Serum T helper 1 cytokine levels are greater in patients with alopecia areata regardless of severity or atopy

P>Background. Alopecia areata (AA) is an organ-specific autoimmune disease characterized by folliculotropic T-cell infiltrates around anagen-stage hair follicles. The role of T helper (Th)1 and Th2 cytokines in the pathogenesis of AA have not been established. Aim. To determine whether serum cytokine profiles define the severity of the AA phenotype or are affected by co-existent atopy. Methods. In total, 17 serum cytokines were measured and compared in 269 patients with AA of varying severity with and without atopy and 18 unrelated controls. Results. Of the 269 patients with AA, 96% had active disease and 54% were atopic. The disease phenotype was transient patchy AA in 27 patients, persistent patchy AA in 89 and alopecia totalis or alopecia universalis in 153. Levels of Th1, interleukin (IL)-1 receptor antagonist (ra) and IL-8 levels were higher in all patients with AA than in controls. IL-1 alpha, IL-12 and tumour necrosis factor-alpha levels were higher in patients with AA and atopy than in patients with AA without atopy. Conclusions. Increased Th1 serum cytokines (IL-2, IL-12 and interferon-gamma) and IL-1ra levels are associated with AA regardless of disease severity or the presence of atopy.