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Alteration of serum and tissue tumor necrosis factor alpha levels: A possible mechanism of action of oral pulse steroids in the treatment of alopecia areata
Author(s) -
Abdel Halim Dalia,
Abu Zeid Ola M.,
Rashed Laila,
Saleh Marwah Adly
Publication year - 2019
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.12795
Subject(s) - alopecia areata , medicine , tumor necrosis factor alpha , endocrinology , necrosis , alpha (finance) , gastroenterology , immunology , surgery , construct validity , patient satisfaction
Summary Background Alopecia areata (AA) is a multifactorial disease in which tumor necrosis factor alpha (TNF‐α) plays an important role. Objective To study the effect of oral pulse steroids on both serum and tissue levels of TNF‐α in AA patients. Methods Skin biopsies and serum samples were collected from 20 patients with patchy AA before and after treatment (oral prednisolone for two consecutive days every week for 3 months) for determination of the levels of TNF‐α levels using ELISA technique. Results Both serum and tissue levels of TNF‐α in AA patients were significantly higher than in controls before ( P < 0.001) as well as after treatment ( P = 0.0169 and P = 0.3051), respectively. The duration of disease negatively correlated with tissue TNF‐α before treatment ( P < 0.0001). Serum and tissue levels of TNF‐α dropped significantly after treatment ( P < 0.0001). The percentage of reduction of both tissue and serum TNF‐α levels correlated positively with the percentage of clinical improvement ( r = 0.682, P = 0.0009; r = 0.567, P = 0.009, respectively). Conclusion TNF‐α plays an important role in the evolution of AA lesions, and alteration in both serum and tissue levels of TNF‐α could be considered one of the important mechanisms of action of systemic oral pulse steroids in the treatment of AA.