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Published in: Archives of Dermatological Research 2/2016

01-03-2016 | Original Paper

B cell activating factor and T-helper 17 cells: possible synergistic culprits in the pathogenesis of Alopecia Areata

Authors: Mostafa A. Elela, Heba I. Gawdat, Rehab A. Hegazy, Marwa M. Fawzy, Rania M. Abdel Hay, Dina Saadi, Olfat Shaker

Published in: Archives of Dermatological Research | Issue 2/2016

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Abstract

The role of T-helper 17 cells (Th17) and regulatory T-cells (Tregs) in the pathogenesis of alopecia areata (AA) has not been clearly elucidated. B cell activating factor (BAFF) being a regulator of T cell activation could be involved in this pathologic process as well. The current study evaluated the expression of IL-17, IL-22, Foxp3 and BAFF in tissue and sera of AA patients. Forty AA patients and 40 age and sex matched healthy controls were included. Tissue and serum levels of IL-17, IL-22, BAFF as well as serum level of Foxp3 were measured by enzyme-linked immunosorbent assay (ELISA). Immunohistochemical staining was used for assessment of tissue level of Foxp3. Tissue and serum levels of IL-17, tissue levels of IL-22 and BAFF were significantly higher in patients. Serum levels of IL-22, Foxp3 and BAFF were non-significantly higher in patients. Foxp3 immunostaining showed negativity in tissue of patients and controls. A significant positive correlation was found between both tissue levels of IL-17 and BAFF (r = 0.474, P = 0.035) and tissue level of IL-22 and disease duration (r = 0.766, P < 0.001) in AA patients. Th17 cells and BAFF are synergistically involved in the pathogenesis of AA. BAFF represents a promising therapeutic target for such a challenging disease. Defective Tregs number and/or function in AA warrants further studies.
Literature
1.
go back to reference Afzali B, Lombardi G, Lechler RI, Lord GM (2007) The role of T helper 17 (Th17) and regulatory T cells (Treg) in human organ transplantation and autoimmune disease. Clin Exp Immunol 148(1):32–46PubMedCentralCrossRefPubMed Afzali B, Lombardi G, Lechler RI, Lord GM (2007) The role of T helper 17 (Th17) and regulatory T cells (Treg) in human organ transplantation and autoimmune disease. Clin Exp Immunol 148(1):32–46PubMedCentralCrossRefPubMed
3.
go back to reference Ansel J, Perry P, Brown J, Damm D, Phan T, Hart C, Luger T, Hefeneider S (1990) Cytokine modulation of keratinocyte cytokines. J Invest Dermatol 94(6 Suppl):101S–107SCrossRefPubMed Ansel J, Perry P, Brown J, Damm D, Phan T, Hart C, Luger T, Hefeneider S (1990) Cytokine modulation of keratinocyte cytokines. J Invest Dermatol 94(6 Suppl):101S–107SCrossRefPubMed
4.
go back to reference Arca E, Muşabak U, Akar A, Erbil AH, Taştan HB (2004) Interferon-gamma in alopecia areata. Eur J Dermatol 14(1):33–36PubMed Arca E, Muşabak U, Akar A, Erbil AH, Taştan HB (2004) Interferon-gamma in alopecia areata. Eur J Dermatol 14(1):33–36PubMed
6.
go back to reference Bodemer C, Peuchmaur M, Fraitaig S, Chatenoud L, Brousse N, De Prost Y (2000) Role of cytotoxic T cells in chronic alopecia areata. J Invest Dermatol 114(1):112–116CrossRefPubMed Bodemer C, Peuchmaur M, Fraitaig S, Chatenoud L, Brousse N, De Prost Y (2000) Role of cytotoxic T cells in chronic alopecia areata. J Invest Dermatol 114(1):112–116CrossRefPubMed
8.
go back to reference De Boer OJ, van der Loos CM, Teeling P, van der Wal AC, Teunissen MB (2007) Immunohistochemical analysis of regulatory T cell markers FOXP3 and GITR on CD4+ CD25+ T cells in normal skin and inflammatory dermatoses. J Histochem Cytochem 55(9):891–898 (epub 2007 May 3) CrossRefPubMed De Boer OJ, van der Loos CM, Teeling P, van der Wal AC, Teunissen MB (2007) Immunohistochemical analysis of regulatory T cell markers FOXP3 and GITR on CD4+ CD25+ T cells in normal skin and inflammatory dermatoses. J Histochem Cytochem 55(9):891–898 (epub 2007 May 3) CrossRefPubMed
12.
