BACKGROUND: Alopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease mediated by T cells directed to the hair follicle. Genetic susceptibility may be conferred by HLA, and an environmental trigger, such as a viral infection, is suspected. The incidence of AA in the population is estimated to be 1.7%, with an average of one in four patients having a positive family history. OBJECTIVE: Our purpose was to examine the concordance rate of AA among identical versus fraternal twins and the correlation between stress, cytomegalovirus (CMV) infection, and disease. METHODS: Families with AA were solicited from dermatologists in the United States and through a Website on the Internet. HLA class 2 typing and identification of CMV early and late genes were performed by polymerase chain reaction (PCR) on genomic peripheral blood DNA. Serum antibodies for CMV were determined by enzyme-linked immunosorbent assay. RESULTS: From 114 families, we identified 11 sets of monozygotic twins and 3 sets of dizygotic twins. The concordance rate was 55% for monozygotic twins and 0% for fraternal twins. Most identical twins were male. The severity of the AA phenotype varied and appeared most severe in the first affected twin. Five of 24 twins were CMV seropositive but CMV DNA was not detected in blood lymphocytes of any of the subjects when studied after the onset of AA. The presence of AA in twins was not correlated with evidence of CMV. CONCLUSION: A 55% concordance rate in identical twins and AA occurring in families support a genetic component as well as possible environmental triggers that remain unknown.
BACKGROUND:Alopecia areata (AA) is hypothesized to be an organ-specific autoimmune disease mediated by T cells directed to the hair follicle. Genetic susceptibility may be conferred by HLA, and an environmental trigger, such as a viral infection, is suspected. The incidence of AA in the population is estimated to be 1.7%, with an average of one in four patients having a positive family history. OBJECTIVE: Our purpose was to examine the concordance rate of AA among identical versus fraternal twins and the correlation between stress, cytomegalovirus (CMV) infection, and disease. METHODS: Families with AA were solicited from dermatologists in the United States and through a Website on the Internet. HLA class 2 typing and identification of CMV early and late genes were performed by polymerase chain reaction (PCR) on genomic peripheral blood DNA. Serum antibodies for CMV were determined by enzyme-linked immunosorbent assay. RESULTS: From 114 families, we identified 11 sets of monozygotic twins and 3 sets of dizygotic twins. The concordance rate was 55% for monozygotic twins and 0% for fraternal twins. Most identical twins were male. The severity of the AA phenotype varied and appeared most severe in the first affected twin. Five of 24 twins were CMV seropositive but CMV DNA was not detected in blood lymphocytes of any of the subjects when studied after the onset of AA. The presence of AA in twins was not correlated with evidence of CMV. CONCLUSION: A 55% concordance rate in identical twins and AA occurring in families support a genetic component as well as possible environmental triggers that remain unknown.
Authors: Amalia Martinez-Mir; Abraham Zlotogorski; Derek Gordon; Lynn Petukhova; Jianhong Mo; T Conrad Gilliam; Douglas Londono; Chad Haynes; Jurg Ott; Maria Hordinsky; Krassimira Nanova; David Norris; Vera Price; Madeleine Duvic; Angela M Christiano Journal: Am J Hum Genet Date: 2007-01-05 Impact factor: 11.025
Authors: Lynn Petukhova; Aakash V Patel; Rachel K Rigo; Li Bian; Miguel Verbitsky; Simone Sanna-Cherchi; Stephanie O Erjavec; Alexa R Abdelaziz; Jane E Cerise; Ali Jabbari; Angela M Christiano Journal: Exp Dermatol Date: 2019-07-09 Impact factor: 3.960
Authors: Lynn Petukhova; Madeleine Duvic; Maria Hordinsky; David Norris; Vera Price; Yutaka Shimomura; Hyunmi Kim; Pallavi Singh; Annette Lee; Wei V Chen; Katja C Meyer; Ralf Paus; Colin A B Jahoda; Christopher I Amos; Peter K Gregersen; Angela M Christiano Journal: Nature Date: 2010-07-01 Impact factor: 49.962
Authors: Lina M Forstbauer; Felix F Brockschmidt; Valentina Moskvina; Christine Herold; Silke Redler; Alexandra Herzog; Axel M Hillmer; Christian Meesters; Stefanie Heilmann; Florian Albert; Margrieta Alblas; Sandra Hanneken; Sibylle Eigelshoven; Kathrin A Giehl; Dagny Jagielska; Ulrike Blume-Peytavi; Natalie Garcia Bartels; Jennifer Kuhn; Hans Christian Hennies; Matthias Goebeler; Andreas Jung; Wiebke K Peitsch; Anne-Katrin Kortüm; Ingrid Moll; Roland Kruse; Gerhard Lutz; Hans Wolff; Bettina Blaumeiser; Markus Böhm; George Kirov; Tim Becker; Markus M Nöthen; Regina C Betz Journal: Eur J Hum Genet Date: 2011-10-26 Impact factor: 4.246
Authors: John P Sundberg; Kathleen A Silva; Weidong Zhang; Beth A Sundberg; Kathryn Edwards; Lloyd E King; Robert L Davis; Steven Black Journal: Vet Dermatol Date: 2009-01-17 Impact factor: 1.589