Areas TA Research Articles

A case control study of the oestrogen receptor beta (ER) gene polymorphism (rs1255953 SNP) in patients with alopecia areata

BackgroundAlopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease phenomenon, mediated by T lymphocytes, resulting from disturbances in hair follicle immune privilege with genetic predisposition and environmental trigger that targets anagen hair follicles. ObjectivesTo investigate the association between the rs1255953 variant of ESRβ gene and the risk of AA in a sample of the Egyptian population aiming at predicting individual susceptibility, disease severity and outcomes. MethodsA case-control study of 116 AA patients and 116 matched healthy controls. The most frequent variants in the ESRβ gene rs1255953 (C/T) polymorphism were selected and genotyped using Real-Time polymerase chain reaction technology. ResultsAllelic discrimination analysis revealed that the heterozygote genotype CT of ESR2 rs1255953 polymorphism was more prevalent in AA female patients than in controls (p-value =0.027), it was found that CT genotype increases the odds of having AA in females by 6.750 times. The rs1255953 ESRB variant was significantly higher in AA female patients than controls, especially among heterozygous and recessive models In males, ESRβ rs1255953 polymorphism had no clinical significance regarding the risk of alopecia areata. Conclusionrs1255953 CT genotype of ESRβ is a risk factor for alopecia areata in females.

Patient characteristics and disease burden of alopecia areata in the Danish Skin Cohort

PurposeAlopecia areata (AA) is a common disorder of patchy hair loss which carries a substantial psychological burden for patients. The current understanding of AA prevalence, disease course and burden is...

Serum level of retinol-binding protein 4 in alopecia areata: relation with recurrence and severity

BackgroundAlopecia areata (AA) is a common, clinically heterogeneous, autoimmune T-cell-mediated, nonscarring hair-loss disorder. Many researchers hypothesize that several components of the retinoic acid metabolic pathway are present in the hair follicles of healthy controls. The pathogenesis of AA may be related to increased serum retinol-binding protein-4 (RBP4) level.ObjectivesTo evaluate RBP4 level in serum obtained from patients with AA in comparison with controls and detect its relation with severity of alopecia areata tool score and recurrence of disease.Patients and methodsThe study included 52 AA patients (26 AA first episode, 26 patients with recurrent alopecia) and 26 patients in the control group.ResultsRBP4 was significantly elevated in serum level of AA patients in comparison with serum level of controls (P < 0.001), but there was no significant positive correlation between serum RBP4 and severity of alopecia areata tool score.ConclusionAA was associated with increased serum levels of RBP4 in comparison with controls. These results suggested the role of RBP4 in the pathogenic process of AA.

Epidemiology, management and the associated burden of mental health illness, atopic and autoimmune conditions, and common infections in alopecia areata: protocol for an observational study series

IntroductionAlopecia areata (AA) is a common cause of immune-mediated non-scarring hair loss. Links between AA and common mental health, autoimmune and atopic conditions, and common infections have previously been described...

A prospective comparative study of two regimens of diphenylcyclopropenone (DPCP) in the treatment of alopecia areata

BackgroundAlopecia areata (AA) is a chronic disorder and the best treatment regimen for it is unknown. Currently, one of the best documented treatment modalities for AA is topical immunotherapy. AimTo evaluate the safety and efficacy of a novel method (multi-concentration patch test) versus standard protocol for topical immunotherapy. MethodsA prospective randomized clinical trial was conducted on 30 patients with Alopecia areata, half of them received DPCP with a novel method using multi-concentration patch test to determine the optimal initiating concentration of DPCP (case group) and the other half experienced immunotherapy according to the standard protocol (control group). Percentage of hair regrowth after 6 months of treatment and the incidence of drug-related adverse effects were evaluated and compared between the two groups. (IRCT registration code: IRCT20141209020250N5). ResultsAbsolute and relative hair regrowth percentages were reported 25% and 41.49% in case group and 8.2% and 14.21% in control group respectively. Considerable response (more than 75% hair regrowth) was observed in 4 (26.6%) patients in case and 1 (6.6%) patient in control group. The clinical response was initiated about 7 weeks sooner in case compared to the control group (14 versus 7.38 weeks, P: 0.001). Overall, clinical response was higher in patients received new protocol, compared to control group. Moreover, patients who experienced new protocol had a higher level of treatment satisfaction in comparison with patients having standard protocol (P: 0.012). ConclusionThis study revealed the effectiveness and safety of the novel multi-concentration patch test DPCP therapy for AA and its priority to conventional method, at least in terms of shortened duration of DPCP immunotherapy.

