Serum level of osteopontin in patients with alopecia areata and its correlation with ocular changes

Abstract

Background Alopecia areata (AA) is a type of nonscarring hair loss affecting anagen-stage hair follicles with a multifactorial autoimmune pathogenesis and an unknown etiology. Osteopontin (OPN), also known as bone sialoprotein I and early T-lymphocyte activation-1, is a member of the small integrin-binding ligand N-linked glycoprotein family. OPN is widely distributed in human tissues and expressed in several cell types. The significant increase in the immunopositivity of the perifollicular inflammatory cells for OPN in AA cases as well as its strong expression in the hair follicles, especially the miniaturized ones, offers further proof for its role in AA. OPN was found to be strongly expressed in retina, trabecular meshwork, optic nerve, iris, and vitreous humour. Ocular findings associated with AA, the most prevalent of these, are cataracts and retinal pigment epithelial changes. Aim The aim of the present study is to evaluate serum level of OPN in patients with AA and correlate it with ocular changes to assess its possible role in the pathogenesis of the disease. Patients and methods This case–control study included 40 patients who presented with AA diagnosed on the basis of typical clinical features, representing the patient group. Moreover, 40 age-matched and sex-matched apparently healthy individuals were also included, representing the control group. All patients were recruited (according to inclusion and exclusion criteria) from the Outpatient Clinic of Dermatology and Venereology of Al-Zahra University Hospital during the period from February 2017 to February 2018. Results In our study, there was a highly statistically increase in serum level of OPN in the patient group. There was no significant difference between male and female regarding serum levels of OPN. There was a statistically significant positive correlation between serum OPN level in patient group and duration of disease. There was no correlation between serum OPN and age and severity of alopecia tool score. There was more significant increase in eye manifestations in patients than controls. Mean break-up time was statistically higher among patients than controls. There was a statistically highly significant positive correlation between serum OPN level and break-up time, lens abnormalities, and fundus abnormalities. Conclusion Patients with alopecia may have more lenticular and retinal abnormal findings than individuals without alopecia, but those findings do not interfere with visual acuity.