{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T07:21:45Z","timestamp":1783840905027,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Alopecia areata (AA) is a common autoimmune disorder characterized by non-scarring hair loss. The destruction of hair follicle cells is mediated by cytotoxic T cells, which release cytokines that contribute to tissue damage. Among these, Th17 cells produce key inflammatory mediators, including IL-17, IL-21, IL-6, and TNF-\u03b1, which may play a role in disease progression. This study aimed to evaluate the serum levels of IL-17A, IL-21, IL-6, and TNF-\u03b1 in patients with patchy AA compared with healthy controls and to assess their association with disease severity. Methods: A cross-sectional analytical study was conducted on 50 patients with patchy AA and 50 age- and gender-matched healthy controls. Blood samples were collected, and serum cytokine levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. Results: Of the patients, 70% were female (35 patients) and 30% were male (15 patients). Disease severity distribution showed that 66% had mild AA, 22% had moderate AA, and 12% had severe AA. Compared with controls, AA patients exhibited significantly elevated serum levels of IL-6, TNF-\u03b1, IL-17A, and IL-21 (p &lt; 0.001). Additionally, cytokine levels showed a positive correlation with both age and disease duration, suggesting their potential role in disease progression. Conclusions: These findings highlight the involvement of pro-inflammatory cytokines in the pathogenesis of patchy AA and their correlation with disease severity. Understanding these cytokine interactions may provide insights into targeted therapeutic strategies in managing AA.<\/jats:p>","DOI":"10.3390\/diseases13090283","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T14:02:46Z","timestamp":1756735366000},"page":"283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Detection of Serum Levels of Interleukins-17, 21, 6 and Tumor Necrosis Factor-\u03b1 in Patients with Patchy Alopecia Areata and Their Association with Disease Severity"],"prefix":"10.3390","volume":"13","author":[{"given":"Abeer Khaled","family":"Abu-El-Azayem","sequence":"first","affiliation":[{"name":"Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo 11956, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8963-8398","authenticated-orcid":false,"given":"Zinab","family":"Alatawi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk 47512, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-7304","authenticated-orcid":false,"given":"Helal F.","family":"Hetta","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Immunology and Biotechnology, Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7946-4477","authenticated-orcid":false,"given":"Ayman","family":"Salama","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutics, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5453-6332","authenticated-orcid":false,"given":"Nizar","family":"Sirag","sequence":"additional","affiliation":[{"name":"Division of Pharmacognosy, Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9211-8118","authenticated-orcid":false,"given":"Eid","family":"Alatwi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehab Mohamed","family":"Naguib","sequence":"additional","affiliation":[{"name":"Dermatology and Venerology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"Erfan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo 11956, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham","family":"Abdelhamid","sequence":"additional","affiliation":[{"name":"Plastic Surgery and Hair Transplantation Center, Vertex \u00c4sthetik Klinik, Cairo 12566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer El-Dessouki","family":"El Sayed","sequence":"additional","affiliation":[{"name":"Health Administration and Information Technology, Faculty of Applied Health Science Technology, Misr University for Science and Technology, 6th of October City, Giza 12566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mera Mohamed","family":"Galal Anan","sequence":"additional","affiliation":[{"name":"Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo 11956, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2535","DOI":"10.1038\/jid.2010.260","article-title":"Collapse of immune privilege in alopecia areata: Coincidental or substantial?","volume":"130","author":"Gilhar","year":"2010","journal-title":"J. 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