• Diphencyprone treatment returns alopecia areata patients' immune system to a more normal state
• Diphencyprone treatment returns alopecia areata patients' immune system to a more normal state references

Diphencyprone treatment returns alopecia areata patients' immune system to a more normal state

Diphenylcyclopropenone [DPCP] or Diphencyprone [DCP] (different names but it’s the same thing) is the most effective treatment available so far for treating extensive Alopecia areata (but not available in the USA – the FDA blocked its use). The effect of DPCP on the hair follicles has been studied using a limited number of biopsy samples from the skin of alopecic patients. The studies indicate that there is an effect of the drug on the activation of lymphocyte T cells around the hair follicles. Since it is difficult to obtain a good number of biopsy samples from both alopecia areata affected and normal individuals for detailed studies, a study of the peripheral blood mononuclear cells was conducted to find what changes occur in the lymphocyte cells as a result of DPCP treatment.

The study involved 43 alopecic patients [26 treated with DPCP and 17 untreated] and 31 normal individuals as controls. The 26 individuals underwent treatments with DPCP ranging from 1-84 months with a mean treatment of 21 months prior to blood collection for the research study.

1. The individuals were evaluated for race, history for autoimmune diseases other than Alopecia areata, hair color, hair loss at the time of blood sample collection to know the severity of alopecia and nail dystrophy.

2. Blood samples were collected from all the individuals and the peripheral blood mononuclear cells were isolated by Ficoll isopaque centrifugation.

3. Monoclonal antibodies for CD4, 8, 11b, 16, 19; accessory molecules CD25, 40, 154; costimulatory molecules CD40, 80, 86 and cytokines such as Interleukin-10, 12, Interferon gamma and Tumor necrosis factor-alpha were used as markers.

4. Peripheral blood mononuclear cells were incubated with primary antibody and then with secondary antibody to label the cells for each of the factors and cytokines of interest. If the cells have the factor or cytokine, the antibodies will label the cells. If the cells don’t have the factor or cytokine that the antibodies bind to, then they won’t be labeled.

Peripheral blood mononuclear cell stimulation was carried out by incubating them with phytohemaglutinin (PHA) in a saline and nutrient solution. PHA stimulates cells non-specifically. By stimulating the cells the scientists can see how the cells respond and what factors and cytokines they produce.

The study revealed the following:-

When DPCP is applied on the skin, an allergic reaction is evident on the skin surface. It was seen that although a reaction took place on the skin surface there was no difference in the levels of cytokine expression or any increase in the costimulatory, accessory molecules and monocytes considered under the study.

Alopecic patients were grouped according to the severity of their condition to evaluate for changes in levels of the peripheral blood mononuclear cells when Alopecia areata ranges from mild to severe. However, it became clear that irrespective of the severity of the disease, only the amount of the components in question increased or decreased on the cells, but the numbers of cells remained pretty much the same regardless of treatment. The increase in factor expression had nothing to do with the percentage of hair loss but only with the onset of the condition. There was an increase in CD16 + cells and Tumor necrosis factor-alpha in alopecic patients along with increase in expression of costimulatory molecules CD40 and 80, accessory molecule CD154 and cytokines Interleukin-12 and IFN gamma though none of these had any relation to the extent of hair loss.

The patients treated with DPCP responded to the treatment which was evident in the marker expression of T-cell activation. Although the drug had no major consequence on the peripheral blood mononuclear cells, the increased levels of the costimulatory molecules, the T-cell activation markers and the cytokines were seen to return to normal as in healthy individuals except for Interleukin -10 and Tumor necrosis factor-alpha which remained at a higher level despite treatment.

When the alopecic condition regressed with administration of DPCP, no difference was seen in the components evaluated in the affected and normal individuals. However, there was an increase in the percentage of CD 40, 80, 154, Interleukin-12 and IFN gamma cells when the condition was in progressive state even after treatment with DPCP. Hence a comparative analysis of peripheral blood mononuclear cells before and after DPCP treatment may help evaluate the patient’s regressive or progressive state of the disease.

Diphencyprone treatment returns alopecia areata patients' immune system to a more normal state references

• Zoller M, McElwee KJ, Vitacolonna M, Hoffmann R. The progressive state, in contrast to the stable or regressive state of alopecia areata, is reflected in peripheral blood mononuclear cells. Exp Dermatol. 2004 Jul;13(7):435-44. PMID: 15217364