Ahmed Mohamed HAMED, Marwa Gamal ABDALSATTAR, Sara Elsayed ABDELAZEEM, Amira Osama ABD EL-GHAFFAR, Radwa Mahmoud AHMED, Ghada Mohamed SHAMS
Turkish Journal of Dermatology - 2026;20(3):131-137
Aim: This cross-sectional investigation aimed to delineate the role of circulating heat shock protein 70 (HSP-70) in alopecia areata (AA) pathogenesis, to assess its correlation with disease severity, and to evaluate its potential association with auditory function. Materials and Methods: A cohort comprising 30 AA patients and 30 matched, healthy, AA-free subjects underwent comprehensive assessment. Circulating HSP-70 levels were quantified using enzyme-linked immunosorbent assay, and the Severity of Alopecia Tool (SALT) score was used to objectively assess AA severity. Audiological integrity was evaluated through pure-tone audiometry across standard frequencies. The predictors of AA were identified using multivariate logistic regression. Results: Revealed a statistically significant elevation of serum HSP-70 in AA patients compared to controls (2.5 +/- 0.8 ng/mL vs. 1.3 +/- 0.6 ng/mL; P < 0.001). Furthermore, AA patients exhibited significantly higher mean auditory thresholds across various frequencies; however, the clinical significance of these differences requires further investigation. Receiver operating characteristic analysis demonstrated robust diagnostic utility for HSP-70, with an area under the curve of 0.847 (P < 0.001) and an optimal diagnostic threshold exceeding 1.4 ng/mL. Multivariate analysis indicated that each unit increase in HSP-70 was associated with ninefold higher odds of AA (odds ratio = 9.213, P < 0.001). A positive correlation was observed between HSP-70 levels and disease duration (r = 0.504, P = 0.004), although no significant associations were found between HSP-70 levels and SALT score or auditory thresholds. Conclusion: Elevated HSP-70 levels show promise as a biomarker for AA and correlate with disease chronicity. Further research is imperative to elucidate HSP-70's mechanistic contributions to AA pathogenesis and its nuanced relationship with auditory function.
