A novel marker in patients with alopecia areata

Abstract

Alopecia areata is a chronic inflammatory disease. The main manifestation of the disease is usually a rapid onset of hair loss in a specific area and usually round.1 The prevalence of Alopecia areata is 1.7%.2,3 The skin of the affected area is flat or slightly red and may have short hair pieces. Hair shaft in alopecia areata not well shaped and fragile when it reaches the surface.4 The presence of hair in the form of an exclamation mark in the lesion near the proximal end of the hair that is thinner can be helpful in diagnosis. Hair loss may be completely reversible, become chronic or cause loss of whole head hair or whole body hair.3‒5 Alopecia areata, depending on the extent and area of involvement, includes various types: PATCHY (most commonly, Ophiasis (at the scalp), Totalis (whole head hair) and Universalis (total head and body hair) .6,7 The presence of eosinophils in biopsy is a useful diagnostic symptom in cases with difficult to diagnose. Measurements of triiodothyronine, thyroxine, thyroid stimulating hormone, antithyroglobulin and anti-microsomal antibodies, especially for children, should be performed.8 Alopecia areata may be associated with these diseases: thyroid disease, severe anemia, Addison disease, vitiligo, lupus erythematosus, ulcerative colitis, diabetes mellitus and Down syndrome.8,9 (HSP) Heat shock protein was first introduced in 1964 by Ritossa showed that due to heat, a rearrangement of the fruit insect’s chromatin called Drosophila busckii is created and concluded that its synthesizing genes are activated by heat, so it is called heat shock protein.10 These proteins include about 1-2% of total protein in normal conditions and 4 to 6% in stress conditions in all eukaryotic cells.11 Based on the molecular weight, they are divided into five families: the heat shock protein family 104, the heat shock protein 90, the heat shock protein 70, the heat shock protein 60, and the small heat shock proteins such as the heat shock protein 27.12 Heat shock proteins exist in normal cells and prevent the creation of inappropriate spatial structures caused by inappropriate protein gathering but, due to biological stress and increased toxic and inflammatory chemicals, it is useful in protecting cells from stress.13,14 Oxidative stress indicates an imbalance between the appearance of free radicals of oxygen and the ability of the biological system to detoxify or repair their destructive effects.15 The HSP70 family is the most sensitive group of these proteins and has the most protected structure. HSP70 is a protein that binds to ATP and is found in 60-80% of the eukaryotic cells.16 The HSP70 is vital to both cell function and survival after stress. In addition to the thermal shock, several stimuli, including hypoxia, acidosis, active oxygen lines, active nitrogen classes, viral infections, malignancies, autoimmune disease, and induced transcription.17 Since inflammatory and immune factors play a role in the pathogenesis of alopecia areata, we decided to study the association between the serum level of HSP70 (as a systemic inflammatory marker) and the pathogenesis of alopecia areata.