title: B cell activating factor and T-helper 17 cells: possible synergistic culprits in the pathogenesis of Alopecia Areata.
abstract: The role of T-helper 17 cells (Th17) and regulatory T-cells (Tregs) in the pathogenesis of alopecia areata (AA) has not been clearly elucidated. B cell activating factor (BAFF) being a regulator of T cell activation could be involved in this pathologic process as well. The current study evaluated the expression of IL-17, IL-22, Foxp3 and BAFF in tissue and sera of AA patients. Forty AA patients and 40 age and sex matched healthy controls were included. Tissue and serum levels of IL-17, IL-22, BAFF as well as serum level of Foxp3 were measured by enzyme-linked immunosorbent assay (ELISA). Immunohistochemical staining was used for assessment of tissue level of Foxp3. Tissue and serum levels of IL-17, tissue levels of IL-22 and BAFF were significantly higher in patients. Serum levels of IL-22, Foxp3 and BAFF were non-significantly higher in patients. Foxp3 immunostaining showed negativity in tissue of patients and controls. A significant positive correlation was found between both tissue levels of IL-17 and BAFF (r = 0.474, P = 0.035) and tissue level of IL-22 and disease duration (r = 0.766, P < 0.001) in AA patients. Th17 cells and BAFF are synergistically involved in the pathogenesis of AA. BAFF represents a promising therapeutic target for such a challenging disease. Defective Tregs number and/or function in AA warrants further studies.
authors.affiliation: Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Elela
authors.affiliation: Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt. heba.gawdat@yahoo.com.
authors.forename: Heba I
authors.initials: HI
authors.lastname: Gawdat
authors.affiliation: Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Rehab A
authors.initials: RA
authors.lastname: Hegazy
authors.affiliation: Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Marwa M
authors.initials: MM
authors.lastname: Fawzy
authors.affiliation: Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Rania M
authors.initials: RM
authors.lastname: Abdel Hay
authors.affiliation: Department of Dermatology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Saadi
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Olfat
authors.initials: O
authors.lastname: Shaker
mesh_terms: D000293:Adolescent; D000328:Adult; D000506:Alopecia Areata / Q000276:immunology / Q000473:pathology*; D053264:B-Cell Activating Factor / Q000097:blood*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D051858:Forkhead Transcription Factors / Q000097:blood* / Q000378:metabolism; D018859:Hair Follicle / Q000276:immunology / Q000473:pathology; D006801:Humans; D020381:Interleukin-17 / Q000097:blood* / Q000378:metabolism; D007378:Interleukins / Q000097:blood* / Q000378:metabolism; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D058504:Th17 Cells / Q000276:immunology*; D055815:Young Adult; D000097043:Interleukin-22
chemical_list: D053264:B-Cell Activating Factor; D051858:Forkhead Transcription Factors; D020381:Interleukin-17; D007378:Interleukins; D000097043:Interleukin-22; C418974:FOXP3 protein, human; C508717:IL17A protein, human; C505719:TNFSF13B protein, human
keywords: Alopecia Areata; B cell activating factor; Pathogenesis; Regulatory T cells; T Helper 17 cells