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

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-1alpha, 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.