go back to reference Heo YJ, Joo YB, Oh HJ, Park MK, Heo YM, Cho ML, Kwok SK, Ju JH, Park KS, Cho SG, Park SH, Kim HY, Min JK (2010) IL-10 suppresses Th17 cells and promotes regulatory T cells in the CD4+ T cell population of rheumatoid arthritis patients. Immunology Lett 127(2):150–156. doi:10.1016/j.imlet.2009.10.006 (epub 2009 Nov 4) CrossRef Heo YJ, Joo YB, Oh HJ, Park MK, Heo YM, Cho ML, Kwok SK, Ju JH, Park KS, Cho SG, Park SH, Kim HY, Min JK (2010) IL-10 suppresses Th17 cells and promotes regulatory T cells in the CD4+ T cell population of rheumatoid arthritis patients. Immunology Lett 127(2):150–156. doi:10.​1016/​j.​imlet.​2009.​10.​006 (epub 2009 Nov 4) CrossRef
13.
go back to reference Huard B, Schneider P, Mauri D, Tschopp J, French LE (2001) T cell co-stimulation by the TNF ligand BAFF. J Immunol 167(11):6225–6231CrossRefPubMed Huard B, Schneider P, Mauri D, Tschopp J, French LE (2001) T cell co-stimulation by the TNF ligand BAFF. J Immunol 167(11):6225–6231CrossRefPubMed
14.
go back to reference Ito T, Ito N, Bettermann A, Tokura Y, Takigawa M, Paus R (2004) Collapse and restoration of MHC class-I-dependent immune privilege: exploiting the human hair follicle as a model. Am J Pathol 164(2):623–634PubMedCentralCrossRefPubMed Ito T, Ito N, Bettermann A, Tokura Y, Takigawa M, Paus R (2004) Collapse and restoration of MHC class-I-dependent immune privilege: exploiting the human hair follicle as a model. Am J Pathol 164(2):623–634PubMedCentralCrossRefPubMed
15.
go back to reference Kolls JK, Lindén A (2004) Interleukin-17 family members and inflammation. Immunity 21(4):467–476CrossRefPubMed Kolls JK, Lindén A (2004) Interleukin-17 family members and inflammation. Immunity 21(4):467–476CrossRefPubMed
16.
go back to reference Kotake S, Udagawa N, Takahashi N, Matsuzaki K, Itoh K, Ishiyama S, Saito S, Inoue K, Kamatani N, Gillespie MT, Martin TJ, Suda T (1999) IL-17 in synovial fluids from patients with rheumatoid arthritis is a potent stimulator of osteoclastogenesis. J Clin Invest 103(9):1345–1352PubMedCentralCrossRefPubMed Kotake S, Udagawa N, Takahashi N, Matsuzaki K, Itoh K, Ishiyama S, Saito S, Inoue K, Kamatani N, Gillespie MT, Martin TJ, Suda T (1999) IL-17 in synovial fluids from patients with rheumatoid arthritis is a potent stimulator of osteoclastogenesis. J Clin Invest 103(9):1345–1352PubMedCentralCrossRefPubMed
17.
go back to reference Krivosikova M, Dallos T, Maslinski W, Buc M (2009) B cell activating factor: its role in autoimmunity, and targeting in autoimmune diseases. Bratisl Lek Listy 110(3):137–145PubMed Krivosikova M, Dallos T, Maslinski W, Buc M (2009) B cell activating factor: its role in autoimmunity, and targeting in autoimmune diseases. Bratisl Lek Listy 110(3):137–145PubMed
20.
go back to reference Langrish CL, Chen Y, Blumenschein WM, Mattson J, Basham B, Sedgwick JD, McClanahan T, Kastelein RA, Cua DJ (2005) IL-23 drives a pathogenic T cell population that induces autoimmune inflammation. J Exp Med 201(2):233–240PubMedCentralCrossRefPubMed Langrish CL, Chen Y, Blumenschein WM, Mattson J, Basham B, Sedgwick JD, McClanahan T, Kastelein RA, Cua DJ (2005) IL-23 drives a pathogenic T cell population that induces autoimmune inflammation. J Exp Med 201(2):233–240PubMedCentralCrossRefPubMed
22.
