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Infiltration of Mast Cells in Scalp Biopsies of Patients with Alopecia Areata or Androgenic Alopecia Versus Healthy Individuals: A Case-Control Study

Soheila Nasiri, Alireza Salehi, Azadeh Rakhshan

Background: Alopecia areata (AA) and androgenic alopecia (AGA) are the most common types of alopecias. Recently, the role of mast cells in inflammatory diseases has become the focus of many studies. However, few studies have been conducted on their role in AA and AGA. Therefore, our study aimed to quantitatively evaluate the presence of mast cells in the AA and AGA specimens.Materials and Methods: Three groups of AA, AGA, and healthy control were studied (each group with 20 subjects). Patients were randomly selected from those referred to the dermatology clinics of Shahid Beheshti University. Specimens were obtained from the scalp, and perifollicular and perivascular areas were investigated. Results: Significantly higher perifollicular and perivascular mast cell counts were seen in both AGA and AA groups compared to healthy control (P<0.001 for both). Moreover, AA patients had more frequent perivascular mast cells than the AGA group (P=0.042). Among patients aged <40 years, perifollicular and perivascular mast cell counts were not significantly different among the three groups; however, subjects over 40 years of age in both groups had significantly more perifollicular and perivascular mast cells than healthy participants. There was a significant positive correlation between disease severity and mast cell counts in both perifollicular and perivascular areas in AA patients (P=0.001 for both). Conclusion: There was a significantly increased infiltration of mast cells in AA and AGA patients, and this increase was age and severity dependent. Moreover, the increase in mast cell proliferation is more dominant in AA patients. [GMJ.2020;9:e1962]

Alopecia Areata; Androgenic Alopecia; Mast Cell; Inflammation

Lolli F, Pallotti F, Rossi A, Fortuna MC, Caro G, Lenzi A, et al. Androgenetic alopecia: a review. Endocrine. 2017;57(1):9-17.

https://doi.org/10.1007/s12020-017-1280-y

PMid:28349362

Pratt CH, King LE, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017;3(1):1-17.

https://doi.org/10.1038/nrdp.2017.11

PMid:28300084 PMCid:PMC5573125

Villasante Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 2015;8:397-403.

https://doi.org/10.2147/CCID.S53985

PMid:26244028 PMCid:PMC4521674

McMichael AJ, Pearce DJ, Wasserman D, Camacho FT, Fleischer AB, Feldman SR, et al. Alopecia in the United States: outpatient utilization and common prescribing patterns. J Am Acad Dermatol. 2007;57(2):S49-S51.

https://doi.org/10.1016/j.jaad.2006.02.045

PMid:17637376

Nigrovic PA, Lee DM. Synovial mast cells: role in acute and chronic arthritis. Immunol Rev. 2007;217(1):19-37.

https://doi.org/10.1111/j.1600-065X.2007.00506.x

PMid:17498049

Peckham SJ, Sloan SB, Elston DM. Histologic features of alopecia areata other than peribulbar lymphocytic infiltrates. J Am Acad Dermatol. 2011;65(3):615-20.

https://doi.org/10.1016/j.jaad.2011.02.017

PMid:21684037

El-Domyati M, Attia S, Saleh F, Abdel-Wahab H. Androgenetic alopecia in males: a histopathological and ultrastructural study. J Cosmet Dermatol. 2009;8(2):83-91.

https://doi.org/10.1111/j.1473-2165.2009.00439.x

PMid:19527330

Benoist C, Mathis D. Mast cells in autoimmune disease. Nature. 2002;420(6917):875-8.

https://doi.org/10.1038/nature01324

PMid:12490961

Fehervari Z. Mast cells in autoimmune disease. Nature immunol. 2018;19(4):316-.

https://doi.org/10.1038/s41590-018-0080-8

PMid:29563623

Grace SA, Sutton AM, Abraham N, Armbrecht ES, Vidal CI. Presence of mast cells and mast cell degranulation in scalp biopsies of telogen effluvium. Int J Trichology. 2017;9(1):25.

