STATE OF ENDOGENOUS INTOXICATION IN PATIENTS WITH ALOPECIA AREATA

Abstract

State of endogenous intoxication in patients with alopecia areata

Objective. To study the state of endogenous intoxication and the characteristics of the body mycobiota in patients with alopecia areata.

Materials and methods. A total of 42 patients with alopecia areata aged 7 to 34 years were examined. All patients underwent clinical, trichoscopic, biochemical, immunological and mycological investigations. The degree of endogenous intoxication was assessed using erythrocyte sorption capacity (ESC) and the level of medium-molecular-weight peptides (MMWP). Mycological examination of body biosubstrates was performed by culture-based methods. Specific IgG antibodies to Candida albicans and total IgE were determined by enzyme-linked immunosorbent assay. The control group consisted of 31 practically healthy individuals.

Results. Patients with alopecia areata showed signs of endogenous intoxication, characterized by a significant increase in erythrocyte sorption capacity to 39.5 ± 0.4% versus 26.8 ± 0.3% in the control group (p<0.001), and in the level of medium-molecular-weight peptides to 0.37 ± 0.006 extinction units versus 0.24 ± 0.007 extinction units, respectively (p<0.05). Fungi of the genus Candida were detected in 39 (92.8%) of 42 examined patients, predominantly in the intestine (69.2%). Among the isolated species, Candida krusei (43.6%), Candida albicans (28.2%), Candida tropicalis (23.1%) and Candida glabrata (12.8%) predominated. A significant increase in the level of specific IgG antibodies to Candida and total IgE was established, indicating the formation of mycogenic sensitization. Statistically significant correlations were identified between the indicators of endogenous intoxication and the level of colonization by Candida fungi.

Conclusions. In patients with alopecia areata, endogenous intoxication syndrome develops and is accompanied by disturbances of the body mycobiota and a high frequency of colonization by Candida fungi. The formation of Candida-associated intestinal dysbiosis and mycogenic sensitization may contribute to the maintenance of chronic inflammation and may participate in the pathogenesis of the disease. The obtained findings substantiate the need for a comprehensive assessment of mycobiota status and endogenous intoxication in patients with alopecia areata.