Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, UK.
The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Clin Exp Dermatol. 2023 Mar 22;48(4):325-331. doi: 10.1093/ced/llac104.
Alopecia areata (AA) has features of both autoimmune and atopic pathogenesis, but information on the risk of people with AA developing autoimmune and atopic conditions is limited.
To assess the prevalence and incidence of atopic and autoimmune conditions in people with AA.
This was a population-based cohort study of 8051 adults with newly diagnosed AA (AA group) and 32 204 adults in the matched control group, using the UK Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network primary care database, 2009-2018 (trial registration number: NCT04239521). Baseline prevalence of common atopic and autoimmune conditions, and risk of new-onset atopic and autoimmune disease, were estimated.
Atopic and autoimmune conditions were more prevalent in the AA group than the control group (atopic 37.2% vs. 26.7%, autoimmune 11.5% vs. 7.9%). The AA group were 43% more likely to develop any new-onset atopic condition [adjusted hazard ratio (aHR) 1.43. 95% confidence interval (CI) 1.28-1.61] and 45% more likely to develop any autoimmune condition (aHR 1.45, 95% CI 1.28-1.66) compared with the control group. When examining individual conditions, the AA group were at increased risk of atopic dermatitis (aHR 1.91, 95% CI 1.67-2.19), allergic rhinitis (aHR 1.32, 95% CI 1.14-1.54), autoimmune hypothyroidism (aHR 1.65, 95% CI 1.35-2.02), systemic lupus erythematosus (aHR 4.51, 95% CI 1.88-10.82) and vitiligo (aHR 2.39, 95% CI 1.49-3.82). There was no evidence for a higher incidence of other conditions examined.
People with AA have an increased burden of atopic and autoimmune comorbidity. This supports previous work suggesting that both T helper cell (Th)1 and Th2 immune responses may be implicated in the pathogenesis of AA.
斑秃 (AA) 具有自身免疫和特应性发病机制的特征，但有关 AA 患者发生自身免疫和特应性疾病风险的信息有限。
评估 AA 患者特应性和自身免疫性疾病的患病率和发病率。
这是一项基于人群的队列研究，纳入了 8051 名新诊断为 AA（AA 组）的成年人和 32204 名匹配对照组成年人，使用英国牛津皇家全科医师学院（RCGP）研究和监测中心（RSC）网络初级保健数据库，时间范围为 2009 年至 2018 年（试验注册编号：NCT04239521）。评估了常见特应性和自身免疫性疾病的基线患病率以及新发特应性和自身免疫性疾病的风险。
与对照组相比，AA 组特应性和自身免疫性疾病更为常见（特应性为 37.2% vs. 26.7%，自身免疫性为 11.5% vs. 7.9%）。与对照组相比，AA 组新发任何特应性疾病的可能性高 43%（校正后的风险比[aHR]为 1.43，95%置信区间[CI]为 1.28-1.61），新发任何自身免疫性疾病的可能性高 45%（aHR 为 1.45，95% CI 为 1.28-1.66）。在检查个别疾病时，AA 组患特应性皮炎（aHR 为 1.91，95% CI 为 1.67-2.19）、过敏性鼻炎（aHR 为 1.32，95% CI 为 1.14-1.54）、自身免疫性甲状腺功能减退症（aHR 为 1.65，95% CI 为 1.35-2.02）、系统性红斑狼疮（aHR 为 4.51，95% CI 为 1.88-10.82）和白癜风（aHR 为 2.39，95% CI 为 1.49-3.82）的风险增加。没有证据表明其他检查的疾病发病率更高。
AA 患者的特应性和自身免疫性合并症负担加重。这支持了先前的研究工作，表明 Th1 和 Th2 辅助性 T 细胞（Th）免疫反应都可能与 AA 的发病机制有关。
