Original article
Immunization and Bacterial Pathogens in the Oropharynx as Risk Factors for Alopecia Areata
Inmunizaciones y bacterias patógenas en la faringe como factores de riesgo para alopecia areata
M.A. Morales-Sánchez
, M.A. Domínguez-Gómez, F. Jurado-Santa Cruz, M.L. Peralta-Pedrero
Corresponding author
Centro Dermatológico Dr. Ladislao de la Pascua, Mexico City, Mexico
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Rojo-España, A. Marquina-Vila, N. Gimeno-Clemente, M.M. Morales-Suárez-Varela" "autores" => array:5 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Tomás-Mallebrera" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Rojo-España" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Marquina-Vila" ] 3 => array:2 [ "nombre" => "N." "apellidos" => "Gimeno-Clemente" ] 4 => array:2 [ "nombre" => "M.M." "apellidos" => "Morales-Suárez-Varela" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010706661?idApp=UINPBA000044" "url" => "/15782190/0000010100000005/v1_201304241523/S1578219010706661/v1_201304241523/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Immunization and Bacterial Pathogens in the Oropharynx as Risk Factors for Alopecia Areata" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "437" "paginaFinal" => "443" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.A. Morales-Sánchez, M.A. Domínguez-Gómez, F. Jurado-Santa Cruz, M.L. Peralta-Pedrero" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M.A." "apellidos" => "Morales-Sánchez" "email" => array:1 [ 0 => "marthams@prodigy.net.mx" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "Domínguez-Gómez" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Jurado-Santa Cruz" ] 3 => array:2 [ "nombre" => "M.L." "apellidos" => "Peralta-Pedrero" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Centro Dermatológico Dr. Ladislao de la Pascua, Mexico City, Mexico" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Inmunizaciones y bacterias patógenas en la faringe como factores de riesgo para alopecia areata" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-06-15" "fechaAceptado" => "2009-12-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84772" "palabras" => array:5 [ 0 => "Alopecia areata" 1 => "Immunization" 2 => "Bacterial colonization" 3 => "Pharynx" 4 => "<span class="elsevierStyleItalic">Streptococcus pyogenes</span> carriage" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84773" "palabras" => array:4 [ 0 => "Alopecia areata" 1 => "Inmunizaciones" 2 => "Bacterias en la faringe" 3 => "Estado de portador de <span class="elsevierStyleItalic">S. pyogenes</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Alopecia areata is an autoimmune inflammatory disease affecting the hair follicles. Researchers are currently interested in whether the presence of bacterial pathogens and/or a history of immunization can trigger an autoimmune response in patients who are genetically predisposed.</p> <span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">This study aimed to determine whether there is an association between the development of alopecia areata and throat carriage of bacterial pathogens or a history of immunization.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Sixty-five men and women with alopecia areata and 65 control patients with other skin diseases were studied at the Dr Ladislao de la Pascua Dermatology Clinic between September 2008 and February 2009. The patients ranged in age from 18 to 59 years. Patients with scalp diseases were excluded from the control group. In all cases, the patient was questioned about immunizations received in the previous 6 months, and a throat swab was cultured.