A Pilot Study Of Clinical Significance And Variation Of Th17/Treg Subsets In Alopecia Areata Patients

BackgroundAlopecia areata (AA) is one of the common diseases in dermatologic clinics, that appears as a sudden patchy, non-scarring hair loss. The accurate pathogenesis of alopecia areata was still unknown. Previous studies showed that the basic etiology is the T cell mediated cytoimmunal action, although it is associated with multiple factors such as genetic factors, environment, psychology, stress and so on. It has been known that the interreaction of Th17cell subset and Treg cell subset plays an important role in autoimmune regulation. Previous studies have indicated that Treg was decreased in alopecia areata. However, the relationship of Th17and alopecia areata has not been clearly elucidated.ObjectiveTo investigate the variations of Th17cell and Treg subsets in peripheral blood of patients with alopecia areata (AA) and explore their possible role in the pathogenesis of AA and clinical significance.MethodsThe levels of Th17and Treg subsets in peripheral blood of97patients with AA and32healthy controls were analyzed by flow cytometry with immunofluorescent staining. SPSS16.0was used for analysis.ResultsIn this study, we found that the proportion of peripheral blood Th17subsets was significantly increased in AA patients in comparison with that of controls (1.52%±0.80%vs0.92%±0.55%, P<0.001), while the proportion of Treg cells was significantly decreased (0.96%±0.63%vs1.63%±0.86%, P<0.001). The ratio of Th17/Treg was significantly higher than that of controls (36.89±6.58vs0.79±0.72, P<0.001)Relapse AA showed higher levels of Th17cells (1.83%±0.85%vs1.30%±0.68%, P<0.05) and lower levels of Treg significantly (0.79%±0.64%vs1.08%±0.61%, P< 0.05). The proportion of Th17was significantly higher in active AA than nonactive AA (1.72%±0.79%vs1.37%±0.79%, P<0.05). Similar results were found in patients with the course of disease less than6months (1.79%±0.86%vs1.09%±0.41%, P<0.001), and with the positive TPO antibody. However, there was no significant difference between slight AA and severe AA.ConclusionsThe increased pro-immunologic action due to high expresstion of Th17cells and the deficit of immunosuppressive effect of Treg cells may participate in the pathogenesis of alopecia areata. The variation of Thl7/Treg is associated with the relapse of AA. The level of Th17subsets is related to the activity and the course of AA.