Gene expression profiling suggests severe, extensive central centrifugal cicatricial alopecia may be both clinically and biologically distinct from limited disease subtypes.
Gene expression profiling suggests severe, extensive central centrifugal cicatricial alopecia may be both clinically and biologically distinct from limited disease subtypes.
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DOI：
10.1111/exd.14524
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发表时间：
2022-05
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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中心性离心性瘢痕性脱发（CCCA）的自然病程变化很大。一些患者经历了快速进展为广泛的终末期疾病，而另一些患者在数十年内从未接近广泛受累，这表明CCCA疾病表型的异质性。为了更好地表征临床严重疾病的CCCA，组织样本获得外周，头发轴承病变的头皮的妇女与临床局灶性，有限和广泛的CCCA疾病的参与。进行微阵列分析以鉴定先前鉴定为在CCCA患者的病变头皮与非病变头皮中优先表达的基因的差异表达。与局灶性和局限性疾病相比，临床广泛的重度CCCA的特征是MMP 9、SFRP 4和MSR1的表达增加。这些生物标志物分别对应于纤维化、Wnt信号传导和巨噬细胞介导的炎症过程的失调途径。这些发现对于未来研究疾病严重程度的预后标志物和新的潜在治疗靶点都具有重要意义。总之，这项研究表明，临床广泛的，严重的CCCA可能有一个不同的基因表达模式，在受影响的患者的病变头皮，除了其临床区别。
The natural history of central centrifugal cicatricial alopecia (CCCA) is widely variable. Some patients experience rapid progression to extensive, end-stage disease while others never approach extensive involvement over decades, suggesting heterogeneity in CCCA disease phenotype. To better characterize clinically severe disease in CCCA, tissue samples were obtained from the peripheral, hair-bearing lesional scalp of women with clinically focal, limited and extensive CCCA disease involvement. A microarray analysis was conducted to identify differential expression of genes previously identified to be preferentially expressed in the lesional scalp vs. non-lesional scalp of CCCA patients. Clinically extensive, severe CCCA was characterized by increased expression of MMP9, SFRP4 and MSR1 when directly compared with focal and limited disease. These biomarkers correspond to dysregulated pathways of fibrosis, Wnt signalling and macrophage-mediated inflammatory processes respectively. These findings hold significance for both possible targets for future study of prognostic markers of disease severity and new potential therapeutic targets. In summary, this study suggests clinically extensive, severe CCCA may have a differential gene expression pattern in the lesional scalp of affected patients, in addition to its clinical distinction.
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