| Background:Alopecia areata(AA)is a non-scarring and local hair loss disease which is involved in Adnexal hair follicles.Its main clinical manifestation is a sudden patchy hair loss with no obvious symptoms.In a patient of alopecia areata,we can oberserve exclamation hairs,vellus hairs,yellow spot signs,broken hairs and other signs by the trichoscope,which help us to distinguish from other simILar diseases.At present,the cause of alopecia areata is not yet clear.Most scholars believe that a variety of factors are related to alopecia areata,such as autoimmunity,inheritance,environment,psychological pressure and so on.T cell mediated autoimmunity is the main reason leading to the onset of alopecia areata among these factors.Modern research have found that Th17/Treg imbalance and its related abnormal cytokine concentrations can lead to the development of autoimmune diseases,such as psoriasis,vitiligo,systemic lupus erythematosus,rheumatoid arthritis et al.This phenomenon is also foud in alopecia areata.Notch signaling pathway may regulate Th17/Treg imbalance,and some studies have found that Notch genes are related to severe alopecia areata.Now domestic and international researchs about Notch signal abnormality and Th17/Treg imbalance of alopecia areatas are less reported.Mostly Notch signal abnormality or Th17/Treg imbalance is reported alone.It is rare that a reaearch including Notch signal abnormality and Th17/Treg imbalance is aiming to explore the pathogenesis of Alopecia areata.The experiment was divided into two partsSection ?:Literature ReviewThrough a review of relevant literatures,literature review 1 described that Notch signaling pathway abnormality and Th17/Treg imbalance were related to the onset of alopecia areata.Literature review 2 analysed in detail the evolution of the etiology,pathogenesis and dialectical t treatment of alopecia areata in traditional Chinese medicine,Since ancient times.Section ?:Experimental StudyObjective:To explore the effect of Th17/Treg imbalance,Notch signaling pathway abnormality in the pathogenesis of alopecia areata.To explore the relationship of the two factors on the duration and severity of alopecia areata.Experimental Method1.C3H/HEJ mice were divided into control group and model group,then we compared the percentage defference of Th17 cells and Treg cells in two groups by flow cytometry.2.We detected the expression difference of Th17 cells,Treg cells,Notchl receptor in peripheral blood of patients with alopecia areata and healthy people by flow cytometry.3.We detected related cytokines of Th17/Treg cells and partial ligands of Notch signal in patients serum with alopecia areata and healthy human serum by enzyme-linked immunosorbent assay(ELISA).Experimental results1.The percentage of Th17 cells in mouse spleen of the model group was higher than that of the control group.The percentage of Treg cells was lower than that of the control group.The percentage of Th17 cells,the percentage of Treg cells in the peripheral blood of two groups had no difference.2.The percentage of Th17 cells in peripheral blood of patients with alopecia areata was higher than that of the control group,the percentage of Treg cells was lower than that of the control group,the percentages of CD4+Notch1+T cells and CD8+Notch1+T cells were both higher than that of the control group.For these four indicators,there was no difference in the groups of short duration(<6 months)and long duration(>6 months).For these four indicators,the percentage of CD4+Notch1+T cell in the group of mild alopecia areata was higher than that of severe alopecia areata;the percentage of Th17 cells,Treg cells,CD8+Notch1+T cells showed no difference in two groups of mild and severe alopecia areata.3.The concentration of IL-17 in serum of patients with alopecia areata was higher than that of the normal group,the concentration of TGF-? and IL-10 was lower than that of the normal group,the concentration of IL-6,IL-23,Jagged-1,and Delta-like4 had no difference in the two groups.The difference of these seven indexs in the two groups of mild and severe alopecia areata:noly the concentration of IL-23 in the two groups was different,the concentration of IL-23 in mild alopecia areata was lower that of severe alopecia areata,the remaining six indexs showed no difference in the two groups.The difference of these seven indexs in the two groups of short and long duration:noly the concentration of IL-23 in the two groups of short and long duration was different,the concentration of IL-23 in the groups of short duration was lower that of long duration,the remaining six indexs showed no difference in the two groupsConclusion:Imbalance of Th17/Treg cells and a rise in Notch1 receptor are involved in the pathogenesis of alopecia areata.There is no clear correlation between the imbalance of Th17/Treg cells and the severity of alopecia areata or duration.The rise of Notchl receptor has nothing to do with the clinical course of alopecia areata.Notch 1 receptor of CD4+T cells is associated with the severity of alopecia areata.IL-23 for the pathogenic factor,its serum level can reflect course and severity of alopecia areata. |
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