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INVESTIGATIVE REPORT
Alopecia Areata is Associated with Increased Expression of Heart
Disease Biomarker Cardiac Troponin I
Eddy Hsi Chun WANG 1,2 , Leopoldo SANTOS 3,4 , Xi Yuan LI 1 , Annie TRAN 1 , Sandra S. Y. KIM 1 , Katrina WOO 1 , Jerry SHAPIRO 3,5
and Kevin J. MCELWEE 1,6
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada, 2 Department of Dermatology, College
of Physicians and Surgeons, Columbia University, New York, USA, 3 Department of Dermatology and Skin Science, Vancouver General
Hospital, Vancouver, BC, Canada, 4 Hospital Universitário de Taubaté Dermatologia, Universidade de Taubaté, Taubaté, Brazil, 5 The Ronald
O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA and 6 Centre for Skin Sciences, University
of Bradford, Bradford, UK
1
The development of androgenetic alopecia is associa-
ted with a risk of developing cardiovascular diseases,
but the association of alopecia areata with cardiovas-
cular diseases in humans is largely unexplored. We
measured the plasma level of two common cardio-
vascular disease markers, cardiac troponin I and C-
reactive protein, in alopecia areata and androgenetic
alopecia-affected subjects. Also, we investigated the
possible presence of pro-apoptotic factors in the plas-
ma of hair loss subjects. The mean plasma cardiac tro-
ponin I level was highest in alopecia areata subjects,
moderately higher in androgenetic alopecia subjects,
and lowest in subjects without hair loss (p < 0.05).
Alopecia areata subjects not receiving treatments had
highest levels of cardiac troponin I (p < 0.05). Alope-
cia areata plasma samples with high cardiac troponin I
levels also induced significantly higher rates of cardio-
myocyte apoptosis in cell culture assays. The results
suggest the potential for increased heart remodelling.
Close monitoring of cardiovascular health in alopecia
areata subjects, as well as subsets of androgenetic
alopecia patients, may be appropriate.
Key words: alopecia areata; androgenetic alopecia; autoim-
mune disease; cardiac troponin I; C-reactive protein; heart re-
mod