Serum Th1, Th2, Th17 and innate immune system biomarkers are elevated in pediatric alopecia areata with and without concurrent atopic dermatitis: A cross-sectional study

Alopecia areata (AA) is a non-scarring alopecia with an autoimmune etiology, where aberrant T-lymphocyte mediated immune responses are implicated in its pathogenesis. Several robust studies have reported elevated Th1 (IFN-γ, CXCL9/10/11, IL-2RA, IL-12), Th2 (IL-10/13, CCL7/11/13/17/22/23, CCR4), Th17 (CCL20, PI3, S100A12) and innate (IL-6/8) immune biomarkers. Differences in biomarker profiles have been observed in AA patients with concomitant atopy. IL-13 was only elevated in atopic AA, while IFN-γ was only elevated in nonatopic AA, suggesting heterogeneity among AA patients. However, studies have yet to report biomarker profiles in pediatric AA patients. With increasing prevalence of AA in pediatric patients, a cross-sectional pilot study was conducted to investigate the biomarker profiles of pediatric patients with AA alone and AA with concomitant atopic dermatitis (AD).斑秃（Alopecia areata, AA）是一类以自身免疫为病因的非瘢痕性脱发，其发病机制涉及异常T淋巴细胞介导的免疫应答。多项高质量研究已报道，斑秃患者体内存在升高的Th1型免疫生物标志物（干扰素γ（IFN-γ）、趋化因子配体9/10/11（CXCL9/10/11）、白细胞介素2受体α（IL-2RA）、白细胞介素12（IL-12））、Th2型免疫生物标志物（白细胞介素10/13（IL-10/13）、趋化因子配体7/11/13/17/22/23（CCL7/11/13/17/22/23）、趋化因子受体4（CCR4））、Th17型免疫生物标志物（趋化因子配体20（CCL20）、PI3、S100A12）以及先天免疫型生物标志物（白细胞介素6/8（IL-6/8））。合并特应性体质的斑秃患者，其生物标志物谱存在显著差异：白细胞介素13（IL-13）仅在合并特应性的斑秃患者中升高，而干扰素γ（IFN-γ）仅在非特应性斑秃患者中升高，这提示斑秃患者群体存在异质性。然而目前尚无研究报道儿童斑秃患者的生物标志物谱。鉴于儿童斑秃的患病率逐年上升，本研究开展了一项横断面先导研究，旨在探究单纯斑秃以及合并特应性皮炎（atopic dermatitis, AD）的儿童斑秃患者的生物标志物谱。