go back to reference Liang SC, Tan XY, Luxenberg DP, Karim R, Dunussi-Joannopoulos K, Collins M, Fouser LA (2006) Interleukin (IL)-22 and IL- 17 are coexpressed by TH17 cells and cooperatively enhance expression of antimicrobial peptides. J Exp Med 203(10):2271–2279 (epub 2006 Sep 18) PubMedCentralCrossRefPubMed Liang SC, Tan XY, Luxenberg DP, Karim R, Dunussi-Joannopoulos K, Collins M, Fouser LA (2006) Interleukin (IL)-22 and IL- 17 are coexpressed by TH17 cells and cooperatively enhance expression of antimicrobial peptides. J Exp Med 203(10):2271–2279 (epub 2006 Sep 18) PubMedCentralCrossRefPubMed
23.
go back to reference Meyer KC, Klatte JE, Dinh HV, Harries MJ, Reithmayer K, Meyer W, Sinclair R, Paus R (2008) Evidence that the bulge region is a site of relative immune privilege in human hair follicles. Br J Dermatol 159(5):1077–1085. doi:10.1111/j.1365-2133.2008.08818.x (epub 2008 Sep 15) PubMed Meyer KC, Klatte JE, Dinh HV, Harries MJ, Reithmayer K, Meyer W, Sinclair R, Paus R (2008) Evidence that the bulge region is a site of relative immune privilege in human hair follicles. Br J Dermatol 159(5):1077–1085. doi:10.​1111/​j.​1365-2133.​2008.​08818.​x (epub 2008 Sep 15) PubMed
24.
go back to reference Min WP, Zhou D, Ichim TE, Strejan GH, Xia X, Yang J, Huang X, Garcia B, White D, Dutartre P, Jevnikar AM, Zhong R (2003) Inhibitory feedback loop between tolerogenic dendritic cells and regulatory T cells in transplant tolerance. J Immunol 170(3):1304–1312CrossRefPubMed Min WP, Zhou D, Ichim TE, Strejan GH, Xia X, Yang J, Huang X, Garcia B, White D, Dutartre P, Jevnikar AM, Zhong R (2003) Inhibitory feedback loop between tolerogenic dendritic cells and regulatory T cells in transplant tolerance. J Immunol 170(3):1304–1312CrossRefPubMed
25.
go back to reference Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, LE King Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D, National Alopecia Areata Foundation (2004) Alopecia areata investigational assessment guidelines—part II. National Alopecia Areata Foundation. J Am Acad Dermatol 51(3):440–447CrossRefPubMed Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, LE King Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D, National Alopecia Areata Foundation (2004) Alopecia areata investigational assessment guidelines—part II. National Alopecia Areata Foundation. J Am Acad Dermatol 51(3):440–447CrossRefPubMed
27.
go back to reference Petukhova L, Duvic M, Hordinsky M, Norris D, Price V, Shimomura Y, Kim H, Singh P, Lee A, Chen WV, Meyer KC, Paus R, Jahoda CA, Amos CI, Gregersen PK, Christiano AM (2010) Genome-wide association study in alopecia areata implicates both innate and adaptive immunity. Nature 466(7302):113–117. doi:10.1038/nature09114 PubMedCentralCrossRefPubMed Petukhova L, Duvic M, Hordinsky M, Norris D, Price V, Shimomura Y, Kim H, Singh P, Lee A, Chen WV, Meyer KC, Paus R, Jahoda CA, Amos CI, Gregersen PK, Christiano AM (2010) Genome-wide association study in alopecia areata implicates both innate and adaptive immunity. Nature 466(7302):113–117. doi:10.​1038/​nature09114 PubMedCentralCrossRefPubMed
28.
go back to reference Picardi A, Pasquini P, Cattaruzza MS, Gaetano P, Baliva G, Melchi CF, Papi M, Camaioni D, Tiago A, Gobello T, Biondi M (2003) Psychosomatic factors in first- onset alopecia areata. Psychosomatics 44(5):374–381CrossRefPubMed Picardi A, Pasquini P, Cattaruzza MS, Gaetano P, Baliva G, Melchi CF, Papi M, Camaioni D, Tiago A, Gobello T, Biondi M (2003) Psychosomatic factors in first- onset alopecia areata. Psychosomatics 44(5):374–381CrossRefPubMed
29.
go back to reference Sato-Kawamura M, Aiba S, Tagami H (2003) Strong expression of CD40, CD54 and HLADR antigen and lack of evide-nce for direct cellular cytotoxicity areunique immunohistopathological features in alopecia areata. Arch Dermatol Res 294(12):536–543 (epub 2002 Dec 3) PubMed Sato-Kawamura M, Aiba S, Tagami H (2003) Strong expression of CD40, CD54 and HLADR antigen and lack of evide-nce for direct cellular cytotoxicity areunique immunohistopathological features in alopecia areata. Arch Dermatol Res 294(12):536–543 (epub 2002 Dec 3) PubMed
30.
