title: Alopecia universalis associated with impaired interleukin-4 production and low serum IgE level.
abstract: A 17-year-old female presented with alopecia universalis, which appeared following widespread eczematous dermatitis. An immunohistochemical study demonstrated that CD8(+) T cells infiltrated into hair follicles with satellite cell necrosis of keratinocytes. The precedence of the autosensitization dermatitis suggested that T cells concerned with the eczematous reaction also attacked hair follicles, or alternatively, that those T cells sequentially activated another population of cytotoxic T cells. We found that she had a continuously low level of serum IgE (<1 units/ml), and this abnormality urged us to investigate interleukin (IL)-4 production of T cells. Although the patient had a normal number of CD4(+) T cells, the production of IL-4, but not IL-10, was profoundly impaired as assessed by a reverse transcriptase polymerase chain reaction analysis, suggesting the possible relationship between the baldness and IL-4 reduction. The autoimmune hair loss might occur via activation of cytotoxic T cells and Th(1) cells as a result of a relief from IL-4 control.
authors.affiliation: Department of Dermatology at the University of Occupational and Environmental Health, Kitakyushu, Japan. tokura@med.uoeh-u.ac.jp
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Tokura
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sugita
authors.forename: Kenji
authors.initials: K
authors.lastname: Kabashima
authors.forename: Taisuke
authors.initials: T
authors.lastname: Ito
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yagi
mesh_terms: D000293:Adolescent; D000328:Adult; D000505:Alopecia / Q000209:etiology / Q000276:immunology*; D001327:Autoimmune Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D015847:Interleukin-4 / Q000096:biosynthesis*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D013601:T-Lymphocytes / Q000378:metabolism
chemical_list: D015847:Interleukin-4; D007073:Immunoglobulin E