الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Alopecia areata is among the most highly prevalent human
autoimmune disease, leading to disfiguring hair loss due to the
collapse of immune privilege of the hair follicle and subsequent
autoimmune attack. The genetic basis of AA is largely unknown.
Alopecia areata affects about 5.3 million people worldwide,
including males and females across all ethnic groups, with a life time
risk of 1.7%.
Autoimmunity develops against the hair follicle, resulting in
non- scanning hair loss that may begin as patches that can coalesce
and progress to cover the entire scalp or eventually the entire body.
Heat shock proteins exist in normal cells and prevent the
creation of inappropriate spatial structure caused by inappropriate
protein gathering but, due to biological stress and increased toxic and
inflammatory chemicals, it is useful in protecting cells from stress.
The HSP70 family is the most sensitive group of these proteins
and has the most protected structure. HSP 70 is a protein that binds to
ATP and is found in 60-80% of the eukaryotic cells.
The expression of HSP70 is highly upregulated upon a large
variety of stress stimuli including thermal stress, anoxia, ethanol,
heavy metals, inflammation, infection and tissue injury. Depending on
its intra- or extracellular location, HSP70 fulfils different functions.
Intracellular HSP70 protects cells against lethal damage induced by
stress, supports the synthesis and transport of other proteins, and
prevents misfolding and aggregation. Extracellular and cell surfacebound
HSP70 plays an essential role in eliciting immune responses.
Summary
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The aim of this work was to evaluate the serum level of HSP70
in alopecia areata patients, and its relation to its pathogenesis.
This case control study included 83 subjects: 43 alopecia areata
patients and 40 apparently age and gender matched healthy controls.
They were recruited from the Dermatology outpatient clinic of
Menoufia University Hospital, after exclusion of obese subjects, those
with dermatological diseases other than AA, patients suffering from
any systemic or autoimmune disorder, smokers, present or past history
of cardiovascular or brain ischemic heart disease, use of antibiotics,
hormonal therapy, nitric oxide compounds and heavy metals since one
month, existence of non-epithelial ovarian cancer, breast, lung and
pancreas cancer.
A written consent form approved by Local Ethical Research
Committee in Menoufia Faculty of Medicine was obtained from every
participant prior to study initiation after explanation of the study
nature and procedure.
All patients included in the study were subjected to full history
taking including onset, course, and duration of alopecia, family
history, occupational history, previous treatment methods used,
history of other diseases, general, dermatological examination
including scalp examination for clinical types of AA, its site, severity
assessment according to Alopecia Areata Progression Index (AAPI),
Severity of Alopecia Tool (SALT) Score, presence of commonly
associated diseases include atopic dermatitis and autoimmune diseases
such as vitiligo, dermoscopic evaluation and analysis of serum levels
of HSP70 using enzyme linked immunosorbent assay technique. Then,
results were tabulated and statistically analyzed.
Summary
80
In the present study, age of patients ranged between (5-57)
years, while age of controls ranged between (6-57) years. Patients
were 62.8% males and 37.2% were females while control group
included 60% males and 40 % females. The course of the disease was
progressive in 22 patients (51.2%), stationary in 11 patients (25.6%)
and regressive in 10 patients (23.3%).
The disease duration ranged between (3-96) weeks with mean±
SD (24.38±26.141). Only 13 patients (30.2%) had positive family
history. According to the extent of involvement 31 patients (72.1%)
had patchy AA, 3 patients (7%) had AT, 1 patient (2.3%) had AU, 6
patients (14%) had ophiasis, 1 patient (2.3%) had patchy AA &
ophiasis and 1 patient (2.3%) had sisaipho.
According to the site of AA 35 patients (81.4%) showed patches
of AA in the scalp, 3 patients (7%) had AA in the beard, 1 patient
(2.3%) had AA in the eyebrow & beard, 3 patients (7%) had AA in
the scalp & beard and 1 patient (2.3%) had AA in the hairy areas all
over the body.
According to the severity of disease which assessed by SALT
score, in cases with scalp involvement, it ranged between 0-100 with
mean±SD (23.54±32.295). 28 patients (71.8%) had S1 grade, 4
patients (10.3%) had S2 grade, 1 patient (2.5%) had S3 grade, 3
patients (7.7%) had S4 grade, and also 3 patients (7.7%) had S5 grade.
According to dermoscopic findings of AA 37 patients (86%) were
showing active patches AA while, 6 patients (14%) were showing
inactive patches of AA. The activity of hair loss was assessed by
(AAPI) which ranged between 0-391 with mean±SD (53.97±91.889).