go back to reference Schneider P, MacKay F, Steiner V, Hofmann K, Bodmer JL, Holler N, Ambrose C, Lawton P, Bixler S, Acha-Orbea H, Valmori D, Romero P, Werner-Favre C, Zubler RH, Browning JL, Tschopp J (1999) BAFF, a novel ligand of the tumor necrosis factor family, stimulates B cellgrowth. J Exp Med 189(11):1747–1756PubMedCentralCrossRefPubMed Schneider P, MacKay F, Steiner V, Hofmann K, Bodmer JL, Holler N, Ambrose C, Lawton P, Bixler S, Acha-Orbea H, Valmori D, Romero P, Werner-Favre C, Zubler RH, Browning JL, Tschopp J (1999) BAFF, a novel ligand of the tumor necrosis factor family, stimulates B cellgrowth. J Exp Med 189(11):1747–1756PubMedCentralCrossRefPubMed
31.
go back to reference Serada S, Fujimoto M, Mihara M, Koike N, Ohsugi Y, Nomura S, Yoshida H, Nishikawa T, Terabe F, Ohkawara T, Takahashi T, Ripley B, Kimura A, Kishimoto T, Naka T (2008) IL-6 blockade inhibits the induction of myelin antigen-specific Th17cells and Th1 cells in experimental autoimmune encephalomyelitis. Proc Natl Acad Sci USA 105(26):9041–9046. doi:10.1073/pnas.0802218105 (epub 2008 Jun 24) PubMedCentralCrossRefPubMed Serada S, Fujimoto M, Mihara M, Koike N, Ohsugi Y, Nomura S, Yoshida H, Nishikawa T, Terabe F, Ohkawara T, Takahashi T, Ripley B, Kimura A, Kishimoto T, Naka T (2008) IL-6 blockade inhibits the induction of myelin antigen-specific Th17cells and Th1 cells in experimental autoimmune encephalomyelitis. Proc Natl Acad Sci USA 105(26):9041–9046. doi:10.​1073/​pnas.​0802218105 (epub 2008 Jun 24) PubMedCentralCrossRefPubMed
33.
go back to reference Sutherland AP, Ng LG, Fletcher CA, Shum B, Newton RA, Grey ST, Rolph MS, Mackay F, Mackay CR (2005) BAFF augments certain Th1-associated inflammatory responses. J Immunol 174(5):5537–5544CrossRefPubMed Sutherland AP, Ng LG, Fletcher CA, Shum B, Newton RA, Grey ST, Rolph MS, Mackay F, Mackay CR (2005) BAFF augments certain Th1-associated inflammatory responses. J Immunol 174(5):5537–5544CrossRefPubMed
34.
go back to reference Tanemura A, Oiso N, Nakano M, Itoi S, Kawada A, Katayama I (2013) Alopecia Areata: infiltration of Th17 Cells in the dermis, Particularly around Hair Follicles. Dermatology 226(4):333–336. doi:10.1159/000350933 (epub 2013 Jul 4) CrossRefPubMed Tanemura A, Oiso N, Nakano M, Itoi S, Kawada A, Katayama I (2013) Alopecia Areata: infiltration of Th17 Cells in the dermis, Particularly around Hair Follicles. Dermatology 226(4):333–336. doi:10.​1159/​000350933 (epub 2013 Jul 4) CrossRefPubMed
35.
37.
go back to reference Tojo G, Fujimura T, Kawano M, Ogasawara K, Kambayashi Y, Furudate S, Mizuashi M, Aiba S (2013) Comparison of Interleukin-17 producing cells in different clinical types of Alopecia Areata. Dermatol 227(1):78–82. doi:10.1159/000353159 (epub 2013 Aug 30) CrossRef Tojo G, Fujimura T, Kawano M, Ogasawara K, Kambayashi Y, Furudate S, Mizuashi M, Aiba S (2013) Comparison of Interleukin-17 producing cells in different clinical types of Alopecia Areata. Dermatol 227(1):78–82. doi:10.​1159/​000353159 (epub 2013 Aug 30) CrossRef
38.
go back to reference Verhagen J, Akdis M, Traidl-Hoffmann C, Schmid-Grendelmeier P, Hijnen D, Knol EF, Behrendt H, Blaser K, Akdis CA (2006) Absence of T- regulatory cell expression and function in atopic dermatitis skin. J Allergy Clin Immunol 117(1):176–183CrossRefPubMed Verhagen J, Akdis M, Traidl-Hoffmann C, Schmid-Grendelmeier P, Hijnen D, Knol EF, Behrendt H, Blaser K, Akdis CA (2006) Absence of T- regulatory cell expression and function in atopic dermatitis skin. J Allergy Clin Immunol 117(1):176–183CrossRefPubMed
40.
