Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.
Allergy. 2018 Mar;73(3):713-723. doi: 10.1111/all.13346. Epub 2017 Dec 22.
Characterizing blood profile of alopecia areata (AA) is important not only for treatment advancements, but also for possibly identifying peripheral biomarkers that will eliminate the need for scalp biopsies. We aimed to compare frequencies of skin homing (CLA ) vs systemic (CLA ) "polar" CD4 and CD8 and activated T-cell subsets in AA vs atopic dermatitis (AD) and control blood.
Flow cytometry was used to measure IFN-γ, IL-13, IL-9, IL-17, and IL-22 cytokines in CD4 and CD8 T cells. Inducible co-stimulator molecule (ICOS) and HLA-DR were used to define mid- and long-term T-cell activation. We compared peripheral blood from 32 moderate-to-severe AA adults with 43 moderate-to-severe AD patients and 30 age-matched controls.
AA patients had increased CLA /CLA Th2 (P < .007), CLA Tc2 (P = .04), and CLA Th22 (P < .05) frequencies than controls. Except of CLA Tc1 cells (P = .03), IFN-γ levels were mostly similar between AA, AD, and controls (P > .1). ICOS and HLA-DR activation were significantly higher in AA than controls (P < .05). T regulatory cells were significantly decreased in AA patients than controls (P < .01) and were correlated with activated CD8 T cells and with multiple cytokine subsets (P < .05). While Th2 and Tc2 clustered with disease severity, IFN-γ producing cells were linked with AA duration.
Alopecia areata is accompanied by Th2/Tc2 activation in skin-homing and systemic subsets, correlating with disease severity, while IFN-γ is linked to disease chronicity. These data hint for a possible role of diverse T-cells subsets in disease pathogenesis and emphasize the systemic nature of AA supporting the need for systemic therapeutic strategies in severe patients.
描述斑秃（AA）的血液特征不仅对治疗进展很重要，而且可能有助于确定外周生物标志物，从而消除头皮活检的需要。我们旨在比较 AA 与特应性皮炎（AD）和对照血液中皮肤归巢（CLA）与全身（CLA）“极地”CD4 和 CD8 和活化 T 细胞亚群的频率。
使用流式细胞术测量 CD4 和 CD8 T 细胞中的 IFN-γ、IL-13、IL-9、IL-17 和 IL-22 细胞因子。诱导共刺激分子（ICOS）和 HLA-DR 用于定义中期和长期 T 细胞活化。我们比较了 32 名中重度 AA 成年患者、43 名中重度 AD 患者和 30 名年龄匹配对照者的外周血。
AA 患者 CLA/CLA Th2（P<.007）、CLA Tc2（P=.04）和 CLA Th22（P<.05）频率增加。除 CLA Tc1 细胞（P=.03）外，AA、AD 和对照组之间 IFN-γ 水平差异无统计学意义（P>.1）。与对照组相比，AA 患者的 ICOS 和 HLA-DR 活化明显更高（P<.05）。AA 患者的调节性 T 细胞明显低于对照组（P<.01），并与活化的 CD8 T 细胞和多种细胞因子亚群相关（P<.05）。虽然 Th2 和 Tc2 与疾病严重程度相关，但 IFN-γ 产生细胞与 AA 持续时间相关。
斑秃伴有皮肤归巢和全身亚群中的 Th2/Tc2 活化，与疾病严重程度相关，而 IFN-γ 与疾病慢性期相关。这些数据提示多种 T 细胞亚群可能在疾病发病机制中起作用，并强调 AA 的全身性，支持对重症患者进行全身治疗策略的必要性。
