IFN-alpha and TNF-alpha serum levels and their association with disease severity in Egyptian children and adults with alopecia areata

Background Alopecia areata (AA) is an autoimmune skin disease characterized by abnormal levels of several cytokines, such as interferon alpha (IFN-alpha) and tumor necrosis factor-alpha (TNF-alpha), which are T-helper type 1 cytokines that have important roles in the pathogenesis of AA. The aim of our study was to correlate circulating IFN-alpha and TNF-alpha levels with disease severity, activity, and clinical type in patients with AA and to evaluate the relationship between the two cytokines. Methods We investigated serum IFN-alpha and TNF-alpha levels in 72 patients with AA (35 children and 35 adults) and 75 healthy control individuals (34 children and 41 adults) using the enzyme-linked immunosorbent assay (ELISA) technique. We evaluated AA severity using the Severity of Alopecia Tool (SALT) and determined the activity based on dermoscopic criteria of disease activity. Results Serum IFN-alpha and TNF-alpha concentrations were significantly higher in the patients than in the controls. There was a significant positive correlation between serum IFN-alpha and TNF-alpha levels in all patients with alopecia areata, as well as between serum TNF-alpha levels and disease severity in all patients and in children. Conclusions Our results support the association between IFN-alpha and TNF-alpha levels and AA and suggest that TNF-alpha might be related to disease severity.