Role of Regulatory T and T-Helper 17 Cells in Patients with Acute Diffuse and Total Alopecia

This study investigated the role of regulatory T cells (Tregs) and T-helper (Th) 17 cells in the pathogenesis of acute diffuse and total alopecia (ADTA) by analyzing 24 patients with ADTA and 12 healthy controls. The findings revealed that patients with ADTA had significantly increased levels of lesional IL-2, IL-10, and IL-23A, as well as serum IL-17, compared to controls. During the progressive stage, lesional IL-17 and IL-15, and serum IL-13, IL-2, and IL-23A were elevated, while in the recovery stage, serum IL-13 and IL-23A remained high. Immunostaining showed an 8.50% ratio of Tregs/CD4+ cells around hair follicles in patients, indicating enhanced Treg function, which differs from classic alopecia areata. The study suggests that the activation of Treg cells and increased IL-10 levels may contribute to the rapid recovery observed in ADTA, highlighting their potential functional role in its pathogenesis.