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.
    This study investigated why glucocorticoid (GC) steroid treatments for alopecia areata (AA) showed variable effectiveness in hair regrowth. Scalp biopsies from 15 patients with extensive AA, male androgenetic alopecia (AGA), and normal controls were analyzed for glucocorticoid receptor (GCR) content. Results indicated 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. These findings suggested that the elevated unoccupied GCR and reduced TR levels might inhibit cellular transcription, potentially explaining the inconsistent responses to GC treatment in AA patients.
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