Thesis (M.Sc. ) - Cairo University - Faculty of Medicine - Department of Dermatology and Venerology

Background: Alopecia areata (AA) is a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin. Alopecia has few physically harmful effects, however, it has a considerable impact on quality of life (QoL), usually being much more debilitating than its inherent clinical severity that may lead to psychological consequences, including high levels of anxiety and depression. The mechanisms that lead to hair loss in AA are still unclear. So far, IFN-gamma, interleukins, TNF-alpha, are cytokines that are well known to play a major role in the pathogenesis of the disease. It has been reported that MMP 2, MMP 9 and TIMP 1 are associated with the hair cycle; however, their expression levels during the hair cycle have not been fully elucidated.Objective: The aim of this study is to evaluate the tissue and serum levels of the Matrix Metalloproteinase 2 (MMP-2) in cases of alopecia areata, to assess their possible role in the pathogenesis of this disease. METHODS: 40 patients fitting the inclusion criteria were randomly recruited to the study as well as 10 healthy sex and age matched subjects as controls. All included participants were subjected to a written consent, detailed history, assessment by severity of Alopecia Tool Score (SALT scoring). 2 mm skin biopsy from scalp and blood samples were collected from patients and controls to evaluate MMP-2 level in tissue and blood samples using ELISA. Results:The tissue MMP-2 level was higher than the serum MMP-2 level in the patients{u2019} group and it showed a statistically significant difference (p{u2264}0.001). Furthermore, both tissue and serum levels of MMP-2 were higher in patients{u2019} group showing a highly statistically significant differences (p=<0.001) as compared to the control group tissue. There was a statistically significant positive correlation (p=.021) between tissue MMP-2 level and the duration of the disease in the patients{u2019} group. Conclusion: The current study offers a proof that MMP-2 plays an important role in the pathogenesis of AA and this high level of MMP-2 should be furtherly targeted in AA patients as a step for achieving better outcome

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