title: The -2T/C polymorphism in the adrenocorticotropin receptor gene affects stress perception of patients with alopecia areata.
abstract: BACKGROUND
  Altered hypothalamic-pituitary-adrenal (HPA) axis response involved in the pathogenesis of stress-associated alopecia areata (AA) has been reported. A novel polymorphism -2T>C of the adrenocorticotropin receptor (ACTHR) can result in an insufficient HPA response to stress; therefore, the functional polymorphism may underlie a role in stress-associated AA.
  
  
  OBJECTIVE
  To investigate the relationship between psychosocial factors and the risk of developing AA and to detect the association between the -2T>C polymorphism of ACTHR and AA.
  
  
  METHODS
  Stressful situations were evaluated using Holmes and Rahe's social readjustment rating scale. The ACTHR -2T>C polymorphism was examined in 263 patients with AA and 241 controls.
  
  
  RESULTS
  Significant elevation of psychological stress experienced by some patients with AA compared with controls (Z = 6.628, P < 0.01). The frequency of the ACTHR C allele showed a significant difference between patients with AA and controls (P = 0.004). Allele C is the risk allele with a dominant model as the -2C allele occurred more often in patients with AA (P = 0.001). There were significant differences between patients with AA with a severe stress attack versus patients with AA with no obvious stress (P < 0.001), whereas the genotype frequencies were not correlated with the type, duration of disease, and age at onset. Notably, the C allele carrier was significantly associated with stress risk in both AA and controls (P = 0.002, OR = 1.576, 95% CI: 1.148-2.162; P = 0.042, OR = 1.529, 95% CI: 1.022-2.288).
  
  
  CONCLUSIONS
  These findings suggest AA in some patients may be associated with stress. The ACTHR gene -2T>C variant may be one important factor that influences stress perception of patients with AA.
authors.affiliation: Department of Dermatology, The Third Military Medical University, Chongqing, China.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Guo
authors.forename: Hong
authors.initials: H
authors.lastname: Guo
authors.forename: Ke-Shen
authors.initials: KS
authors.lastname: Li
authors.forename: Jiang
authors.initials: J
authors.lastname: Wu
authors.forename: Shao-Yan
authors.initials: SY
authors.lastname: Yang
authors.forename: Bao-Heng
authors.initials: BH
authors.lastname: Liu
authors.forename: Fei
authors.initials: F
authors.lastname: Hao
authors.forename: Yun
authors.initials: Y
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D000506:Alopecia Areata / Q000209:etiology / Q000235:genetics* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005787:Gene Frequency; D006579:Heterozygote; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010465:Perception; D020641:Polymorphism, Single Nucleotide; D018043:Receptors, Corticotropin / Q000235:genetics*; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000235:genetics*; D055815:Young Adult
chemical_list: D018043:Receptors, Corticotropin