Scalp Biomarkers During Dupilumab Treatment Support Th2 Pathway Pathogenicity in Alopecia Areata

November 2022 in “ Allergy ”

Yael Renert‐Yuval, Ana B. Pavel, Ester Del Duca, Paola Facheris, Angel D Pagan, Swaroop Bose, Pedro J Gómez-Arias, Michael Angelov, Jennifer Bares, Margo Chima, Yeriel Estrada, Sandra Garcet, Mark Lebwohl, James G. Krueger, Emma Guttman‐Yassky

dupilumab Th2 pathway alopecia areata Th2-related markers hair keratins Th1-related suppression atopic AA Th2 cytokines Dupixent AA

TLDR Dupilumab treatment reduces Th2-related markers and helps hair growth in alopecia areata, showing Th2's role in the condition.

The study investigated the effects of dupilumab, a Th2-targeting drug, on scalp biomarkers in alopecia areata (AA) patients over 48 weeks. Patients were randomized to receive either dupilumab or a placebo for the first 24 weeks, followed by open-label dupilumab for the next 24 weeks. Significant suppression of Th2-related markers and upregulation of hair keratins were observed in dupilumab-treated patients by week 24, preceding clinical hair regrowth. Th1-related suppression was noted later at week 48. The results were more pronounced in atopic AA patients, showing substantial improvements in scalp profiles, while placebo-treated patients experienced worsening conditions. The findings suggest that Th2 cytokines may play a crucial role in AA pathogenesis, with dupilumab showing potential efficacy in treating AA.

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