Hair follicle-derived mesenchymal stem cells decrease alopecia areata mouse hair loss and reduce inflammation around the hair follicle

BackgroundAlopecia areata (AA) is a common autoimmune hair loss disease with increasing incidence. Corticosteroids are the most widely used for hair loss treatment; however, long-term usage of hormonal drugs is associated with various side effects. Mesenchymal stem cells (MSCs) therapy has been studied extensively to curb autoimmune diseases without affecting immunity against diseases.MethodsHair follicle-derived MSCs (HF-MSCs) were harvested from the waste material of hair transplants, isolated and expanded. The therapeutic effect of HF-MSCs for AA treatment was investigated in vitro AA-like hair follicle organ model and in vivo C3H/HeJ AA mice model.ResultsAA-like hair follicle organ in vitro model was successfully established by pre-treatment of mouse vibrissa follicles by interferon-γ (IFN-γ). The AA-like symptoms were relieved when IFN-γ induced AA in vitro model was co-cultured with HF-MSC for 2 days. In addition, when skin grafted C3H/HeJ AA mice models were injected with 106 HF-MSCs once a week for 3 weeks, the transcription profiling and immunofluorescence analysis depicted that HF-MSCs treatment significantly decreased mouse hair loss and reduced inflammation around HF both in vitro and in vivo.ConclusionsThis study provides a new therapeutic approach for alopecia areata based on HF-MSCs toward its future clinical application.

Determination of serum 25-hydroxyvitamin D levels in patients with alopecia areata and their comparison with levels in healthy controls: A cross-sectional study

BackgroundAlopecia areata (AA) has been postulated to be an autoimmune disease affecting the hair follicles. Because vitamin D receptors are present in the immune system and hair follicles, vitamin D has been hypothesized to affect the disease.ObjectiveThe aim of this study was to determine serum 25-hydroxyvitamin D levels and the percentage of vitamin D deficiency in AA patients and compare them with those in healthy controls in a Philippine tertiary hospital.MethodsThis cross-sectional study included 29 AA patients and 29 healthy controls. The serum 25-hydroxyvitamin D levels were determined using the chemiluminescent immunoassay method.ResultsThere was no significant difference in the mean vitamin D levels between AA patients (24.41 ± 6.87 ng/mL) and healthy controls (24.68 ± 6.68 ng/mL) (P = .88). The percentage of patients with vitamin D deficiency, defined as <20 ng/mL, trended to higher among AA patients (34.4%) than among healthy controls (17.2%), with an odds ratio of 2.53 (95% CI 0.73-8.65), though this was not statsitically significant.LimitationsThis study involved a limited number of patients in an urbanized area in the Philippines, and majority of the AA cases seen had mild AA.ConclusionThe trend toward the increased percentage of vitamin D-deficient individuals among AA patients seen in this study may provide insight into the association of vitamin D with AA.

