TY - JOUR
T1 - Alopecia areata and cytomegalovirus infection in twins
T2 - Genes versus environment?
AU - Jackow, C.
AU - Puffer, N.
AU - Hordinsky, M.
AU - Nelson, J.
AU - Tarrand, J.
AU - Duvic, M.
N1 - Funding Information:
Supported by a grant from the National Alopecia Areata Foundation and in part by NIAMS grant AR39915 (to M. D.).
PY - 1998
Y1 - 1998
N2 - 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 is identical twins and AA occurring in families support a genetic component as well as possible environmental triggers that remain unknown.
AB - 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 is identical twins and AA occurring in families support a genetic component as well as possible environmental triggers that remain unknown.
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U2 - 10.1016/S0190-9622(98)70499-2
DO - 10.1016/S0190-9622(98)70499-2
M3 - Article
C2 - 9520023
AN - SCOPUS:0031952818
SN - 0190-9622
VL - 38
SP - 418
EP - 425
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -