PMID- 37087083
OWN - NLM
STAT- MEDLINE
DCOM- 20230612
LR  - 20230612
IS  - 1873-0183 (Electronic)
IS  - 1568-9972 (Linking)
VI  - 22
IP  - 7
DP  - 2023 Jul
TI  - Biomarkers in alopecia Areata: A systematic review and meta-analysis.
PG  - 103339
LID - S1568-9972(23)00073-3 [pii]
LID - 10.1016/j.autrev.2023.103339 [doi]
AB  - BACKGROUND: Alopecia areata (AA) is an autoimmune non-scarring alopecia that 
      affects the scalp or any hair-bearing areas in the body. The pathophysiology of 
      AA is complex, but Th1, Th2, and Th17 cytokines dysregulation, as well as 
      chemokines, immunoglobulins and other biomarkers have been shown to play a role 
      in the pathogenesis of the disease. OBJECTIVE: To conduct a systematic review and 
      Meta-analysis to identify biomarkers that reflect AA activity and severity that 
      could be used to better assess disease activity and response in both trials and 
      clinical practice. METHODS: A literature search was conducted using the PUBMED, 
      EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) 
      from inception to December 2021. Articles reporting on associations between AA 
      and serum clinical biomarkers (cytokines, chemokines, antibodies, 
      immunoglobulins, and others) were included. Serum biomarkers were identified in 
      patients with AA and were correlated with disease severity and patient 
      characteristics (ex. age, sex, comorbidities). The quality of the studies was 
      assessed using the National Heart, Lung, and Blood Institute's Quality Assessment 
      Tool for Case-Control Studies. Meta-analysis pooling of the standardized mean 
      differences (SMD) by the method of Cohen using the common-effect inverse-variance 
      model was performed. For the Meta-analysis, data was pulled for all the markers 
      with a minimum of 4 studies with means and standard deviations. Analysis of data 
      reported as Median with range or inter-quartile range (IQR) revealed that the 
      data was too skewed to recommend calculation and use of mean with standard 
      deviation (SD). If the data were not skewed, mean and SD were calculated. 
      RESULTS: One thousand seven hundred fourteen studies were screened, with 91 
      included, reporting on a total of 52 biomarkers. Meta-analyses revealed pooled 
      SMD that were significant for interleukin 6 (IL6), C-reactive protein (CRP) and 
      vitamin D. CONCLUSIONS: Serum IL6 and CRP levels are significantly increased in 
      patients with AA compared to healthy age and sex matched controls. Conversely, 
      serum vitamn D levels are significantly decreased in patients with AA compared to 
      healthy age and sex matched controls. This data has the potential to influence 
      the clinical guidelines for the diagnostic workup of AA to include testing the 
      serum levels of CRP and vitamin D.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Zaaroura, Hiba
AU  - Zaaroura H
AD  - Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick 
      Children, University of Toronto, Toronto, ON, Canada.
FAU - Gilding, Anthony J
AU  - Gilding AJ
AD  - Canadian Alopecia Areata Foundation, Toronto, ON, Canada.; Department of 
      Chemistry & Biology, Faculty of Science, Toronto Metropolitan University, 
      Toronto, ON, Canada.
FAU - Sibbald, Cathryn
AU  - Sibbald C
AD  - Division of Dermatology, Department of Paediatric Medicine, The Hospital for Sick 
      Children, University of Toronto, Toronto, ON, Canada. Electronic address: 
      cathryn.sibbald@mail.utoronto.ca.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230420
PL  - Netherlands
TA  - Autoimmun Rev
JT  - Autoimmunity reviews
JID - 101128967
RN  - 0 (Interleukin-6)
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
RN  - 1406-16-2 (Vitamin D)
RN  - 0 (Chemokines)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - 0 (Vitamins)
RN  - Diffuse alopecia
SB  - IM
MH  - Humans
MH  - *Alopecia Areata/diagnosis/pathology
MH  - Interleukin-6
MH  - Biomarkers
MH  - Cytokines/metabolism
MH  - Vitamin D
MH  - Chemokines
MH  - C-Reactive Protein
MH  - Vitamins
OTO - NOTNLM
OT  - Alopecia areata
OT  - Biomarker
OT  - Chemokine
OT  - Cytokine
OT  - Immunoglobulin
COIS- Declaration of Competing Interest The authors declare the following financial 
      interests/personal relationships which may be considered as potential competing 
      interests: Cathryn SIbbald reports a relationship with Pfizer that includes: 
      consulting or advisory, funding grants, and speaking and lecture fees. Cathryn 
      SIbbald reports a relationship with AbbVie Inc. that includes: consulting or 
      advisory. Cathryn SIbbald reports a relationship with LEO Pharma Inc. that 
      includes: consulting or advisory. Cathryn SIbbald reports a relationship with 
      Novartis that includes: speaking and lecture fees. Cathryn SIbbald reports a 
      relationship with Arcutis Biotherapeutics, Inc. that includes: speaking and 
      lecture fees.
EDAT- 2023/04/23 00:41
MHDA- 2023/06/12 06:42
CRDT- 2023/04/22 19:29
PHST- 2023/03/22 00:00 [received]
PHST- 2023/04/13 00:00 [accepted]
PHST- 2023/06/12 06:42 [medline]
PHST- 2023/04/23 00:41 [pubmed]
PHST- 2023/04/22 19:29 [entrez]
AID - S1568-9972(23)00073-3 [pii]
AID - 10.1016/j.autrev.2023.103339 [doi]
PST - ppublish
SO  - Autoimmun Rev. 2023 Jul;22(7):103339. doi: 10.1016/j.autrev.2023.103339. Epub 
      2023 Apr 20.