Sung Calvin T, Choi Franchesca D, Juhász Margit, Mesinkovska Natasha Atanaskova
Department of Dermatology, University of California, Irvine, Irvine, California, USA.
School of Medicine, University of California, Riverside, Riverside, California, USA.
Skin Appendage Disord. 2019 Jun;5(4):230-237. doi: 10.1159/000496445. Epub 2019 Feb 26.
While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory diseases not established. The relationship between T-helper (Th)1-mediated AA and Th2-mediated atopy challenges the conventional Th1/Th2 paradigm of autoimmune disease categorization.
To determine the association between AA and atopic respiratory diseases in adults and children, and respiratory diseases in general.
All primary literature, excluding case reports, were identified within PubMed/MEDLINE, CINAHL, and Web of Science in May 2018 using the following search terms: "(alopecia OR hair loss) AND (respiratory OR pulmonary OR lungs OR asthma OR rhinitis OR bronchitis OR COPD OR atopy OR atopic)." Information from 32 articles meeting the inclusion and exclusion criteria was reviewed.
Among the 32 articles identified for inclusion, the prevalence of AA was more strongly associated with allergic rhinitis compared to asthma among pediatric and adult populations. While a significant association was identified between AA, allergic rhinitis, and a late age of onset, the association of AA and asthma remains controversial despite asthma's prevalence among AA patients. No significant difference was identified with regard to the association of AA and non-atopic respiratory diseases between adult and pediatric patients.
Adult and pediatric patients with AA warrant further workup for atopic respiratory diseases such as allergic rhinitis. AA may have an underlying Th2-mediated immunological component, which supports its association with atopic respiratory diseases and provides a new avenue for targeted therapies in select cases.
虽然斑秃（AA）与特应性相关，但免疫关系尚不清楚，特定特应性疾病与全身性呼吸道疾病之间的关联尚未确立。辅助性T细胞（Th）1介导的AA与Th2介导的特应性之间的关系挑战了自身免疫性疾病分类的传统Th1/Th2范式。
确定成人和儿童中AA与特应性呼吸道疾病以及一般呼吸道疾病之间的关联。
2018年5月，在PubMed/MEDLINE、CINAHL和科学网中使用以下检索词识别所有排除病例报告的原始文献：“（斑秃或脱发）和（呼吸道或肺部或肺或哮喘或鼻炎或支气管炎或慢性阻塞性肺疾病或特应性或特应性的）”。对符合纳入和排除标准的32篇文章的信息进行了综述。
在确定纳入的32篇文章中，在儿童和成人人群中，与哮喘相比，AA的患病率与过敏性鼻炎的关联更强。虽然在AA、过敏性鼻炎和发病较晚之间发现了显著关联，但尽管哮喘在AA患者中普遍存在，但AA与哮喘之间的关联仍存在争议。在成人和儿童患者中，关于AA与非特应性呼吸道疾病的关联未发现显著差异。
患有AA的成人和儿童患者需要进一步检查是否患有特应性呼吸道疾病，如过敏性鼻炎。AA可能具有潜在的Th2介导的免疫成分，这支持了其与特应性呼吸道疾病的关联，并为某些情况下的靶向治疗提供了新途径。
