BACKGROUND
Alopecia areata (AA) is associated with atopic diseases (ADs), which are considered to be the predictors of severe course. An increase in the level of total IgE (tIgE), the Th2-mediated inflammation marker, is also noted in AA, but its correlation with the severity of alopecia is unreliable. Dupilumab, IL-4/IL-13 receptor blocking agent, shows efficacy in AA, especially in patients with high tIgE content.
OBJECTIVE
To analyze the relationship between the level of tIgE and clinical manifestations of AA considering the presence of ADs.
MATERIAL AND METHODS
The study included 102 patients aged 5—51 years diagnosed with AA, 55 (54%) of them had concomitant ADs. Quantified tIgE level was determined, the indices were compared with a control group of 16 healthy participants aged 5—42 years.
RESULTS
Patients with AA have been distributed according to the disease severity: mild (SALT<25%) was noted in 29/102 (28.5%), moderate (SALT 25—49%) — in 29/102 (28.5%), severe and very severe (SALT≥50%) — in 44/102 (43%). The mean tIgE level in patients with AA and ADs (261.72±38.61 IU/mL) has been significantly higher than in patients without ADs (107.79±18.93 IU/mL). More than 62% of patients with AA and ADs had severe forms (SALT≥50%) regardless of the tIgE level. Positive dependence has been observed: tIgE level rose with SALT increase (r=0.897), especially in patients with AD (r=0.909); dependence was moderate (r=0.650) in the group with AA and without AD.
CONCLUSION
The high tIgE level in AA is most common in patients with comorbid ADs, which worsens the alopecia prognosis. The increase in tIgE is also observed in patients with severe AA regardless of the ADs presence. These data allow to identify a certain immunophenotype of AA, which is characterized by increased tIgE level, indicating the involvement of Th2 immune response in the pathophysiology of AA.