title: The progressive state, in contrast to the stable or regressive state of alopecia areata, is reflected in peripheral blood mononuclear cells.
abstract: Alopecia areata (AA) is a putative autoimmune disease of the skin with an inflammatory component that can be treated by the local application of contact sensitizers. Here, we explored whether responsiveness toward diphenylcyclopropenone (DPCP) is reflected by the composition and the activation state of peripheral blood mononuclear cells (PBMCs). PBMCs of 43 AA patients, 26 treated and 17 untreated, and of 31 healthy volunteers were tested. AA patients' PBMCs differed from that of healthy donors by a slight increase in CD16- and tumor necrosis factor-alpha (TNF-alpha)-expressing cells. These features were independent of the disease state and treatment. Additional changes in the activation state of PBMCs, upregulation of the costimulatory molecules CD40 and CD80, of the accessory molecule CD154, and of interferon-gamma expression were identified only in AA patients where the disease was advancing, i.e. these changes were independent of the extent of hair loss and were not seen in patients with spontaneous or DPCP treatment-induced, regressing AA. Thus, the progressive state of AA is accompanied by a systemic activation of T cells, and the therapeutic efficacy of treatment can be estimated by restoration of the non-activated state. Furthermore, an increase in CD16(+)- and TNF-alpha-expressing cells may contribute to AA susceptibility.
authors.affiliation: Department of Tumor Progression and Tumor Defense, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany. mzoeller@dkfz.de
authors.forename: Margot
authors.initials: M
authors.lastname: Zöller
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: McElwee
authors.forename: Mario
authors.initials: M
authors.lastname: Vitacolonna
authors.forename: Rolf
authors.initials: R
authors.lastname: Hoffmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000506:Alopecia Areata / Q000097:blood* / Q000175:diagnosis / Q000473:pathology*; D018122:B7-1 Antigen / Q000096:biosynthesis; D019013:CD40 Antigens / Q000096:biosynthesis; D023201:CD40 Ligand / Q000096:biosynthesis; D002648:Child; D003521:Cyclopropanes / Q000494:pharmacology; D016207:Cytokines / Q000096:biosynthesis; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007249:Inflammation; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000473:pathology*; D008024:Ligands; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D017452:Receptors, IgG / Q000096:biosynthesis; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D018122:B7-1 Antigen; D019013:CD40 Antigens; D003521:Cyclopropanes; D016207:Cytokines; D008024:Ligands; D017452:Receptors, IgG; D014409:Tumor Necrosis Factor-alpha; D023201:CD40 Ligand; C029402:diphenylcyclopropenone