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

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Frontal fibrosing alopecia/FFA is a progressive, scarring alopecia of the frontotemporal scalp, and poses a substantial burden on quality of life. Largescale global profiling of FFA is lacking, preventing the development of effective therapeutics.To characterize FFA compared to normal and alopecia areata/AA using broad molecular profiling, and to identify biomarkers linked to disease severity.This cross-sectional study assessed 33118 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) (FCH>1.5, FDR1.3, FDR.6; P

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Authors: Celina Dubin, Jacob W Glickman, Ester Del Duca, Sumanth Chennareddy, Joseph Han, Dante Dahabreh, Yeriel D Estrada, Ning Zhang, Grace W Kimmel, Giselle Singer, Mashkura Chowdhury, Andrew Zheng, Michael Angelov, James G Krueger, Ana B Pavel, Emma Guttman-Yassky