Serum granulysin as a possible key marker of the activity of alopecia areata

Abstract Background Alopecia areata (AA) is an organ-restricted autoimmune condition of the hair follicles (HFs) that presents as nonscarring hair loss. A collapse of immunoprivilege for cell-mediated cytotoxicity and following attacks by cytotoxic T cells to anagen HFs are considered to play a majo...

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Published in:Journal of dermatological science 2014-01, Vol.73 (1), p.74-79
Main Authors: Ono, Sachiko, Otsuka, Atsushi, Yamamoto, Yosuke, Kataoka, Tatsuki R, Koyanagi, Itsuko, Miyachi, Yoshiki, Kabashima, Kenji
Format: Article
Language:English
Subjects:
Activity
Acute Disease
Adolescent
Adult
Aged
Allergic disorders
Alopecia areata
Alopecia Areata - blood
Alopecia Areata - diagnosis
Alopecia Areata - immunology
Antigens, Differentiation, T-Lymphocyte - blood
Biomarkers - blood
Case-Control Studies
Cell-mediated cytotoxicity
Chronic Disease
Comorbidity
Dermatology
Enzyme-Linked Immunosorbent Assay
Female
Granulysin
Humans
Immunohistochemistry
Male
Middle Aged
Predictive Value of Tests
Prognosis
Skin - immunology
Up-Regulation
Young Adult
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Summary:Abstract Background Alopecia areata (AA) is an organ-restricted autoimmune condition of the hair follicles (HFs) that presents as nonscarring hair loss. A collapse of immunoprivilege for cell-mediated cytotoxicity and following attacks by cytotoxic T cells to anagen HFs are considered to play a major role in the pathogenesis of AA. However, there has been no useful marker for the activity of AA to date. Objective The aim of this study is to examine whether granulysin, which is known to reflect the activity of cytotoxic immune responses, is related to the disease activity of AA. Methods We evaluated serum granulysin levels in acute and chronic AA patients compared to healthy controls in the perspective of bald skin areas, prognosis, and co-existence of other allergic diseases. In addition, immunohistochemical analysis for granulysin-, CD4-, CD8-, and CD56-positive cells in the lesional skin of acute and chronic AA patients was performed. Results Serum granulysin levels were significantly elevated in both acute and chronic AA patients ( p = 0.00081 and p = 0.0012, respectively). Intriguingly, serum granulysin levels were significantly associated with the broader bald skin areas (Spearman's r = 0.59, p = 0.017), and poorer prognosis in acute AA patients ( p = 0.0080). They were also associated with co-existence of allergic disorders in AA patients ( p = 0.026). Immunohistochemical staining demonstrated that perifollicular granulysin-bearing cells were mainly detected in acute AA lesions with dense lymphocytic infiltration, and that these granulysin-bearing cells were consistent with CD8+ T cells. Conclusion The serum granulysin level may be a useful and novel marker for the disease activity in the acute phase of AA.
ISSN:0923-1811
1873-569X
DOI:10.1016/j.jdermsci.2013.08.009