A randomized trial of diphenylcyclopropenone (DPCP) combined with anthralin versus DPCP alone for treating moderate to severe alopecia areata

BackgroundAlopecia areata (AA) is a chronic autoimmune disorder. Finding the best treatment regimen for it remains a challenge. Currently, one of the best documented treatment modalities for AA is topical immunotherapy. AimTo evaluate the safety and efficacy of combined DPCP and anthralin versus standard protocol (DPCP alone). MethodsA prospective randomized clinical trial was conducted on 50 patients with Alopecia areata who received DPCP alone (group D) or in combination with anthralin (group D/A). Percentage of hair regrowth after 6 months of treatment and the incidence of drug-related adverse effects were evaluated and compared between the two groups. ResultsComplete hair regrowth was observed among three patients in each group (18.75% in Group D and 15.79% in Group D/A) after 6 months. Moreover, 25% and 31% of patients in group D and 21% and 47% of patients in group D/A had > 75% and > 50% hair regrowth respectively at the end of the study (P-value: 0.696). In addition, earlier age of onset, chronicity of lesions, nail involvement, facial hair loss and extensive lesions at baseline were associated with poor clinical outcome. ConclusionDPCP and anthralin was as effective as DPCP alone and anthralin did not add to the effect of DPCP in treating AA.

Evaluation of the level of serum Interleukins (IL-2, IL-4, IL-15 andIL-17) and its relationship with disease severity in patients with alopecia areata

BackgroundAlopecia areata (AA) is a hair disease that causes hair loss without scarring. The etiopathogenesis of AA has not been fully understood yet. ObjectiveTo determine serum interleukin levels (IL-2, IL-4, IL-15, and IL-17) in patients diagnosed with alopecia areata and to investigate the relationship of IL levels with the duration and severity of alopecia areata and the response to tofacitinib therapy. MethodsPatients (≥16 years old) diagnosed with alopecia areata and healthy individuals as a control group was enrolled. Baseline serum interleukin levels of the patients and controls were measured. In the patient group receiving tofacitinib therapy, serum interleukin levels were measured again after 6 months. Disease severity for alopecia areata was assessed using the Severity of Alopecia Tool. ResultsSixty-one AA patients and 30 healthy individuals were included; they were comparable regarding age and sex. The mean disease duration for AA was 7 ± 6 years and the baseline mean Severity of Alopecia Tool score was 71 ± 30 (range, 20–100). Baseline IL-2, IL-4 and IL-15 levels were significantly higher in the patient group than those in the control group (p < 0.001 for each). No significant correlation was found between the baseline interleukin levels and either disease duration or disease severity (baseline Severity of Alopecia Tool score). Among the patients receiving tofacitinib (n = 22), all interleukin levels significantly decreased after treatment. However, no significant relationship between the change in interleukin levels and the change in the Severity of Alopecia Tool scores was observed after tofacitinib treatment. Study limitationsThis is a monocentric study conducted in a single university hospital. ConclusionHigh interleukin levels in alopecia areata patients and the significant decrease with treatment support the idea that interleukins have a role in pathogenesis. Nevertheless, no relationship could be demonstrated between IL levels and disease duration or severity.

Alternative uses of ustekinumab for non-indicated dermatological conditions: a systematic review.

Ustekinumab is approved for the treatment of psoriasis and Crohn's disease. Because many dermatological conditions are due to immune-mediated development, ustekinumab may be effective in other conditions. A systematic review of the off-label uses of ustekinumab, as well as on-label adverse effect, was performed, reporting on clinical improvement. MEDLINE, Embase, Web of Science, and Cochrane databases were searched for studies regarding ustekinumab treatment of rativa (HS), lichen planus (LP), pyoderma gangrenosum (PG), pityriasis rubra pilaris (PRP), cutalopecia areata (AA), atopic dermatitis (AD), Bechet's disease, bullous pemphigoid (BP), hidradenitis suppuaneous sarcoidosis, cutaneous systemic lupus erythematosus (SLE), and vitiligo. Descriptive statistics were performed. 74 articles of 4596 screened were included, and reported on 212 patients receiving ustekinumab treatment. Across all studies, ustekinumab showed promise in treating patients: AA (10/12 patients; 83.3% improvement), AD (28/74 patients; 37.8% improvement), HS (42/52 patients; 80.8% improvement), and PRP (25/27 patients; 92.6% improvement), among others. Adverse events were noted with the use of ustekinumab, including development of AA (four patients), AD (three patients), and BP (four patients), among others. Ustekinumab can be a promising option for patients with dermatological conditions refractory to traditional therapies. Adverse events must be monitored in certain patients.

