title: Effects of low-dose recombinant interleukin 2 to promote T-regulatory cells in alopecia areata.
abstract: OBJECTIVE
  An impaired inhibitory function of circulating CD4+CD25+ regulatory T (Treg) cells was reported to play a key role in alopecia areata (AA). We report the first use to our knowledge of low-dose interleukin 2 for treating severe AA by promoting the recruitment of Treg cells.
  
  
  METHODS
  We conducted a prospective open pilot study in 5 patients with severe AA resistant to previous systemic treatments. Subcutaneous interleukin 2 (1.5 million IU/d) was administered during 5 days, followed by three 5-day courses of 3 million IU/d at weeks 3, 6, and 9. The primary outcome was the evolution of the Severity of Alopecia Tool (SALT) score, evaluated by 2 independent investigators on standardized photographs. Lesional skin biopsy specimens and peripheral blood lymphocyte phenotype were analyzed. The median SALT score went from 82 (range, 63-100) at baseline to 69 (range, 28-100) at 6 months. Immunochemical analysis revealed the appearance or a notable increase in Treg cell count in 4 of 5 patients at the end of the treatment compared with baseline. No serious adverse event was reported.
  
  
  CONCLUSIONS
  The partial regrowth achieved in 4 of 5 patients and the recruitment of Treg cells in lesional skin support the interest of promoting Treg cells for treating AA. Further investigations are now required to confirm and to optimize the design in order to enhance the Treg cell response.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01840046.
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France.
authors.forename: Emeline
authors.initials: E
authors.lastname: Castela
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France2Centre de Recherche Clinique (CRC), University Hospital of Nice, Nice, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Le Duff
authors.affiliation: Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, Nice, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Butori
authors.affiliation: Laboratory of Immunology, University Hospital of Nice, Nice, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Ticchioni
authors.affiliation: Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, Nice, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Hofman
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France2Centre de Recherche Clinique (CRC), University Hospital of Nice, Nice, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bahadoran
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lacour
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France5Institut National de la Santé et de la Récherche Médicale (INSERM) U1065, Team 12, Mediterranean Centre of Molecular Medicine, Nice, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Passeron
mesh_terms: D000328:Adult; D000506:Alopecia Areata / Q000188:drug therapy* / Q000473:pathology; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage*; D008213:Lymphocyte Activation / Q000187:drug effects*; D018655:Lymphocyte Count; D010865:Pilot Projects; D011446:Prospective Studies; D012720:Severity of Illness Index; D050378:T-Lymphocytes, Regulatory; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D007376:Interleukin-2