Can the Cytokine Analysis of the Scales on Alopecic Patch Predict the Response to Diphenylcyclopropenone Treatment in Alopecia Areata Patients?

Abstract

Background: Contact immune modulating therapy with diphenylcyclopropenone (DPCP) is a topical treatment option for extensive alopecia areata (AA). Because the response to DPCP treatment varies according to the patient, and it takes several months to evaluate the clinical effectiveness of the treatment, it is necessary to identify the factors that can predict the prognosis of the disease while treating with topical DPCP.

Objective: In this study, cytokine levels in the scales of alopecic patches were investigated to identify whether they could predict response to DPCP during the early treatment period.

Methods: Scale samples were taken from the alopecic patches in eight AA patients at 1 week, 2 months, and 4 months after DPCP sensitization. The patients were divided into responders and non-responders according to the clinical responses of DPCP treatment. Interferon (IFN)-gamma, interleukin (IL)-2, IL-12 and IL-10 levels of the subjects were compared in several perspectives.

Results: Cytokine levels after 1 week of DPCP sensitization showed no statistically significant difference between two groups. After 4 months of treatment, IFN-gamma levels were significantly lower in responders than in non-responders.

Conclusion: The results of this study show IFN-gamma levels in the scales of alopecic patches might possibly reflect the clinical response in AA patients treated with DPCP. However, initial cytokine levels could not predict the treatment response.

Keywords: Alopecia areata; Cytokines; Diphenylcyclopropenone.

Fig. 1. Gross photograph of patient no. 3 (responder) and patient no. 7 (non-responder) at before and 4 months after DPCP treatment. Before treatment (A, E: patient no. 3; C, G: patient no. 7). After 4 months of treatment (B, F: patient no. 3; D, H: patient no. 7).

Fig. 2. Dot plot showing each value of cytokines in the patients treated with diphenylcyclopropenone (DPCP). Red bar in the graph indicates mean values. Before significant clinical differences appear (1 week and 2 months after treatment), interferon (IFN)-gamma, interleukin (IL)-12, and IL-10 showed no significant difference between responders and non-responders. IL-2 levels at 1 week showed difference between the two groups, however, it did not showed difference at 4 months after treatment. IFN-gamma levels at 4 months after DPCP treatment showed statistically significant differences between responder and non-responder groups (p=0.024).