Induction of alopecia areata in C3H/HeJ mice using cryopreserved lymphocytes

BackgroundAlopecia areata (AA) is an autoimmune disease resulting in non-scarring hair loss. Animal models are useful means to identify candidates for therapeutic agents. The C3H/HeJ mouse AA model induced via transferring cultured lymphoid cells isolated from AA-affected mice is widely used for AA research. However, this conventional method requires the continuous breeding of AA mice. ObjectiveWe aimed to establish a new method to generate AA model using the transfer of cryopreserved cells, which allows the rapid induction of a large number of AA mice when needed. MethodsWe cryopreserved lymph node cells soon after isolation from AA-affected mice and injected thawed-cultured cells into recipient mice. H&E staining, immunohistochemical staining, quantitative real-time PCR and ELISA were conducted to identify pathological characteristics. Flow cytometry was performed to reveal the profile of transferred cells. ResultsMore than 90 % of recipient mice developed AA-like hair loss and showed inflammatory cell infiltration around anagen hair follicles, markedly increased mRNA expressions of interferon-γ, CXCL11, and granzyme B, and elevated interferon-α protein levels in the skin compared with naïve mice. Higher percentages of effector memory T cells and dendritic cells in transferred cells resulted in a higher incidence of AA. ConclusionThis is the first report to establish a method for generating AA mice using cryopreserved lymphocytes. These AA mice have similar pathological characteristics to AA mice generated with the conventional method and AA patients. This convenient and reproducible method is expected to be valuable for AA study.

UL 16 Binding Protein 3 gene expression: Does it have an association with Alopecia Areata?

ObjectiveThis study aimed to detect UL-16 Binding Protein -3 (ULBP3) gene expression levels in cases with AA and to correlate those levels with the clinical course of the disease. BackgroundAlopecia Areata (AA) is considered as the most widespread immune-mediated disorder in both sexes of all ages in all ethnic individuals. Gene theory is considered to be a well appreciated tool for understanding the disease's pathogenesis. Association with UL 16 Binding Protein (ULBP) genes has been detected with autoimmune disorders. Patients and methodsThis study included 85 subjects: 55 patients suffering from AA and 30 age- and sex-matched healthy control subjects. The expression level of ULBP3 mRNA was estimated using the technique of Real-Time Polymerase Chain Reaction (RT-PCR). ResultsLevels of ULBP3 mRNA in cases were significantly higher in patients with AA in comparison with controls. Also, there were significant correlations between ULBP3 mRNA levels and age of patients and disease duration in years. ConclusionsULBP3 upregulation in AA enforces the theory that postulates the autoimmune nature of AA and ULBP3 may be involved in the pathogenesis of Alopecia Areata and its progression.

Patient Perspectives of the Social, Emotional and Functional Impact of Alopecia Areata: A Systematic Literature Review.

IntroductionAlopecia areata (AA) is a chronic, autoimmune disease of hair loss, which can significantly affect the emotional and psychological well-being of patients. A systematic literature review was conducted to better understand the burden of AA from the patient perspective.MethodsEmbase, MEDLINE and Cochrane databases were searched for published studies (2008–2018) reporting on assessments of health-related quality of life (HRQoL) for patients with AA. Qualitative, and quantitative data were collected.ResultsThe review included 37 studies encompassing a range of clinical outcome assessment (COA) tools. None of the COA tools were specific for AA, and only one study used the Hairdex scale, which was designed to evaluate HRQoL in patients with disorders of the hair and scalp. All studies reported substantial impact on HRQoL due to AA, both overall and in domains related to personality (i.e. temperament and character), emotions and social functioning. Acute stress was also noted, and several studies identified lack of emotional awareness (alexithymia) in 23–50% of the patients with AA.ConclusionsAlthough it is well-established that patients with AA experience anxiety and depression, they also experience a decrease in HRQoL in many other areas, including personality, emotions, behaviors and social functioning, and these changes may be accompanied by acute stress and alexithymia. There is a need to achieve consensus on a core set of measures for AA and to develop and validate AA-specific measurement tools for use in future studies, to attain a clearer understanding of the impact of AA on patients.Trial RegistrationPROSPERO registration number; CRD42019118646.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-021-00512-0.

