Scalp and serum profiling of frontal fibrosing alopecia reveals scalp immune and fibrosis dysregulation with no systemic involvement

Frontal fibrosing alopecia (FFA) is a progressive, scarring alopecia of the frontotemporal scalp that poses a substantial burden on quality of life. Large-scale global profiling of FFA is lacking, preventing the development of effective therapeutics. To characterize FFA compared to normal and alopec...

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Published in:Journal of the American Academy of Dermatology 2022-03, Vol.86 (3), p.551-562
Main Authors: Dubin, Celina, Glickman, Jacob W., Del Duca, Ester, Chennareddy, Sumanth, Han, Joseph, Dahabreh, Dante, Estrada, Yeriel D., Zhang, Ning, Kimmel, Grace W., Singer, Giselle, Chowdhury, Mashkura, Zheng, Andrew Y., Angelov, Michael, Gay-Mimbrera, Jesús, Ruano Ruiz, Juan, Krueger, James G., Pavel, Ana B., Guttman-Yassky, Emma
Format: Article
Language:English
Subjects:
Alopecia - genetics
Alopecia - pathology
Alopecia Areata
biomarkers
Biomarkers - metabolism
Cross-Sectional Studies
Female
Fibrosis
frontal fibrosing alopecia
hair keratins
Humans
JAK/STAT
Lichen Planus - pathology
OLINK
proteomics
Quality of Life
Scalp - pathology
Th1
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Summary:Frontal fibrosing alopecia (FFA) is a progressive, scarring alopecia of the frontotemporal scalp that poses a substantial burden on quality of life. Large-scale global profiling of FFA is lacking, preventing the development of effective therapeutics. To characterize FFA compared to normal and alopecia areata using broad molecular profiling and to identify biomarkers linked to disease severity. This cross-sectional study assessed 33,118 genes in scalp using RNA sequencing and 350 proteins in serum using OLINK high-throughput proteomics. Disease biomarkers were also correlated with clinical severity and a fibrosis gene set. Genes differentially expressed in lesional FFA included markers related to Th1 (IFNγ/CXCL9/CXCL10), T-cell activation (CD2/CD3/CCL19/ICOS), fibrosis (CXCR3/FGF14/FGF22/VIM/FN1), T-regulatory (FOXP3/TGFB1/TGFB3), and Janus kinase/JAK (JAK3/STAT1/STAT4) (Fold changes [FCH]>1.5, FDR1.3, FDR.6; P 
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2021.05.016