Evaluation of Serum Inflammatory Markers and Their Relationship to Treatment Response in Alopecia Areata Patients
Abstract
Introduction: Alopecia areata is a type of non-scarring alopecia, which is thought to be associated with T-cell mediated immune response.
Objective: This study aims to compare the levels of serum inflammatory markers before and after treatment in patients with alopecia areata. The study will explore the utility of the systemic immune-inflammation index (SII) in assessing the severity and treatment response in alopecia areata patients.
Methods: The study included 60 alopecia areata patients and 40 control patients diagnosed with tinea unguium, aged between 18 and 65 years. Sociodemographic characteristics such as age, gender, and medical history were recorded for both groups. For alopecia areata patients, serum inflammatory markers were recorded before and at the third month of treatment. Serum inflammatory markers for the control group were also recorded. Furthermore, the Severity of Alopecia Tool (SALT) score was calculated for alopecia areata patients before and at the third month of treatment.
Results: The alopecia areata group had a significantly higher neutrophil-lymphocyte ratio, mean platelet volume, and SII values compared to the control group, while high-density lipoprotein (HDL) values were significantly lower. Serum inflammatory markers, assessed at the third month of treatment in the alopecia areata group, were lower and HDL values were significantly higher compared to pre-treatment levels. A statistically significant correlation was observed between disease severity and the SII.
Conclusion: The SII is a cost-effective marker that can be utilized in assessing the severity of alopecia areata and treatment response.
References
Strazzulla LC, Wang EHC, Avila L, et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol 2018;78(1):1-12. doi:10.1016/j.jaad.2017.04.1141
Zhou C, Li X, Wang C, Zhang J. Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management. Clin Rev Allergy Immunol 2021;61(3):403-423. doi:10.1007/s12016-021-08883-0
Dincer Rota D, Tanacan E. The utility of systemic-immune inflammation index for predicting the disease activation in patients with psoriasis. Int J Clin Pract 2021;75(6):e14101. doi:10.1111/ijcp.14101
Tanacan E, Dincer D, Erdogan FG, Gurler A. A cutoff value for the Systemic Immune-Inflammation Index in determining activity of Behçet disease. Clin Exp Dermatol2021;46(2):286-291. doi:10.1111/ced.14432
Turan Ç, Metin N. A Novel Inflammatory Marker in the Follow-up of Moderate-to-Severe Acne Vulgaris Administered Isotretinoin: Systemic Immune-Inflammation Index (SII). Curr Health Sci J 2022;48(1):63-67. doi:10.12865/CHSJ.48.01.09
Özkur E, Şeremet S, Afşar FŞ, Altunay İK, Çalıkoğlu EE. Platelet Count and Mean Platelet Volume in Psoriasis Patients. SisliEtfalHastan Tip Bul 2018;54(1):58-61. Published 2018 Dec 19. doi:10.14744/SEMB.2018.69370
Olayinka JJT, Richmond JM. Immunopathogenesis of alopecia areata. Curr Res Immunol 2021; 2:7-11. doi:10.1016/j.crimmu.2021.02.001
Lundin M, Chawa S, Sachdev A, Bhanusali D, Seiffert-Sinha K, Sinha AA. Gender differences in alopecia areata. J Drugs Dermatol 2014;13(4):409-413
Uzuncakmak TK, Engin B, Serdaroglu S, Tuzun Y. Demographic and Clinical Features of 1,641 Patients with Alopecia Areata, Alopecia Totalis, and Alopecia Universalis: A Single-Center Retrospective Study. Skin Appendage Disord 2021;7(1):8-12. doi:10.1159/000510880
Lyakhovitsky A, Gilboa S, Eshkol A, Barzilai A, Baum S. Late-Onset Alopecia Areata: A Retrospective Cohort Study. Dermatology 2017;233(4):289-294. doi:10.1159/000481881
Kavak A, Yeşildal N, Parlak AH, et al. Alopecia areata in Turkey: demographic and clinical features. J EurAcad Dermatol Venereol 2008;22(8):977-981. doi:10.1111/j.1468-3083.2008.02699.x
Lee S, Lee H, Lee CH, Lee WS. Comorbidities in alopecia areata: A systematic review and meta-analysis. J Am Acad Dermatol 2019;80(2):466-477.e16. doi:10.1016/j.jaad.2018.07.013
Laitinen I, Jokelainen J, Tasanen K, Huilaja L. Comorbidities of Alopecia Areata in Finland between 1987 and 2016. Acta Derm Venereol 2020;100(4):adv00063. doi:10.2340/00015555-3412
Villasante Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin CosmetInvestig Dermatol2015;8:397-403. doi:10.2147/CCID.S53985
Aksoy Sarac G, Acar O, Nayır T, Hararcı Yıldırım P, Dinçer Rota D. The Use of New Hematological Markers in the Diagnosis of Alopecia Areata. Dermatol Pract Concept 2023;13(2):e2023118. doi:10.5826/dpc.1302a118
İslamoğlu ZGK, Demirbaş A. Evaluation of complete blood cell and inflammatory parameters in patients with alopecia areata: Their association with disease severity. J Cosmet Dermatol 2020;19(5):1239-1245. doi:10.1111/jocd.13131
Dere G, Gündoğdu M. Investigation of the relationship between alopecia areata and inflammatory blood parameters. J Cosmet Dermatol 2021;20(12):4048-4051. doi:10.1111/jocd.14048
Karaosmanoglu N, Ozdemir Cetinkaya P, Orenay OM. Evaluation of inflammatory status in blood in patients with rosacea. Sci Rep 2023;13(1):9068. doi:10.1038/s41598-023-36247-5
Cosansu NC, Yuksekal G, Turan U, Umitfer F, Yaldiz M, Sevimli Dikicier B. Investigation of systemic immune-inflammation index and systemic inflammation response index as an indicator of the anti-inflammatuary effect of isotretinoin in patients with acne vulgaris. CutanOculToxicol2022;41(2):174-178. doi:10.1080/15569527.2022.2081700
Turan Ç, Coşansu NC, Yüksekal G. The SII reflects inflammation in acne vulgaris, but fails to determine categorical severity. J Cosmet Dermatol 2022;21(11):6385- 6392. doi:10.1111/jocd.15301
Yorulmaz A, Hayran Y, Akpinar U, Yalcin B. Systemic Immune-Inflammation Index (SII) Predicts Increased Severity in Psoriasis and Psoriatic Arthritis. Curr Health Sci J 2020;46(4):352-357. doi:10.12865/CHSJ.46.04.05
Melikoglu M, Pala E. Systemic immune-inflammation index as a biomarker of psoriasis severity. Arch Basic Clin Res 2023;5(2):291-295.
Kelesoglu Dincer AB, Sezer S. Systemic Immune Inflammation Index as a Reliable Disease Activity Marker in Psoriatic Arthritis. J Coll Physicians Surg Pak 2022;32(6):773-778. doi:10.29271/jcpsp.2022.06.773
Tanacan E, Dinçer Rota D, Oktem R, Erdogan FG. The correlation of systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, derived neutrophil-tolymphocyte ratio, and platelet-to-lymphocyte ratio with disease severity in recurrent aphthous stomatitis. J Cosmet Dermatol 2022;21(10):4858-4863. doi:10.1111/jocd.14838
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