Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
J Dermatol Sci. 2014 Jan;73(1):74-9. doi: 10.1016/j.jdermsci.2013.08.009. Epub 2013 Sep 2.
Alopecia areata (AA) is an organ-restricted autoimmune condition of the hair follicles (HFs) that presents as nonscarring hair loss. A collapse of immunoprivilege for cell-mediated cytotoxicity and following attacks by cytotoxic T cells to anagen HFs are considered to play a major role in the pathogenesis of AA. However, there has been no useful marker for the activity of AA to date.
The aim of this study is to examine whether granulysin, which is known to reflect the activity of cytotoxic immune responses, is related to the disease activity of AA.
We evaluated serum granulysin levels in acute and chronic AA patients compared to healthy controls in the perspective of bald skin areas, prognosis, and co-existence of other allergic diseases. In addition, immunohistochemical analysis for granulysin-, CD4-, CD8-, and CD56-positive cells in the lesional skin of acute and chronic AA patients was performed.
Serum granulysin levels were significantly elevated in both acute and chronic AA patients (p=0.00081 and p=0.0012, respectively). Intriguingly, serum granulysin levels were significantly associated with the broader bald skin areas (Spearman's r=0.59, p=0.017), and poorer prognosis in acute AA patients (p=0.0080). They were also associated with co-existence of allergic disorders in AA patients (p=0.026). Immunohistochemical staining demonstrated that perifollicular granulysin-bearing cells were mainly detected in acute AA lesions with dense lymphocytic infiltration, and that these granulysin-bearing cells were consistent with CD8(+) T cells.
The serum granulysin level may be a useful and novel marker for the disease activity in the acute phase of AA.
斑秃（AA）是一种毛囊局限性自身免疫性疾病，表现为非瘢痕性脱发。细胞介导的细胞毒性作用的免疫豁免崩溃以及随后对生长期毛囊的细胞毒性 T 细胞的攻击被认为在 AA 的发病机制中起主要作用。然而，迄今为止，AA 的活动还没有有用的标志物。
本研究旨在研究颗粒溶素是否与 AA 的疾病活动有关，已知颗粒溶素反映细胞毒性免疫反应的活性。
我们评估了急性和慢性 AA 患者与健康对照组相比在光秃皮肤面积、预后和其他过敏性疾病共存方面的血清颗粒溶素水平。此外，还对急性和慢性 AA 患者皮损中的颗粒溶素、CD4、CD8 和 CD56 阳性细胞进行了免疫组织化学分析。
急性和慢性 AA 患者的血清颗粒溶素水平均显著升高（p=0.00081 和 p=0.0012）。有趣的是，血清颗粒溶素水平与更广泛的光秃皮肤面积显著相关（Spearman's r=0.59，p=0.017），并且与急性 AA 患者的预后较差相关（p=0.0080）。它们还与 AA 患者过敏疾病共存相关（p=0.026）。免疫组织化学染色显示，急性 AA 病变中存在浓密淋巴细胞浸润，毛囊周围颗粒溶素阳性细胞主要存在于急性 AA 病变中，这些颗粒溶素阳性细胞与 CD8+T 细胞一致。
血清颗粒溶素水平可能是 AA 急性期疾病活动的一个有用的新标志物。