go back to reference Weaver CT, Harrington LE, Mangan PR, Gavrieli M, Murphy KM (2006) Th17: an effector CD4 T cell lineage with regulatory T cell ties. Immunity 24(6):677–688CrossRefPubMed Weaver CT, Harrington LE, Mangan PR, Gavrieli M, Murphy KM (2006) Th17: an effector CD4 T cell lineage with regulatory T cell ties. Immunity 24(6):677–688CrossRefPubMed
41.
go back to reference Lu W, Shapiro J, Yu M, Barekatain A, Lo B, Finner A, McElwee K (2006) Alopecia areata: pathogenesis and potential for therapy. Expert Rev Mol Med 8(14):1–19CrossRefPubMed Lu W, Shapiro J, Yu M, Barekatain A, Lo B, Finner A, McElwee K (2006) Alopecia areata: pathogenesis and potential for therapy. Expert Rev Mol Med 8(14):1–19CrossRefPubMed
42.
go back to reference Wolk K, Witte E, Wallace E, Döcke WD, Kunz S, Asadullah K, Volk HD, Sterry W, Sabat R (2006) IL-22 regulates the expression of genes responsible for antimicrobial defense, cellular differentiation, and mobility in keratinocytes: a potential role in psoriasis. Eur J Immunol 36(5):1309–1323CrossRefPubMed Wolk K, Witte E, Wallace E, Döcke WD, Kunz S, Asadullah K, Volk HD, Sterry W, Sabat R (2006) IL-22 regulates the expression of genes responsible for antimicrobial defense, cellular differentiation, and mobility in keratinocytes: a potential role in psoriasis. Eur J Immunol 36(5):1309–1323CrossRefPubMed
43.
44.
go back to reference Zhang Z, Li X, Guo J, Xu F, He Q, Zhao Y, Yang Y, Gu S, Zhang Y, Wu L, Chang C (2013) Interleukin-17 enhances the production of interferon-γ and tumour necrosis factor-α by bone marrow T lymphocytes from patients with lower risk myelodysplastic syndromes. Eur J Haematol 90(5):375–384. doi:10.1111/ejh.12074 (epub 2013 Mar 1) CrossRefPubMed Zhang Z, Li X, Guo J, Xu F, He Q, Zhao Y, Yang Y, Gu S, Zhang Y, Wu L, Chang C (2013) Interleukin-17 enhances the production of interferon-γ and tumour necrosis factor-α by bone marrow T lymphocytes from patients with lower risk myelodysplastic syndromes. Eur J Haematol 90(5):375–384. doi:10.​1111/​ejh.​12074 (epub 2013 Mar 1) CrossRefPubMed
45.
go back to reference Zheng SG, Wang J, Horwitz DA (2008) Cutting edge: Foxp3+ CD4+ CD25+ regulatory T cells induced by IL-2 and TGF- beta are resistant to Th17 conversion by IL-6. J Immunol 180(11):7112–7116CrossRefPubMed Zheng SG, Wang J, Horwitz DA (2008) Cutting edge: Foxp3+ CD4+ CD25+ regulatory T cells induced by IL-2 and TGF- beta are resistant to Th17 conversion by IL-6. J Immunol 180(11):7112–7116CrossRefPubMed
47.
go back to reference Zöller M, McElwee KJ, Engel P, Hoffmann R (2002) Transient CD44 variant isoform expression and reduction in CD4(+)/CD25(+) regulatory T cells in C3H/HeJ mice with alopecia areata. J Invest Dermatol 118(6):983–992CrossRefPubMed Zöller M, McElwee KJ, Engel P, Hoffmann R (2002) Transient CD44 variant isoform expression and reduction in CD4(+)/CD25(+) regulatory T cells in C3H/HeJ mice with alopecia areata. J Invest Dermatol 118(6):983–992CrossRefPubMed
Metadata
Title
B cell activating factor and T-helper 17 cells: possible synergistic culprits in the pathogenesis of Alopecia Areata
Authors
Mostafa A. Elela
Heba I. Gawdat
Rehab A. Hegazy
Marwa M. Fawzy
Rania M. Abdel Hay
Dina Saadi
Olfat Shaker
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Dermatological Research / Issue 2/2016
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI
https://doi.org/10.1007/s00403-016-1617-z

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