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Indian J Dermatol Venereol Leprol. 2019 Apr 23. doi: 10.4103/ijdvl.IJDVL_738_17. [Epub ahead of print]

A cross-sectional study of the histopathology and immunology of alopecia areata: Unearthing the role of the Janus kinase-signal transducer and activator of transcription pathway.

Author information

1
Department of Dermatology, Maulana Azad Medical College, Govind Ballabh Pant Hospital, New Delhi, India.
2
Department of Pathology, Maulana Azad Medical College, Govind Ballabh Pant Hospital, New Delhi, India.

Abstract

Background:

Alopecia areata is an autoimmune disease that occurs as a result of the loss of the inherent immune privilege of the hair follicle. It has been recently demonstrated that the interferon-γ/interleukin-15 feedback loop that signals via the Janus kinase-signal transducer and activator of transcription pathway is critical to the breakdown of this immune privilege.

Aims:

To evaluate the immunological distribution of CD4+ T-cells, CD8+ T-cells, phosphorylated signal transducer and activator of transcription 1 and study its relation with the clinical and histopathological findings of the disease.

Materials and Methods:

A total of 30 patients of alopecia areata were included in the study. Following a detailed history and clinical examination, a scalp biopsy was performed. Histopathology was studied and immunohistochemistry was done to demonstrate the positivity and distribution of CD4+ T-cells, CD8+ T-cells and phosphorylated signal transducer and activator of transcription 1.

Results:

The follicular count, number of anagen and terminal hair were found to be decreased, whereas the catagen, telogen and vellus hair were found to be increased in number. A peribulbar CD4+ T-cell infiltrate was seen in 70% cases, whereas a CD8+ T-cell infiltrate was seen in 83.3% cases. An intrabulbar CD4+ T-cell infiltrate was seen in 26.7% cases, whereas a CD8+ T-cell infiltrate was seen in 70% cases. Among the 25 hair follicles dermal papilla identified, 36.8% cases were found to be positive for phospho-signal transducer and activation of transcription-1.

Limitations:

The drawbacks of our study included a small sample size and the use of only vertical sectioning for the scalp biopsy samples.

Conclusion:

Phosphorylated signal transducer and activator of transcription 1 positivity as an indicator of signalling via the Janus kinase-1/2 pathway was seen in 36.8% of our cases highlighting the integral role of this pathway in the pathogenesis of alopecia areata.

KEYWORDS:

Alopecia areata; Janus kinase–signal transducer and activator of transcription; histopathology; immunology; pathogenesis

PMID:
31031313
DOI:
10.4103/ijdvl.IJDVL_738_17

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