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A history of immunization (odds ratio [OR], 3.3; 1.6% confidence interval [CI], 1.6-6.7; <span class="elsevierStyleItalic">P</span>=.001), the presence of bacterial pathogens in the oropharynx (OR, 2.6; 95% CI, 1.1-6.2; <span class="elsevierStyleItalic">P</span>=.033), and being a carrier of Streptococcus pyogenes (OR, 2.1; 95% CI, 1.7-2.5; <span class="elsevierStyleItalic">P</span>=.042) were risk factors for alopecia areata. <span class="elsevierStyleItalic">Klebsiella pneumoniae, S pyogenes, Pseudomonas aeruginosa, Streptococcus pneumoniae, Serratia marcescens</span> and <span class="elsevierStyleItalic">Escherichia coli</span> were isolated from cultures.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">This is the first study to show an association between alopecia areata and throat carriage of bacterial pathogens or history of immunization, as risk factors for development of the disease. Given the characteristics of our study population, the association appears valid for patients with less than 25% hair loss and a course of disease under 1 year.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">La alopecia areata es una enfermedad inflamatoria autoinmune que afecta al pelo. Actualmente se estudia si las bacterias patógenas y las inmunizaciones son inductores de la respuesta autoinmune en pacientes con susceptibilidad genética.</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio fue determinar si las bacterias patógenas en la faringe y el antecedente de haber recibido inmunizaciones están asociados a la enfermedad.</p> <span class="elsevierStyleSectionTitle">Materiales y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">En el Centro Dermatológico «Dr. Ladislao de la Pascua», desde septiembre de 2008 a febrero de 2009, se estudiaron 65 pacientes con alopecia areata y 65 controles con otras dermatosis, excluyendo las del cuero cabelludo. Se incluyeron pacientes de 18 a 59 años de edad y de ambos sexos. A todos se les interrogó sobre inmunizaciones recibidas 6 meses antes y se les realizó un cultivo de exudado faríngeo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Haber recibido inmunizaciones, la presencia de bacterias patógenas en la faringe y ser portador de <span class="elsevierStyleItalic">S. pyogenes</span> se comportaron como factores de riesgo para la alopecia areata, con una razón de probabilidades de 3,3 (IC 95% 1,6-6,7; p = 0,001), 2,6 (IC 95%: 1,1-6,2; p = 0,033) y 2,1 (IC 95% 1,7-2,5; p = 0,042), respectivamente. Las bacterias aisladas fueron <span class="elsevierStyleItalic">Klebiella penumoniae, Streptococcus pyogenes, Pseudomonas aeruginosa, Streptococcus pneumoniae, Serratia marcescens</span> y <span class="elsevierStyleItalic">Escherichia coli</span>.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Este es el primer estudio que apoya los hallazgos de estado de portador de bacterias patógenas en la faringe y la aplicación de inmunizaciones como factores de riesgo para desarrollar alopecia areata. Por las características de nuestra población, esta asociación es válida para los pacientes con menos del 25% de pérdida de pelo y con una evolución inferior a un año.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 11 | 14 |
| 2024 October | 63 | 54 | 117 |
| 2024 September | 63 | 29 | 92 |
| 2024 August | 109 | 66 | 175 |
| 2024 July | 60 | 33 | 93 |
| 2024 June | 65 | 37 | 102 |
| 2024 May | 63 | 39 | 102 |
| 2024 April | 44 | 24 | 68 |
| 2024 March | 58 | 36 | 94 |
| 2024 February | 45 | 38 | 83 |
| 2024 January | 49 | 31 | 80 |
| 2023 December | 47 | 29 | 76 |
| 2023 November | 47 | 29 | 76 |
| 2023 October | 55 | 37 | 92 |
| 2023 September | 50 | 40 | 90 |
