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We investigated the local expression of MC2R by immunohistochemistry to identify the role of ACTH/MC2R in stress-associated alopecia areata (AA). MC2R appeared to be highly compartmentalized in scalp skin including the epidermal cells of hair follicles and epidermis, sebaceous and eccrine glands, as well as dermal fibroblasts. The expression of MC2R was lower in AA lesions than in normal scalp tissue in almost all scalp skin cells, especially in epithelial cells. These findings demonstrate that MC2R expression is aberrant in AA and suggest a deficit in ACTH/MC2R activity may play an important role in the pathophysiology of AA. Stress reactivity is believed to play a role in the pathogenesis of alopecia areata (AA) (1�C3). Recently, a local HPA axis with a role in skin responses to emotional and environmental stress has been described, and these studies show that adrenocorticotropic hormone (ACTH) is the strongest stimulus for cortisol [http://bestofhousemusic.be/members/bonedirt5/activity/198589/ http://bestofhousemusic.be/members/bonedirt5/activity/198589/] production in skin (4,5). Moreover, ACTH is recognized to have the strongest effect [http://028ybtg.com/comment/html/?211668.html The Way I Improved My AZD4547 Accomplishment By 300%] on hair growth among all of the proopiomelanocortin (POMC) peptides (5), so the ACTH-specific receptor melanocortin receptor type 2 (MC2R) could be important in the physiological response to stressors in hair follicles. However, the exact location and role of MC2R remain unclear (6). Many reports demonstrate that humans and animals with AA have similar abnormalities in HPA activity (7,8). CRH is thought to require ACTH as an ��endocrine second messenger�� for the stimulation of cortisol synthesis (5), so the specific ACTH receptor MC2R might be a key molecule in the modified HPA axis of AA. To answer this critical question, we assessed AA lesions and normal human scalp tissue for the expression of MC2R. Longitudinal sections of scalp were taken from lesional regions of 12 patients (seven men and five women, median age of 31 years) with AA. Although the duration of hair loss was variable (6?months�C10?years, SD 3?years), biopsies were taken only during periods of acute and active hair loss. A total of 10 scalp specimens (seven men and three women, median age of 33?years) from normal subjects were taken as the controls. Fluorescence immunohistochemistry (IF) and diaminobenzidine (DAB) immunohistochemistry were performed following published protocols. Immunostaining was evaluated semiquantitatively on a scale [http://b3nson.net/vanilla/discussion/729475/to-individuals-who-would-like-to-grasp-carfilzomib-but-is-unable-to-get-rolling#Item_1 To Individuals Who Would Like To Grasp Carfilzomib But Is Unable To Get Rolling] of 0�C3: 0, negative; 1, barely discernible; 2, moderately intense; 3, strong staining. Tissues showing membrane or cytoplasmic staining of any cells was assessed as positive. The Kruskal�CWallis H test was used for statistical analysis of immunohistochemistry data for MC2R expression level differences between patients with AA and healthy controls. P values