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Int J Trichology. 2019 May-Jun;11(3):113-117. doi: 10.4103/ijt.ijt_9_19.

Tumor Necrosis Factor-like Weak Inducer of Apoptosis: A Novel Serum Marker in Patients with Severe Alopecia.

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Department of Dermatology and Andrology, Faculty of Medicine, Benha Univesity, Banha, Egypt.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha Univesity, Banha, Egypt.



Alopecia areata (AA) is a common form of nonscarring hair loss of scalp and/or body. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a multifunctional cytokine expressed on various cell types and tissues and acts through binding to its sole receptor factor-inducible 14 (Fn14). TWEAK/Fn14 activation contributes to various pathological processes, including cell proliferation and death, angiogenesis, carcinogenesis, and inflammation.


The aim of this current study was to measure serum levels of TWEAK in patients with AA and to assess the correlation between it and severity of the disease.

Subjects and Methods:

This study included 50 patients who had patchy AA, in addition to 50 apparently healthy controls. Severity of AA was assessed using Severity of Alopecia Tool Score. Serum TWEAK levels in all participants were determined using ELISA technique and were correlated with the severity of the disease.


Mean serum levels of TWEAK were significantly higher in AA patients, with a positive significant correlation between serum levels of TWEAK and severity of the disease.


TWEAK as a novel marker of many autoimmune inflammatory dermatological diseases, could be a promising marker in the diagnosis of AA, and also can be used as a prognostic marker for its severity.


Alopecia areata; Severity of Alopecia Tool Score; tumor necrosis factor-like weak inducer of apoptosis

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