Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations

Chuang Wei Wang; Ming Ying Wu; Chun Bing Chen; Wei Chen Lin; Jennifer Wu; Chun Wei Lu; Wei Ti Chen; Fang Ying Wang; Rosaline Chung Yee Hui; Min Hui Chi; Tsu Man Chiu; Ya Ching Chang; Jing Yi Lin; Yang Yu Wei Lin; Wan Ting Tsai; Shuen Iu Hung; Wen Hung Chung

doi:10.1016/j.clim.2023.109737

Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations

Chuang Wei Wang
, Ming Ying Wu
, Chun Bing Chen
, Wei Chen Lin
, Jennifer Wu
, Chun Wei Lu
, Wei Ti Chen
, Fang Ying Wang
, Rosaline Chung Yee Hui
, Min Hui Chi
, Tsu Man Chiu
, Ya Ching Chang
, Jing Yi Lin
, Yang Yu Wei Lin
, Wan Ting Tsai
, Shuen Iu Hung^*
, Wen Hung Chung^*

^*Corresponding author for this work

Chang Gung Memorial Hospital
Xiamen Chang Gung Hospital
Chang Gung University
National Tsing Hua University
National Taiwan University
Chung Shan Medical University
National Yang Ming Chiao Tung University
Tsinghua University
Shanghai Jiao Tong University

Research output: Contribution to journal › Journal Article › peer-review

9 Scopus citations

Abstract

Background: The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized. Objective: We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA). Study design: 27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis. Results: The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 × 10⁻⁵-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002–0.04). Conclusions: Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.

Original language	English
Article number	109737
Pages (from-to)	109737
Journal	Clinical Immunology
Volume	255
DOIs	https://doi.org/10.1016/j.clim.2023.109737
State	Published - 10 2023
Externally published	Yes

Bibliographical note

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Alopecia areata
Autoimmune disease
COVID-19 vaccine
Granulysin
Lymphocyte activation test
Polyethylene glycol
Spike protein
Vaccination/adverse effects
Humans
Alopecia Areata/etiology
Spike Glycoprotein, Coronavirus
COVID-19
COVID-19 Vaccines/adverse effects

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10.1016/j.clim.2023.109737

Cite this

Wang, C. W., Wu, M. Y., Chen, C. B., Lin, W. C., Wu, J., Lu, C. W., Chen, W. T., Wang, F. Y., Hui, R. C. Y., Chi, M. H., Chiu, T. M., Chang, Y. C., Lin, J. Y., Lin, Y. Y. W., Tsai, W. T., Hung, S. I., & Chung, W. H. (2023). Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations. Clinical Immunology, 255, 109737. Article 109737. https://doi.org/10.1016/j.clim.2023.109737

@article{f6bc16f6d810428c95673525522ddb04,

title = "Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations",

abstract = "Background: The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized. Objective: We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA). Study design: 27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis. Results: The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 {\texttimes} 10−5-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002{\textendash}0.04). Conclusions: Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.",

keywords = "Alopecia areata, Autoimmune disease, COVID-19 vaccine, Granulysin, Lymphocyte activation test, Polyethylene glycol, Spike protein, Vaccination/adverse effects, Humans, Alopecia Areata/etiology, Spike Glycoprotein, Coronavirus, COVID-19, COVID-19 Vaccines/adverse effects",

author = "Wang, \{Chuang Wei\} and Wu, \{Ming Ying\} and Chen, \{Chun Bing\} and Lin, \{Wei Chen\} and Jennifer Wu and Lu, \{Chun Wei\} and Chen, \{Wei Ti\} and Wang, \{Fang Ying\} and Hui, \{Rosaline Chung Yee\} and Chi, \{Min Hui\} and Chiu, \{Tsu Man\} and Chang, \{Ya Ching\} and Lin, \{Jing Yi\} and Lin, \{Yang Yu Wei\} and Tsai, \{Wan Ting\} and Hung, \{Shuen Iu\} and Chung, \{Wen Hung\}",

note = "Copyright {\textcopyright} 2023. Published by Elsevier Inc.",

year = "2023",

month = oct,

doi = "10.1016/j.clim.2023.109737",

language = "英语",

volume = "255",

pages = "109737",

journal = "Clinical Immunology",

issn = "1521-6616",

publisher = "Academic Press Inc.",

}

Wang, CW, Wu, MY, Chen, CB, Lin, WC, Wu, J, Lu, CW, Chen, WT, Wang, FY, Hui, RCY, Chi, MH, Chiu, TM, Chang, YC, Lin, JY, Lin, YYW, Tsai, WT, Hung, SI & Chung, WH 2023, 'Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations', Clinical Immunology, vol. 255, 109737, pp. 109737. https://doi.org/10.1016/j.clim.2023.109737

TY - JOUR

T1 - Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations

AU - Wang, Chuang Wei

AU - Wu, Ming Ying

AU - Chen, Chun Bing

AU - Lin, Wei Chen

AU - Wu, Jennifer

AU - Lu, Chun Wei

AU - Chen, Wei Ti

AU - Wang, Fang Ying

AU - Hui, Rosaline Chung Yee

AU - Chi, Min Hui

AU - Chiu, Tsu Man

AU - Chang, Ya Ching

AU - Lin, Jing Yi

AU - Lin, Yang Yu Wei

AU - Tsai, Wan Ting

AU - Hung, Shuen Iu

AU - Chung, Wen Hung

PY - 2023/10

Y1 - 2023/10

N2 - Background: The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized. Objective: We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA). Study design: 27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis. Results: The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 × 10−5-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002–0.04). Conclusions: Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.

AB - Background: The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized. Objective: We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA). Study design: 27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis. Results: The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 × 10−5-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002–0.04). Conclusions: Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.

KW - Alopecia areata

KW - Autoimmune disease

KW - COVID-19 vaccine

KW - Granulysin

KW - Lymphocyte activation test

KW - Polyethylene glycol

KW - Spike protein

KW - Vaccination/adverse effects

KW - Humans

KW - Alopecia Areata/etiology

KW - Spike Glycoprotein, Coronavirus

KW - COVID-19

KW - COVID-19 Vaccines/adverse effects

UR - https://www.scopus.com/pages/publications/85168478380

U2 - 10.1016/j.clim.2023.109737

DO - 10.1016/j.clim.2023.109737

M3 - 文章

C2 - 37586672

AN - SCOPUS:85168478380

SN - 1521-6616

VL - 255

SP - 109737

JO - Clinical Immunology

JF - Clinical Immunology

M1 - 109737

ER -

Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations

Abstract

Bibliographical note

UN SDGs

Keywords

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