-α in AA patients 11,23,25,27-30, 32 , and no significant difference was seen in three studies 15,18,31 . Forest plots of TNF-α, IL-6, and IL-10 are shown in Figures 2 and 3and…”