• K Sayed, F Mohammed, R Abdel Hay, N Ezzeldin, L Rashed, and A Fahim.
• Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
• Clin. Exp. Dermatol. 2020 Jun 1; 45 (4): 426-431.

BackgroundAlopecia areata (AA) is, an organ-specific autoimmune disease, characterized by an aberrant expression of cytokines of the T helper 1 type. Tumour necrosis factor-like weak inducer of apoptosis (TWEAK) is a multifactorial cytokine that exerts a role in the pathogenesis of inflammatory and autoimmune diseases, especially in cutaneous diseases.AimTo estimate the serum level of TWEAK in AA and to correlate it with different parameters.MethodsThis case-control study enrolled 40 patients with AA and 50 clinically healthy volunteers matched for age and sex. A blood sample (5 mL) was extracted from each participant for analysis of serum TWEAK levels by ELISA.ResultsLevels of TWEAK were significantly higher in patients with AA (mean ± SD 213.7 ± 59.2 pg/mL, range 109.1-341.6 pg/mL) than in controls (95.97 ± 13.28 pg/mL, range 80.1-152.3 pg/mL) (P < 0.001). A significant positive correlation was found between serum TWEAK level and the Severity of Alopecia Tool (SALT) score (r = 0.56, P < 0.001).ConclusionTo our knowledge, this study highlights for the first time a possible link between higher serum TWEAK level and AA. Serum TWEAK level appears to reflect AA disease severity.© 2019 British Association of Dermatologists.

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