Abstract
Background
Increased reactive oxygen species (ROS) and lipid peroxidation are seen in many dermatologic disorders, including atopic dermatitis, psoriasis, vitiligo, acne vulgaris, pemphigus vulgaris, and lichen planus. In alopecia areata (AA), there is increased production of ROS from perifollicular inflammatory cells.
Objective
The aim of this study was to determine the oxidative stress index (OSI) and lipid peroxidation by studying serum total oxidant capacity (TOC), total antioxidant capacity (TAC), and malondialdehyde (MDA) values in AA patients.
Methods
The study included 35 AA patients and a control group consisting of 30 age- and sex-matched healthy volunteers. The serum TOC, TAC, and MDA values were measured, and the OSIs were calculated and compared in both groups.
Results
The mean serum TOC (p < 0.001), MDA (p < 0.001), and OSI (p < 0.001) values were found to be significantly higher in AA patients than in the control group. The mean serum TAC value was significantly lower (p < 0.05) in cases than in controls. Significantly higher MDA (p < 0.001), TOC (p < 0.001), and OSI values (p < 0.001) and lower TAC values (p < 0.01) were found in severe AA than in mild or moderate AA.
Conclusion
The demonstrated results confirmed the presence of oxidative stress and lipid peroxidation in AA. Whether these changes play a role in disease pathogenesis or result from the inflammatory process requires further investigation.
Similar content being viewed by others
References
Madani S, Shapiro J. Alopecia areata update. J Am Acad Dermatol. 2000;42:549–66.
McDonagh AJ, Tazi-Ahnini R. Epidemiology and genetics of alopecia areata. Clin Exp Dermatol. 2002;27:405–9.
Duvic M, Nelson A, de Andrade M. The genetics of alopecia areata. Clin Dermatol. 2001;19:135–9.
Lontz W, Sirsjo A, Liu W, et al. Increased mRNA expression of manganese superoxide dismutase in psoriasis skin lesions and in cultured human keratinocytes exposed to IL-1 beta and TNF-alpha. Free Radic Biol Med. 1995;18:349–55.
Therond P, Gerbaud P, Dimon S, et al. Antioxidant enzymes in psoriatic fibroblasts and erythrocytes. J Invest Dermatol. 1996;106:1325–8.
Niwa Y, Kanoh T, Sakane T, et al. Detection of enhanced lipid peroxide levels in patients with inflammatory skin diseases. J Clin Biochem Nutr. 1987;2:245–51.
Emerit I. Free radicals and aging of the skin. EXS. 1992;62:328–41.
Miyachi Y. Photoaging from an oxidative standpoint. J Dermatol Sci. 1995;9:79–86.
Schallreuter K, Wood J. Free radical reduction in the human epidermis. Free Radic Biol Med. 1989;6:519–32.
Fuchs J, Huflejt ME, Rothfuss LM, et al. Impairment of enzymic and nonenzymic antioxidants in skin by UVB irradiation. J Invest Dermatol. 1989;93:769–73.
Bacchetti T, Campanati A, Ferretti G, et al. Oxidative stress and psoriasis: the effect of antitumour necrosis factor-α inhibitor treatment. Br J Dermatol. 2013;168:984–9.
Grange A, Weill B, Dupin N, et al. Does inflammatory acne result from imbalance in the keratinocyte innate immune response? Microbes Infect. 2010;12:1085–90.
Yesilova Y, Ucmak D, Selek S, et al. Oxidative stress index may play a key role in patients with pemphigus vulgaris. J Eur Acad Dermatol Venereol. 2013;27:465–7.
Sapuntsova SG, Lebed’ko OA, Shchetkina MV, et al. Status of free-radical oxidation and proliferation processes in patients with atopic dermatitis and lichen planus. Bull Exp Biol Med. 2011;150:690–2.
Akoglu G, Emre S, Metin A, et al. Evaluation of total oxidant and antioxidant status in localized and generalized vitiligo. Clin Exp Dermatol. 2013 (Epub ahead of print).
Briganti S, Picardo M. Antioxidant activity, lipid peroxidation and skin diseases: what’s new. J Eur Acad Dermatol Venereol. 2003;17:663–9.
Naziroglu M, Kokcam I. Antioxidants and lipid peroxidation status in the blood of patients with alopecia. Cell Biochem Funct. 2000;18:169–73.
Portugal M, Barak V, Ginsburg I, et al. Interplay among oxidants, antioxidants, and cytokines in skin disorders: present status and future considerations. Biomed Pharmacother. 2007;61:412–22.
Akar A, Arca E, Erbil H, et al. Antioxidant enzymes and lipid peroxidation in the scalp of patients with alopecia areata. J Dermatol Sci. 2002;29:85–90.