Alopecia areata—New updates with long‐term use of JAK inhibitors

AbstractAlopecia areata (AA) is an autoimmune condition of multifactorial etiology that affects about 2% of the general population. It is a disease leading to significant emotional and psychosocial distress. There are very limited treatment options available for AA with no therapy demonstrating sustained remission long term. Understanding the genetic and molecular mechanisms of AA have led to the development of novel molecularly targeted treatments such as the Janus Kinase (JAK) inhibitors. Evidence suggests that JAK inhibitors may be broadly useful in dermatology with promising developments in open‐label clinical trials for AA. Here, the results of long‐term use of JAK inhibitors are reviewed and discussed for moderate‐to‐severe AA.

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

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.

Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grounded theory study

BackgroundAlopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions.MethodsThe study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved.ResultsThe constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance.ConclusionThe findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model.

\u201c\u2018You lose your hair, what\u2019s the big deal?\u2019 I was so embarrassed, I was so self-conscious, I was so depressed:\u201d a qualitative interview study to understand the psychosocial burden of alopecia areata

BackgroundAlopecia areata (AA) is characterized by hair loss that can affect the scalp and body. This study describes the psychosocial burden of AA.MethodsParticipants diagnosed with AA who had experienced ≥50% scalp hair loss according to the Severity of Alopecia Tool (SALT) were identified by clinicians. A semi-structured interview guide, developed with expert clinician input, included open-ended questions to explore patients’ experiences of living with AA. Data were thematically analyzed to identify concepts and relationships.ResultsParticipants (n = 45, 58% female, mean age 33.3 years [range 15–72], mean SALT 67.2 [range 0–100]) described the AA diagnosis as “devastating”. Both males and females reported emotional and psychological impacts of AA including feeling sad/depressed (n = 21), embarrassed/ashamed (n = 10) and angry/frustrated (n = 3). Patients felt helpless (n = 5) due to the unpredictability of disease recurrence, and anxious (n = 19) about judgement from others. Many patients avoided social situations (n = 18), which impaired relationships and increased isolation. Coping strategies included concealment of hair loss through wigs or make-up, although fear of the displacement of these coverings also caused anxiety and the avoidance of activities that could result in scalp exposure (n = 22). Some patients became more accepting of AA over time, which lessened the emotional impact, though efficacious treatment was still desired. A conceptual framework was developed, and a conceptual model was created to depict the relationship between the physical signs/symptoms and the associated psychosocial effects of AA.ConclusionAA impairs patients’ emotional and psychological wellbeing, relationships and lifestyles. Greater disease awareness and effective treatments are needed.

Prevalence of Alopecia Areata in Saudi Arabia: Cross-Sectional Descriptive Study.

BackgroundAlopecia areata (AA) is a common autoimmune disorder worldwide that affects the hair. Population differences have been observed in disease prevalence and clinical features, but no studies have examined AA prevalence at a large scale. In Saudi Arabia, information is lacking about AA characteristics.ObjectivesA quantitative, observational, cross-sectional study was conducted to assess AA prevalence, characteristics, and gender differences in Saudi Arabia.Materials and methodsThe study has used a validated Arabic questionnaire that targeted Saudi Arabia residents with a history of AA.A validated Arabic questionnaire was used to target Saudi Arabia residents with a history of AA, and the data collection instrument and written informed consent were distributed on Twitter and Facebook after permission from the Institutional Review Board. Prior to the study, accuracy validation for correct diagnosis by participants was performed in a 50-volunteer pilot test, which indicated an acceptable level of 96% accuracy. The questionnaire included high-quality images of different AA types and the collected data focused on variables such as the age of onset, affected body parts, treatment type, and family history of AA.ResultsA total of 5,362 participants returned completed questionnaires, of whom 741 (13.8%) had experienced AA at least once in their lives. Most were aged 11-30 years (69%), and the mean age of diagnosis was 18.6 years. Thirty-six percent (36%) of those with AA reported having a first-degree relative with the disease, and cross-sectional prevalence was 5.2%. Three-hundred fifty-nine (359; 18.9%) males and 382 (11%) females had AA. Twenty-nine point four percent (29.4%) of AA patients recovered in less than three months of AA onset, and 59.4% recovered in less than one year.ConclusionAA prevalence in Saudi Arabia is higher than in Western countries with a lower age of onset than in the former. AA affected males more than females and the mean age of onset was lower in the latter. Both male gender and young age of onset implied a worse prognosis.

