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Serum thymus and activation‐regulated chemokine as disease activity and response biomarker in alopecia areata
Author(s) -
Inui Shigeki,
Noguchi Fumihito,
Nakajima Takeshi,
Itami Satoshi
Publication year - 2013
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.12273
Subject(s) - alopecia areata , cd68 , biomarker , medicine , ccl17 , chemokine , immunology , pathology , immunohistochemistry , chemokine receptor , chemistry , inflammation , biochemistry
Serum thymus and activation‐regulated chemokine/ CCL 17 (s TARC ) is known as a good indicator for atopic dermatitis severity. Herein, we investigate whether s TARC correlates with severity and therapeutic response for alopecia areata ( AA ) in our 121 patients. The s TARC mean of AA totalis and universalis was significantly higher than mild AA . Next, we compared s TARC of diffuse AA ( n = 14) and severity‐controlled patchy AA ( n = 32) and found that s TARC in diffuse AA (564.2 ± 400.0 pg/mL) was significantly higher than that of the patchy type (344.0 ± 239.8 pg/mL), suggesting a potential role of TARC in active progression of diffuse AA . Ten patients with diffuse AA were treated with i.v. corticosteroid pulse therapy. Then, we tested whether s TARC can predict prognosis after the pulse therapy and found that baseline s TARC in the poor responders (1025.5 ± 484.8 pg/mL) was significantly higher than that in the good responders (complete remission at 24 months after the pulse therapy, 347.8 ± 135.7 pg/mL), indicating s TARC as a response biomarker in the corticosteroid pulse therapy for diffuse AA . Finally, to investigate TARC production in the affected hair follicles, we performed immunohistochemical double staining of TARC and CD 68 using scalp skin specimens of diffuse AA with high titers of s TARC . The results showed their co‐localization in the infiltrating cells around the AA hair follicles, suggesting that TARC is mainly produced from CD 68 + histiocytes. In conclusion, s TARC is a disease activity and response biomarker in AA , providing new insight beyond the T ‐helper 1/2 paradigm to solve the immunological pathogenesis of AA .