The Role of Serum Th1, Th2, and Th17 Cytokines in Patients with Alopecia Areata: Clinical Implications

Cells. 2021 Dec 2;10(12):3397. doi: 10.3390/cells10123397.


Alopecia areata is a type of non-scarring hair loss. The dysregulation of numerous systemic Th1 (IL-2, IFN-γ, TNF, IL-12, and IL-18), Th2 (IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17E, IL-31 and IL-33) and Th17 (IL-17, IL-17F, IL-21, IL-22, IL-23 and TGF-β) cytokines was observed in patients with alopecia areata. Positive correlations between the severity of alopecia areata and an increased serum level of various cytokines including IL-2, TNF, IL-12, IL-17, and IL-17E were reported in the literature. An increased serum level of numerous cytokines, such as IL-2, IL-6, TNF, IL-12, IL-17E, and IL-22, was described as positively correlated with the duration of the disease. Moreover, it was shown that increased pre-treatment serum level of IL-12 was a positive, while increased serum levels of IL-4 and IL-13 were negative prognostic markers for the efficacy of diphenylcyclopropenone. In conclusion, alopecia areata is associated with the dysregulation of systemic Th1, Th2 and Th17 cytokines with their role in the pathogenesis, clinical manifestations and prognosis of the disease. Available data indicate the most significant role of serum IL-2, TNF, IL-12, IL-17, and IL-17E as markers of disease activity. The serum levels IL-4, IL-12 and IL-13 may be useful as potential predictors of diphenylcyclopropenone efficacy.

Keywords: chemokine; cytokine; immunology; interleukin.

Publication types

  • Review

MeSH terms

  • Alopecia Areata / blood*
  • Alopecia Areata / genetics
  • Alopecia Areata / immunology
  • Alopecia Areata / pathology
  • Cytokines / blood*
  • Cytokines / classification
  • Cytokines / genetics
  • Humans
  • Interleukin-12 / blood
  • Interleukin-17 / blood
  • Interleukin-2 / blood
  • Th1 Cells / metabolism*
  • Th1 Cells / pathology
  • Th17 Cells / metabolism*
  • Th17 Cells / pathology
  • Th2 Cells / metabolism*
  • Th2 Cells / pathology
  • Tumor Necrosis Factor-alpha / blood


  • Cytokines
  • IL25 protein, human
  • Interleukin-17
  • Interleukin-2
  • Tumor Necrosis Factor-alpha
  • Interleukin-12