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
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Date
2019-09
Journal Title
Journal ISSN
Volume Title
Publisher
Indian Association of Dermatologists, Venereologists & Leprologists
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.
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Keywords
Alopecia areata, histopathology, immunology, Janus kinase–signal transducer and activator of transcription, pathogenesis
Citation
Bansal Anuva, Relhan Vineet, Garg Vijay Kumar, Saran Ravindra Kumar. 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. Indian Journal of Dermatology, Venereology and Leprology. 2019 Sep; 85(5): 455-461