CD27 and IL-35 as Diagnostic Biomarkers in Alopecia Areata: First Evidence of Association with Pathogenic Scalp Bacterial Infections

This study investigated the potential of CD27 and IL-35 as diagnostic biomarkers in Alopecia Areata (AA), particularly in relation to pathogenic bacterial infections. Involving 60 AA patients and 60 healthy controls, the study found that 43.3% of AA patients had bacterial growth, with 12 isolates deemed pathogenic. CD27 and IL-35 levels were significantly higher in AA patients with bacterial infections compared to those without and to healthy controls. A strong positive correlation was found between CD27 and IL-35 in infected patients. CD27 demonstrated perfect diagnostic performance, while IL-35 was a strong predictor in infected cases. The findings suggest that CD27 and IL-35 could be valuable biomarkers for AA, with elevated IL-35 levels linked to bacterial-induced immune activation, indicating potential for combined immunomodulatory and antimicrobial therapies.