Serum levels of IL‐18 and sIL‐2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids

Lee, Dong Hoon; Hong, Soon-Kwon; Park, Sung Wook; Hur, Daeyoung; Shon, Ji‐Hong; Shin, Jae‐Gook; Hwang, Seon-Wook; Sung, Ho-Suk

doi:10.1111/j.1600-0625.2009.00937.x

Cited by 23 publications

(16 citation statements)

References 21 publications

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“…It is also possible that AA activated lymphocytes release IL18 into circulation as observed in other autoimmune diseases [80]. Increased IL18 has been found in AA patient plasma [81]. Increased IL18 activity in the heart could lead to cardiac hypertrophy and increased cell apoptosis without direct lymphocyte infiltration [65].…”

Section: Discussionmentioning

confidence: 99%

Development of Autoimmune Hair Loss Disease Alopecia Areata Is Associated with Cardiac Dysfunction in C3H/HeJ Mice

Wang

Chong

et al. 2013

PLoS ONE

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Alopecia areata (AA) is a chronic autoimmune hair loss disease that affects several million men, women and children worldwide. Previous studies have suggested a link between autoimmunity, stress hormones, and increased cardiovascular disease risk. In the current study, histology, immunohistology, quantitative PCR (qPCR) and ELISAs were used to assess heart health in the C3H/HeJ mouse model for AA and heart tissue response to adrenocorticotropic hormone (ACTH) exposure. Mice with AA exhibited both atrial and ventricular hypertrophy, and increased collagen deposition compared to normal-haired littermates. QPCR revealed significant increases in Il18 (4.6-fold), IL18 receptor-1 (Il18r1; 2.8-fold) and IL18 binding protein (Il18bp; 5.2-fold) in AA hearts. Time course studies revealed a trend towards decreased Il18 in acute AA compared to controls while Il18r1, Il18bp and Casp1 showed similar trends to those of chronic AA affected mice. Immunohistochemistry showed localization of IL18 in chronic AA mouse atria. ELISA indicated cardiac troponin-I (cTnI) was elevated in the serum and significantly increased in AA heart tissue. Cultures of heart atria revealed differential gene expression between AA and control mice in response to ACTH. ACTH treatment induced significant increase in cTnI release into the culture medium in a dose-dependent manner for both AA and control mice. In conclusion, murine AA is associated with structural, biochemical, and gene expression changes consistent with cardiac hypertrophy in response to ACTH exposure.

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Section: Discussionmentioning

confidence: 99%

Development of Autoimmune Hair Loss Disease Alopecia Areata Is Associated with Cardiac Dysfunction in C3H/HeJ Mice

Wang

Chong

et al. 2013

PLoS ONE

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“…The combined therapeutic effect of cyclosporin and systemic steroids has been studied extensively. The efficacy rates of this combination vary widely (25–76.7%) . Still, few robust studies of cyclosporin as a monotherapy have been conducted.…”

Section: Third‐line Therapiesmentioning

confidence: 99%

Management of alopecia areata: Updates and algorithmic approach

Lee

2017

The Journal of Dermatology

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Alopecia areata is a chronic, recurrent and non-scarring alopecia. The prognoses of patients are very diverse. The larger the area of hair loss, the poorer the treatment response and greater the probability of chronic disease progression. Numerous treatments have been introduced, but curative treatments have yet to be established. The long-term efficacy of the current treatments is minimal, and the therapeutic response varies widely. Recent clinical trials have attempted to apply therapeutic metrics, such as the Severity of Alopecia Tool, and many have been designed as randomized controlled studies, enabling a more precise evaluation of existing treatments. There have been updates in practice, efficacy or indications of therapeutics that have been previously used. Moreover, the use of novel treatments such as biologics has recently been introduced. Commonly, the most important factor in determining the treatment modality for alopecia areata has been the extent of hair loss. However, if the disease activity is high and likely to progress, combination therapy with adjuvant modalities will be more desirable. This review will discuss the therapeutic effects of existing and newly-introduced treatments based on their quantity, quality of evidence and expected complications. In addition, an algorithmic approach to management of alopecia areata is proposed according to clinical subtype, severity, onset and activity of the disease.

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“…A recent study showed that a good response to oral cyclosporine can be predicted if the serum level of IL 18 is elevated and the level of soluble IL 2 receptor is low 61. The use of oral cyclosporine in patients with alopecia areata is not generally favored due to its adverse event profile (nephrotoxicity, immune suppression, and hypertension) and a high relapse rate (up to 100%) 62.…”

Section: Third-line Therapiesmentioning

confidence: 99%

Alopecia areata: a new treatment plan

Alsantali

2011

CCID

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Many therapeutic modalities have been used to treat alopecia areata, with variable efficacy and safety profiles. Unfortunately, none of these agents is curative or preventive. Also, many of these therapeutic agents have not been subjected to randomized, controlled trials, and, except for topical immunotherapy, there are few published studies on long-term outcomes. The treatment plan is designed according to the patient’s age and extent of disease. In this paper, the therapeutic agents are organized according to their efficacy and safety profiles into first-line, second-line, and third-line options.

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Serum levels of IL‐18 and sIL‐2R in patients with alopecia areata receiving combined therapy with oral cyclosporine and steroids

Cited by 23 publications

References 21 publications

Development of Autoimmune Hair Loss Disease Alopecia Areata Is Associated with Cardiac Dysfunction in C3H/HeJ Mice

Development of Autoimmune Hair Loss Disease Alopecia Areata Is Associated with Cardiac Dysfunction in C3H/HeJ Mice

Management of alopecia areata: Updates and algorithmic approach

Alopecia areata: a new treatment plan

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