https://doi.org/10.4103/ijt.ijt_43_16

PMid:28761261 PMCid:PMC5514792

Hogan AD, Schwartz LB. Markers of mast cell degranulation. Methods. 1997;13(1):43-52.

https://doi.org/10.1006/meth.1997.0494

PMid:9281467

Metz M, Maurer M. Innate immunity and allergy in the skin. Curr Opin Immunol. 2009;21(6):687-93.

https://doi.org/10.1016/j.coi.2009.09.009

PMid:19828302

Christoph T, Müller‐Röver S, Audring H, Tobin DJ, Hermes B, Cotsarelis G, et al. The human hair follicle immune system: cellular composition and immune privilege. Br J Dermatol. 2000;142(5):862-73.

https://doi.org/10.1046/j.1365-2133.2000.03464.x

PMid:10809841

Botchkarev VA, Eichmüller S, Peters EMJ, Pietsch P, Johansson O, Maurer M, et al. A simple immunofluorescence technique for simultaneous visualization of mast cells and nerve fibers reveals selectivity and hair cycle-dependent changes in mast cell-nerve fiber contacts in murine skin. Arch Dermatol Res. 1997;289(5):292-302.

https://doi.org/10.1007/s004030050195

PMid:9164640

Cetin ED, Savk E, Uslu M, Eskin M, Karul A. Investigation of the inflammatory mechanisms in alopecia areata. Am J Dermatopathol. 2009;31(1):53-60.

https://doi.org/10.1097/DAD.0b013e318185a66e

PMid:19155726

Bertolini M, Zilio F, Rossi A, Kleditzsch P, Emelianov VE, Gilhar A, et al. Abnormal interactions between perifollicular mast cells and CD8+ T-cells may contribute to the pathogenesis of alopecia areata. PLoS One. 2014;9(5).

https://doi.org/10.1371/journal.pone.0094260

PMid:24832234 PMCid:PMC4022513

Gunin AG, Kornilova NK, Vasilieva OV, Petrov VV. Age-related changes in proliferation, the numbers of mast cells, eosinophils, and cd45-positive cells in human dermis. J. Gerontol. A Biol Sci Med Sci. 2011;66(4):385-92.

https://doi.org/10.1093/gerona/glq205

PMid:21106704

Dunlop SP, Jenkins D, Spiller RC. Age-related decline in rectal mucosal lymphocytes and mast cells. Eur J Gastroenterol Hepatol. 2004;16(10):1011-5.

https://doi.org/10.1097/00042737-200410000-00010

PMid:15371925

Nguyen M, Pace AJ, Koller BH. Age-induced reprogramming of mast cell degranulation. J. Immunol. 2005;175(9):5701-7.

https://doi.org/10.4049/jimmunol.175.9.5701

PMid:16237060

Zhang X, Zhao Y, Ye Y, Li S, Qi S, Yang, Y, et al. Lesional infiltration of mast cells, Langerhans cells, T cells and local cytokine profiles in alopecia areata. Arch. Dermatol. 2015;307(4):319-31.

https://doi.org/10.1007/s00403-015-1539-1

PMid:25638328

Zhang B, Zhao Y, Cai Z, Caulloo S, McElwee KJ, Li Y, et al. Early stage alopecia areata is associated with inflammation in the upper dermis and damage to the hair follicle infundibulum. Australas. J. Dermatol. 2013;54(3):184-91.

https://doi.org/10.1111/ajd.12065

PMid:23808570

Szepietowski JC, Morita A, Tsuji T. Ultraviolet B induces mast cell apoptosis: a hypothetical mechanism of ultraviolet B treatment for uraemic pruritus. Med. Hypotheses 2002;58(2):167-70.

https://doi.org/10.1054/mehy.2001.1505

PMid:11812197

Jeong D-H, Lee G-P, Jeong W-I, Do S-H, Yang H-J, Yuan D-W, et al. Alterations of mast cells and TGF-β1 on the silymarin treatment for CCl4-induced hepatic fibrosis. WJG. 2005;11(8):1141.

https://doi.org/10.3748/wjg.v11.i8.1141

PMid:15754394 PMCid:PMC4250703

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