{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T20:40:02Z","timestamp":1768250402533,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T00:00:00Z","timestamp":1355184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Altered hypothalamic\u2013pituitary\u2013adrenal (<jats:styled-content style=\"fixed-case\">HPA<\/jats:styled-content>) axis response involved in the pathogenesis of stress\u2010associated alopecia areata (<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>) has been reported. A novel polymorphism \u22122<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>&gt;<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> of the adrenocorticotropin receptor (<jats:styled-content style=\"fixed-case\">ACTHR<\/jats:styled-content>) can result in an insufficient <jats:styled-content style=\"fixed-case\">HPA<\/jats:styled-content> response to stress; therefore, the functional polymorphism may underlie a role in stress\u2010associated <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the relationship between psychosocial factors and the risk of developing <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> and to detect the association between the \u22122<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>&gt;<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> polymorphism of <jats:styled-content style=\"fixed-case\">ACTHR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Stressful situations were evaluated using <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>olmes and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ahe's social readjustment rating scale. The <jats:styled-content style=\"fixed-case\">ACTHR<\/jats:styled-content> \u22122<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>&gt;<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> polymorphism was examined in 263 patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> and 241 controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant elevation of psychological stress experienced by some patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> compared with controls (<jats:italic>Z<\/jats:italic>\u00a0=\u00a06.628, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). The frequency of the <jats:styled-content style=\"fixed-case\">ACTHR<\/jats:styled-content> C allele showed a significant difference between patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> and controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004). Allele <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> is the risk allele with a dominant model as the \u22122<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> allele occurred more often in patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001). There were significant differences between patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> with a severe stress attack versus patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> with no obvious stress (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), whereas the genotype frequencies were not correlated with the type, duration of disease, and age at onset. Notably, the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> allele carrier was significantly associated with stress risk in both <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> and controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.576, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.148\u20132.162; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.042, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.529, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.022\u20132.288).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> in some patients may be associated with stress. The <jats:styled-content style=\"fixed-case\">ACTHR<\/jats:styled-content> gene \u22122<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>&gt;<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> variant may be one important factor that influences stress perception of patients with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-4632.2012.05749.x","type":"journal-article","created":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T12:56:55Z","timestamp":1355230615000},"page":"441-445","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The \u22122<scp>T<\/scp>\/<scp>C<\/scp> polymorphism in the adrenocorticotropin receptor gene affects stress perception of patients with alopecia areata"],"prefix":"10.1111","volume":"52","author":[{"given":"Hong\u2010Wei","family":"Guo","sequence":"first","affiliation":[{"name":"Department 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