Integrated Meta-Analysis of Scalp Transcriptomics and Serum Proteomics Defines Alopecia Areata Subtypes and Core Disease Pathways

October 2025 in “ International Journal of Molecular Sciences ”

Xi Li, Elena Peeva, Yuji Yamaguchi, Zhan Ye, Craig Hyde, Emma Guttman‐Yassky

alopecia areata patch-type alopecia alopecia totalis alopecia universalis scalp transcriptomics serum proteomics immune signatures keratin loss oxidative stress ferroptosis biomarkers immune pathways keratin preservation AA AAP AT AU

TLDR Early intervention in patch-type alopecia may prevent progression to more severe forms by targeting immune pathways and preserving keratin.

This study conducted an integrated meta-analysis of scalp transcriptomics and serum proteomics to explore molecular differences across alopecia areata (AA) subtypes, including patch-type alopecia (AAP) and more severe forms like alopecia totalis/universalis (AT/AU). It identified distinct immune signatures and structural disruptions, with early immune activation and keratin loss in AAP potentially leading to full follicular collapse in AT/AU. The research highlighted the role of oxidative stress and ferroptosis-related genes in AA pathology and found key immune markers consistently different in both tissue and serum, suggesting their potential as biomarkers. The findings emphasize the importance of early intervention in AAP to prevent progression to AT/AU and suggest targeting immune pathways and keratin preservation as therapeutic strategies.

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