Increased CRHR1 Expression on Monocytes from Patients with AA Enables a Pro-Inflammatory Response to Corticotrophin-Releasing Hormone

This study investigates the role of stress in alopecia areata (AA) by examining the expression of the corticotropin-releasing hormone receptor (CRHR1) on peripheral blood mononuclear cells (PBMCs) from 54 AA patients and 66 controls. The results show that CRHR1 is primarily expressed on monocytes and is significantly higher in AA patients compared to controls (3.17% vs. 1.44%). Increased CRHR1 expression is correlated with chronic AA, larger lesion areas, and elevated CD14+ monocyte numbers. Additionally, AA patients exhibit more active monocytes and fewer CD16+ CD3- NK cells. In vitro treatment with CRH enhances CD86 expression, suggesting that CRH and CRHR1 play a role in AA development and progression, particularly in chronic cases with larger lesions.