The value of immunohistochemical expression of SOX9 and CD34 in alopecia areata

ABSTRACT

Background

Alopecia areata (AA), an immune-mediated disorder, is marked by temporary, nonscarring hair loss. The bulge area is protected from immune attacks by immune privilege; however, recent studies demonstrated immune cells infiltrating the bulge area.

Objective

This study aims to investigate the immunohistochemical expression of the sex-determining region Y-box 9 (SOX9) and cluster of differentiation 34 (CD34) in AA patients as markers of hair follicle stem cells (HFSCs) and progenitor cells, respectively.

Methods

Immunohistochemical staining of SOX9 and CD34 was applied on skin samples of 20 AA patients and 20 healthy controls.

Results

SOX9 and CD34 were significantly lower in lesional samples of cases compared to perilesional and control skin biopsies. Furthermore, SOX9 level was negatively correlated with the severity of alopecia tool score (SALT score) among the studied AA patients. Moreover, lowered SOX9 expression was present in patients with recurrent attacks.

Conclusions

The significant reduction of stem cell markers (SOX9 and CD34) in our studied AA cases signifies the pathological affection of HFSCs and their progeny in AA. This is thought to cause a loss of competence in generating new hair in some AA cases, which needs to be validated in further research.

Limitations of the study

This study has a small sample size.

KEYWORDS:

• Alopecia areata
• hair follicle
• stem cells
• CD34
• SOX9

Disclosure statement

No potential conflict of interest was reported by the author(s).

Contribution Details

The authors contributed as follows:

Table

Data availability statement

The data that support the findings of this study are available from the corresponding author upon request.

Ethical statement

Prior to the collection of samples, written informed consent was obtained from all studied subjects and the Local Ethics Committee of Research involving human subjects in Faculty of Medicine, Menoufia University approved this study; record number: 2/2020DERMA44, in agreement with the Declaration of Helsinki (World Medical Assembly).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.