Assessment of the level of tumor necrosis factor-a in localized alopecia areata

Background Different cytokines may play a role in the pathogenesis of alopecia areata (AA). Tumor necrosis factor-a (TNF-a) has been shown to be inhibitory to hair follicle growth in in-vitro studies, suggesting that it may play an important role in AA. However, there are many reports of the failure of anti-TNF-a agents in the treatment of AA that has made the role of TNF-a unclear, and needs further investigations. Objective This study was carried out to detect the presence of TNF-a in skin biopsies of AA patients and to review its possible role in the pathogenesis of AA. Patients and methods Thirty-six patients with localized and recent-onset AA as well as 36 age-matched and sex-matched healthy controls were included in the study. Punch skin biopsy was taken from lesional and nonlesional skin of every patient, as well as from the normal skin of each individual in the control group for the quantitative analysis of TNF-a by enzymelinked immunosorbent assay. Results The level of TNF-a in lesional skin biopsies was significantly higher than that in nonlesional skin biopsies of patients as well as controls’ biopsies. Also, the TNF-a level in nonlesional biopsies of patients was significantly higher than the level in controls’ biopsies. Conclusion We can conclude that skin of early localized cases of AA has a high level of TNF-a. This high level may point to the important role of TNF-a in the pathogenesis of AA.