Koca R, Armutcu F, Altinyazar CH, et al. Evaluation of lipid peroxidation, oxidant/antioxidant status, and serum nitric oxide levels in alopecia areata. Med Sci Monit. 2005;11:296–9.
Kavak A, Baykal C, Ozarmağan G, et al. HLA in alopecia areata. Int J Dermatol. 2000;39:589–92.
Draper H, Hadley M. Malondialdehyde determination as index of lipid peroxidation. Methods Enzymol. 1990;186:421–31.
Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem. 2004;37:112–29.
Cakmak A, Zeyrek D, Atas A, et al. Oxidative status and paraoxonase activity in children with asthma. Clin Invest Med. 2009;32:327–34.
Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38:1103–11.
Demirbag R, Gur M, Yilmaz R, et al. Influence of oxidative stress on the development of collateral circulation in total coronary occlusions. Int J Cardiol. 2007;116:14–9.
Valko M, Leibfritz D, Moncol J, et al. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol. 2007;39:44–84.
Devasagayam TPA, Tilak JC, Boloor KK, et al. Free radicals and antioxidants in human health: current status and future prospects. J Assoc Physicians India. 2004;52:794–804.
Sies H. Oxidative stress: oxidants and antioxidants. Exp Physiol. 82:291–95.
Alp R, Selek S, Alp SI, et al. Oxidative and antioxidative balance in patients of migraine. Eur Rev Med Pharmacol Sci. 2010;14:877–82.
Weiss SJ. Tissue destruction by neutrophils. N Engl J Med. 1989;320:365–76.
Kannan K, Jain SK. Oxidative stress and apoptosis. Pathophysiology. 2000;7:153–63.
Kim SW, Kim BJ, Youn SW, et al. Evaluation of free oxygen radical and antioxidant capacity in alopecia areata. J Dermatol. 2010;37:762–4.
Eken A, Dogan P, Karaoglu S, et al. Selenium and glutathione peroxidase in patients with alopecia. Turk Derm. 1996;30:23–34.
Mussalo-Rauhamaa H, Lakomaa EL, Kianto U, et al. Element concentrations in serum, erythrocytes, hair and urine of alopecia patients. Acta Derm Venereol. 1986;66:103–9.
Abdel Fattah NSA, Ebrahim AA, El Okda ES. Lipid peroxidation/antioxidant activity in patients with alopecia areata. JEADV. 2011;25:403–8.
Tobin DJ. Morphological analysis of hair follicles in alopecia areata. Microsc Res Tech. 1997;38:443–51.
Reid MB, Li YP. Cytokines and oxidative signaling in skeletal muscle. Acta Physiol Scand. 2001;171:225–32.
Latha B, Babu M. The involvement of free radicals in burn injury: a review. Burns. 2001;27:309–17.
Khan MF, Wu X, Ansari GA. Anti-malondialdehyde antibodies in MRL +/+ mice treated with trichloroethene and dichloroacetyl chloride: possible role of lipid peroxidation in autoimmunity. Toxicol Appl Pharmacol. 2001;170:88–92.
Wang L, Muxin G, Nishida H, et al. Psychological stress-induced oxidative stress as a model of sub-healthy condition and the effect of TCM. Evid Based Complement Alternat Med. 2007;4:195–202.
Manolache L, Benea V. Stress in patients with alopecia areata and vitiligo. J Eur Acad Dermatol Venereol. 2007;21:921–8.
Al-Mutairi N, Eldin ON. Clinical profile and impact on quality of life: seven years experience with patients of alopecia areata. Indian J Dermatol Venereol Leprol. 2011;77:489–93.
Sheu MY, Fowler AJ, Kao J, et al. Topical peroxisome proliferator activated receptor-alpha activators reduce inflammation in irritant and allergic contact dermatitis models. J Invest Dermatol. 2002;118:94–101.
Sertznig P, Seifert M, Tilgen W, Reichrath J. Peroxisome proliferator activated receptors (PPARs) and the human skin: importance of PPARs in skin physiology and dermatologic diseases. Am J Clin Dermatol. 2008;9:15–31.
Acknowledgments
This manuscript has been read and approved by all authors, the requirements for authorship have been met, and each author believes that the manuscript represents honest work. The authors have no conflicts of interest that are directly relevant to the content of this study. No sources of funding were used to conduct this study or to prepare this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bakry, O.A., Elshazly, R.M.A., Shoeib, M.A.M. et al. Oxidative Stress in Alopecia Areata: A Case–Control Study. Am J Clin Dermatol 15, 57–64 (2014). https://doi.org/10.1007/s40257-013-0036-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40257-013-0036-6