Assessment of Serum Level of Brain-Derived Neurotrophic Factor (BDNF) In Pediatric Alopecia Areata: A Case - Control Study

Alopecia areata (AA) is a type of non-scaring hair loss condition caused by immune system dysfunction that frequently manifests in childhood, often leading to significant psychological distress. Brain-derived neurotrophic factor (BDNF), participating in neuroimmune and stress pathways, could be involved in the pathogenesis of AA. The objective of this study was to measure serum BDNF levels in pediatric AA patients and explore the relation between it and AA severity, depression, and quality of life. This case-control study was conducted on 40 AA children with 40 healthy controls matched for sex and age. BDNF levels were measured using ELISA. AA extent assessment was measured using the Severity of Alopecia Tool (SALT) score, depressive symptoms with the Children’s Depression Inventory (CDI), and life quality with the Children's Dermatology Life Quality Index (CDLQI). Pediatric AA patients showed significantly lower BDNF levels in comparison with controls (0.99 ± 0.7 vs. 1.65 ± 0.9 ng/ml; p  < 0.001). SALT scores were positively correlated with both CDI (r = 0.606) and CDLQI (r = 0.607) scores ( p  < 0.001). BDNF levels negatively correlated with SALT (r = − 0.34), CDI (r = − 0.46), and CDLQI (r = − 0.49) scores. In conclusion, serum BDNF may serve as a potential biomarker reflecting both neuroimmune activity and psychological distress in pediatric alopecia areata. Reduced BDNF concentrations were strongly associated with greater disease severity, higher depressive symptom scores, and poorer quality of life. These findings highlight the importance of a multidisciplinary approach that incorporates psychological support into the dermatologic care of affected children.