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Immune-Mediated Alopecia Areata Associated With COVID-19 Vaccinations

According to a study published in Clinical Immunology, spike protein and excipients of COVID-19 vaccines could contribute to the pathogenesis of immune-mediated alopecia areata (AA).

Researchers aimed to investigate the relationship between COVID-19 vaccines and AA in a study that included 27 patients who developed AA after receiving COVID-19 vaccines and 106 individuals who tolerated the vaccines without experiencing AA. The researchers compared various immune markers and parameters between the 2 groups to identify potential differences.

The results showed significant variations in several immune factors between the patients with AA and the vaccine-tolerant individuals. Notably, antinuclear antibodies, total IgE, granulysin, and PARC/CCL18 levels were elevated in the patients with AA. Additionally, the number of peripheral eosinophils, a type of immune cell, was also higher in the AA group. These differences indicated an immune response dysregulation in patients with AA compared with the vaccine-tolerant individuals.

Furthermore, the researchers conducted in vitro experiments to explore the immune response triggered by components of COVID-19 vaccines. They found that certain vaccine excipients (polyethylene glycol 2000 and polysorbate 80), as well as the spike protein of the SARS-CoV-2 virus, could lead to increased release of specific immune molecules, such as granulysin, granzyme B, and interferon-gamma, from T cells of patients with AA. These molecules are associated with T cell-mediated cytotoxicity, where T cells attack and damage cells.

“Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines,” the authors concluded.

Reference
Wang CW, Wu MY, Chen CB, et al. Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations. Clin Immunol. Published online August 14, 2023. doi:10.1016/j.clim.2023.109737

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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of The Dermatologist or HMP Global, their employees, and affiliates.

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