MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL FEATURES OF TISSUE HOMEOSTASIS IN PATIENTS WITH ALOPECIA AREATA IN THE CHRONIC STAGE ASSOCIATED WITH METABOLIC SYNDROME AND THE NON-BURDENED COURSE OF THE DISEASE

Abstract

Introduction: Alopecia areata (AA) is a tissue-specific disease of the hair follicles, manifested by foci of baldness on the head and other areas of the skin. The aim of the study was to identify the tissue homeostasis state on the basis of pathomorphological and immunohistochemical changes taking into account the features of Ki67, bcl-2, caspase-3, and CD31 expression in patients with AA in the chronic stage associated with metabolic syndrome and the non-burdened course of the disease. Materials and methods: Pathomorphological and immunohistochemical studies of Ki67, bcl-2, caspase-3, and CD31 expression in biopsies specimens from skin lesions in the chronic stage of the disease were performed in 11 patients with AA associated with metabolic syndrome and the non-burdened course of the disease. Results: The results of complex morphological study showed that in skin biopsies of patients with AA with metabolic disorders pathomorphological changes were more affected both in the epidermis and skin appendages - degenerative changes in the epithelium, in the dermis, manifestations of appendage atrophy and stromal fibrosis. In patients with AA without metabolic disorders the proliferative potential of epithelial cells (Ki67 proliferation index) was 20-25%, in cases of AA with metabolic syndrome - 5-10%, indicating a decrease in regenerative capacity of the tissue. The state of the microcirculatory bed (CD31) in cases of AA without metabolic disorders is more favorable for the trophic tissue function and decreases in the group of AA with metabolic disorders. It was found that activation of pathological cell apoptosis was observed in cases of AA with metabolic disorders and lower level of bcl-2 expression. In our observations, the level of expression of caspase-3 was at a relatively high level, indicating the activation of pathological apoptosis in the tissues of the affected areas. Conclusions: Our pathomorphological, immunohistochemical data allows us to assert that it is advisable to carry out a biopsy of the affected areas with the establishment of levels of proliferative activity of epithelial and stroma cells, the state of the microcirculatory vessels, the possibilities of repair of the affected areas, assessment of the level of apoptosis in order to predict the course of the disease and usage of the personified approach to treatment.