Role of cytomegalovirus replication in alopecia areata pathogenesis

Background: Cytomegalovirus (CMV) infection has been correlated with various autoimmune disorders. Using molecular biology techniques, DNA sequences of CMV have been reported in paraffin sections of alopecia areata (AA) lesions. Reactivation of the CMV infection has been postulated as one of the pathogenic mechanisms in AA. Other studies, using different techniques however have demonstrated no correlation between CMV and AA. Objectives: This study was to clarify the role of CMV infection and to demonstrate the absence of replication of other autoimmune diseases-related herpes virus (EBV) in the pathogenesis of AA. Methods: After extraction of mRNA from tissue samples of a patient with active patchy AA, reverse transcriptase-polymerase chain reaction was carried out using primers specific for some viral members of the β-herpes viridae family (CMV, EBV, HSV). Results: No replication of the CMV or other β-herpes viridae has been detected in any of the samples collected. Conclusions: The results strongly support the hypothesis that CMV is not the triggering factor in AA, neither as a re-activator of the immune response nor as a trigger of the autoimmunity. No other herpes virus is implicated in the pathogenesis of this disease.