Alopecia areata susceptibility variant in MHC region impacts expressions of genes contributing to hair keratinization and is involved in hair loss.

BackgroundAlopecia areata (AA) is considered a highly heritable, T-cell-mediated autoimmune disease of the hair follicle. However, no convincing susceptibility gene has yet been pinpointed in the major histocompatibility complex (MHC), a genome region known to be associated with AA as compared to other regions.MethodsWe engineered mice carrying AA risk allele identified by haplotype sequencing for the MHC region using allele-specific genome editing with the CRISPR/Cas9 system. Finally, we performed functional evaluations in the mice and AA patients with and without the risk allele.FindingsWe identified a variant (rs142986308, p.Arg587Trp) in the coiled-coil alpha-helical rod protein 1 (CCHCR1) gene as the only non-synonymous variant in the AA risk haplotype. Furthermore, mice engineered to carry the risk allele displayed a hair loss phenotype. Transcriptomics further identified CCHCR1 as a novel component interacting with hair cortex keratin in hair shafts. Both, these alopecic mice and AA patients with the risk allele displayed morphologically impaired hair and comparable differential expression of hair-related genes, including hair keratin and keratin-associated proteins (KRTAPs).InterpretationOur results implicate CCHCR1 with the risk allele in a previously unidentified subtype of AA based on aberrant keratinization in addition to autoimmune events.FundingThis work was supported by JSPS KAKENHI (JP16K10177) and the NIHR UCLH Biomedical Research center (BRC84/CN/SB/5984).

Efficacy of Postbiotics in a PRP-Like Cosmetic Product for the Treatment of Alopecia Area Celsi: A Randomized Double-Blinded Parallel-Group Study.

IntroductionAlopecia areata (AA), also known as ‘area Celsi’, is the second most common form of hair loss affecting the scalp. Newly proposed treatments for AA include low-level light therapy, biologics such as Janus kinase inhibitors and autologous platelet-rich plasma (PRP), which is a well-known “elixir” for hair growth. Bioactive peptides developed through biotechnological applications have been used to overcome the limitations of PRP. More recently, the involvement of microbiota in hair growth disorders, in AA in particular, has been reported, and the usefulness of microbial metabolites, i.e. postbiotics, has been suggested.MethodsThis study was a randomized double-blinded parallel-group study in which 160 persons of both sexes affected by AA and aged between 18 and 60 years were enrolled. The subjects were randomly assigned to a treatment group (group 1), receiving the TR-PRP plus-Celsi cosmetic product, and a placebo group (group 2). The SALT (Severity of Alopecia Tool) score was determined in both groups at baseline and after 2 and 3 months of treatment, and the results compared between groups.ResultsThe subjects in group 1 showed a significant change from baseline in SALT score at 2 months of treatment (61.04% ± 3.45%; p < 0.0001), with a further improvement at the end of treatment (3 months) (69.56% ± 4.32%; p < 0.0001). No significant changes from baseline were reported for the subjects in group 2 (T1: 26.45% ± 3.64%; T3: 27.63% ± 7.61%).ConclusionsThe results of this study provide further proof of the efficacy of bioactive peptides that mimick the growth factors present in PRP in subjects affected by AA. They also add to our knowledge of the link between microbiota and hair growth disorders, emphasizing the importance of studies on the microbial community and microbial metabolites as a novel therapeutic approach.