Why Steroids May Not Always Work in Alopecia Areata: Elevated Unoccupied Glucocorticoid Receptors and Decreased Levels of Thioredoxin

    December 2001 in “ Dermatologic Therapy ”
    Marty E. Sawaya, Maria Hordinsky
    TLDR Steroids may not work well for alopecia areata because of high unoccupied receptors and low thioredoxin levels.
    The study investigated why glucocorticoid (GC) steroids may not always be effective in treating alopecia areata (AA). Scalp biopsies from 15 patients with AA, male androgenetic alopecia (AGA), and normal controls were analyzed for glucocorticoid receptor (GCR) content. Results showed that patients with AA had elevated levels of unoccupied type II GCR compared to AGA and normal controls, along with decreased levels of thioredoxin (TR), a factor that activates GCR. This suggested an inhibition of cellular transcription, which could explain the variable responses to GC treatment in AA patients and why steroids might not always work effectively for hair regrowth in this condition.
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