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
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
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
Exp Dermatol. 2004 Jul;13(7):435-44. PMID: 15217364