| Objective: Alopecia Areata (AA) is a common disease with hair loose and without effective therapy. It can relieve and recur by itself. AA usually has no symptom, however, its negative influences on appearance and emotion can not be neglected. Despite its etiology and pathogenesis are not well known, most researchers considered that immune mechanism may play an important role in AA. Early experiments suggested that sex hormones (SH) could affect the occurrence, development of diseases by their receptors (sex hormone receptors, SHR) or by influencing immune system. It has been known that SH are targeted on skin and its affiliated apparatuses, whose metabolism may be affected by the changes of SH and SHR. Recently, the more and more attention has been paid to the study on the relations between sex hormone and its receptor and skin diseases. The purpose of our study is to explore the relations between SH and SHR and AA, offering approaches for clinical practice and assessing prognosis.Materials and methods: 31 experimental objects were collected from the dermatology department of fourth affiliated hospital of Hebei Medical University. They include17 females and 14 males with a ratio of 1.2:1, and their age ranges from 11 to 69 years old (an average 31.2). All the biopsy specimens were used for histopathologic and immunohistochemical analyses of SHR, respectively. The specimens of 20 healthy scalps were taken from patients in the department of neurosurgery as controls and processed as described above. They are divided into two groups with 10 male and 10 female patients, whose age ranges from 32 to 73 (an average 45.1). Blood samples were collected from 50 AA patients including 27 males and 23 females with ratio of 1.2:1, with the age range from 10 to 66 (an average 32.5). And 20 healthy volunteers as controls included 10 males and 10 females, whose age ranges from 23 to 47 (an average 26.8). All blood samples were used for SH measurement.HE staining was used in histopathology and histostain-SP method in immunohistochemistry. Radioimmunoassay (RIA) was used to measure HS concentration in serum.Results: The experimental results were analysed and compared according to the different sex of patients. 1 We measured the serum concentrations of testosterone (T), progesterone(P) and estradiol (E2), and found that comparing to controls T level was significantly higher in AA with both male and female patients. E2 and P levels lower in male patients, but no significant difference between females. 2 Androgen, estrogen and progesterone receptor (AR, ER and PR) assays were carried out respectively. It was found thatcomparing to controls the expression of AR in eccrine gland of male patients and in the basal layer, outer root sheath and arrector pili muscle of the female patients is significantly lower. ER is significantly higher in the basal layer, outer root sheath, sebaceous gland, eccrine gland and arrector pili muscle in the female patients. PR in arrector pili muscle of male patients and in the basal layer, eccrine gland of the female patients is significantly higher.Conclusion: Although there is no distinctive manifestation between male and female patients, their pathogeneses may be quite different. Our study indicated that SH and SHR had significant differences between the male and female patients. It is suggested that the changes of the serum SH level may play a leading role in the onset of AA in male patients, but abnormal expression of SHR is very important in female patients. Therefore, we believed that there was sex difference in the pathogenesis of AA. For this reason, treatment should be emphasized on the regulation of endocrine in male patients, while in female patients the more attention should be paid to the modulation of the numbers and function of the local SHR. for female. |
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