| 2023 August | 28 | 18 | 46 |
| 2023 July | 50 | 49 | 99 |
| 2023 June | 41 | 24 | 65 |
| 2023 May | 31 | 29 | 60 |
| 2023 April | 20 | 21 | 41 |
| 2023 March | 25 | 21 | 46 |
| 2023 February | 27 | 19 | 46 |
| 2023 January | 29 | 24 | 53 |
| 2022 December | 37 | 34 | 71 |
| 2022 November | 15 | 27 | 42 |
| 2022 October | 15 | 15 | 30 |
| 2022 September | 20 | 32 | 52 |
| 2022 August | 17 | 27 | 44 |
| 2022 July | 16 | 30 | 46 |
| 2022 June | 13 | 37 | 50 |
| 2022 May | 22 | 31 | 53 |
| 2022 April | 32 | 25 | 57 |
| 2022 March | 17 | 51 | 68 |
| 2022 February | 28 | 24 | 52 |
| 2022 January | 18 | 31 | 49 |
| 2021 December | 18 | 43 | 61 |
| 2021 November | 26 | 44 | 70 |
| 2021 October | 23 | 56 | 79 |
| 2021 September | 22 | 49 | 71 |
| 2021 August | 11 | 28 | 39 |
| 2021 July | 15 | 33 | 48 |
| 2021 June | 17 | 23 | 40 |
| 2021 May | 16 | 28 | 44 |
| 2021 April | 34 | 48 | 82 |
| 2021 March | 41 | 24 | 65 |
| 2021 February | 63 | 32 | 95 |
| 2021 January | 40 | 23 | 63 |
| 2020 December | 23 | 13 | 36 |
| 2020 November | 18 | 28 | 46 |
| 2020 October | 21 | 16 | 37 |
| 2020 September | 15 | 10 | 25 |
| 2020 August | 20 | 17 | 37 |
| 2020 July | 16 | 18 | 34 |
| 2020 June | 18 | 20 | 38 |
| 2020 May | 16 | 15 | 31 |
| 2020 April | 9 | 20 | 29 |
| 2020 March | 18 | 24 | 42 |
| 2020 February | 0 | 1 | 1 |
| 2020 January | 0 | 4 | 4 |
| 2019 December | 0 | 6 | 6 |
| 2019 November | 0 | 5 | 5 |
| 2019 October | 0 | 13 | 13 |
| 2019 September | 0 | 5 | 5 |
| 2019 August | 0 | 6 | 6 |
| 2019 July | 0 | 13 | 13 |
| 2019 June | 0 | 3 | 3 |
| 2019 May | 0 | 39 | 39 |
| 2019 April | 0 | 9 | 9 |
| 2019 March | 0 | 6 | 6 |
| 2019 February | 0 | 3 | 3 |
| 2018 June | 0 | 1 | 1 |
| 2018 May | 0 | 7 | 7 |
| 2018 April | 0 | 3 | 3 |
| 2018 March | 1 | 2 | 3 |
| 2018 February | 13 | 3 | 16 |
| 2018 January | 11 | 3 | 14 |
| 2017 December | 18 | 12 | 30 |
| 2017 November | 17 | 6 | 23 |
| 2017 October | 23 | 6 | 29 |
| 2017 September | 28 | 8 | 36 |
| 2017 August | 38 | 8 | 46 |
| 2017 July | 25 | 2 | 27 |
| 2017 June | 37 | 20 | 57 |
| 2017 May | 44 | 18 | 62 |
| 2017 April | 44 | 22 | 66 |
| 2017 March | 49 | 33 | 82 |
| 2017 February | 26 | 6 | 32 |
| 2017 January | 15 | 9 | 24 |
| 2016 December | 24 | 14 | 38 |
| 2016 November | 17 | 17 | 34 |
| 2016 October | 29 | 34 | 63 |
| 2016 September | 34 | 8 | 42 |
| 2016 August | 35 | 9 | 44 |
| 2016 July | 24 | 6 | 30 |
| 2016 June | 10 | 8 | 18 |
| 2016 May | 8 | 10 | 18 |
| 2016 April | 7 | 7 | 14 |
| 2016 March | 4 | 5 | 9 |
| 2016 February | 6 | 1 | 7 |
| 2016 January | 5 | 2 | 7 |
| 2015 December | 15 | 1 | 16 |
| 2015 November | 3 | 1 | 4 |
| 2015 October | 7 | 1 | 8 |
| 2015 September | 4 | 4 | 8 |
| 2015 August | 24 | 2 | 26 |
| 2015 July | 34 | 3 | 37 |
| 2015 June | 30 | 9 | 39 |
| 2015 May | 57 | 15 | 72 |
| 2015 April | 38 | 10 | 48 |
| 2015 March | 69 | 12 | 81 |
| 2015 February | 23 | 13 | 36 |
| 2015 January | 29 | 12 | 41 |
| 2014 December | 26 | 18 | 44 |
| 2014 November | 21 | 23 | 44 |
| 2014 October | 27 | 34 | 61 |
| 2014 September | 24 | 19 | 43 |
| 2014 August | 27 | 13 | 40 |
| 2014 July | 36 | 20 | 56 |
| 2014 June | 38 | 12 | 50 |
| 2014 May | 40 | 10 | 50 |
| 2014 April | 40 | 7 | 47 |
| 2014 March | 50 | 19 | 69 |
| 2014 February | 42 | 20 | 62 |
| 2014 January | 33 | 13 | 46 |
| 2013 December | 29 | 10 | 39 |
| 2013 November | 28 | 19 | 47 |
| 2013 October | 25 | 15 | 40 |
| 2013 September | 40 | 22 | 62 |
| 2013 August | 30 | 17 | 47 |
| 2013 July | 35 | 23 | 58 |
| 2013 June | 36 | 26 | 62 |
| 2013 May | 25 | 25 | 50 |
| 2013 April | 31 | 28 | 59 |
| 2013 March | 35 | 21 | 56 |
| 2013 February | 17 | 14 | 31 |
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