Yıldız-Altay Ümmügülsüm, Burns Laura J, Chen Li-Chi, Dave Himanee Parag, Yasuda Mariko R, Richmond Jillian M, Senna Maryanne M
Department of Dermatology, Yale Medical School, New Haven, Connecticut 06510, USA.
Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts 01605, USA.
Dermatol Res Pract. 2025 May 29;2025:5545886. doi: 10.1155/drp/5545886. eCollection 2025.
The pathophysiology of lichen planopilaris (LPP), a lymphocytic primary cicatricial alopecia, is largely unknown. We evaluated RNA expression of lesional scalp biopsies taken before and after 6 months of treatment monotherapy with oral hydroxychloroquine (HCQ), narrow band ultraviolet B (NB-UVB), or low level laser light therapy (LLLLT). and were significantly increased in all patients after treatment. , a drug metabolism enzyme, and , a gene involved in B cell activation and maturation, were increased posttreatment for the HCQ arm. , which has been reported to be downregulated by phototherapy was decreased post NB-UVB treatment, while , an apolipoprotein gene present in plasma that is upregulated in response to tissue injury, was increased posttreatment for the NB-UVB arm. No significant differentially expressed genes (DEGs) in the LLLLT arm before and after treatment. The expressions of , , , , and were significantly higher at the baseline in biopsies from patients with a Lichen Planopilaris Activity Index (LPPAI) score ≥ 4 compared with those with an LPPAI < 4. These genes are involved in extracellular matrix organization and M2, or profibrotic, macrophage polarization, which is congruent with follicular scarring. Our data identify potential RNA biomarkers of LPPAI and suggest that M2 macrophages may play a role in LPP immunopathogenesis.
扁平苔藓性毛发扁平苔藓（LPP）是一种淋巴细胞性原发性瘢痕性脱发，其病理生理学在很大程度上尚不清楚。我们评估了口服羟氯喹（HCQ）、窄谱中波紫外线（NB-UVB）或低强度激光疗法（LLLLT）单一疗法治疗6个月前后病变头皮活检组织的RNA表达。治疗后所有患者的[具体基因1]和[具体基因2]均显著增加。药物代谢酶[具体基因3]和参与B细胞活化和成熟的基因[具体基因4]在HCQ治疗组治疗后增加。据报道，[具体基因5]受光疗下调，在NB-UVB治疗后降低，而[具体基因6]是血浆中存在的一种载脂蛋白基因，在组织损伤时上调，在NB-UVB治疗组治疗后增加。LLLLT治疗组治疗前后无显著差异表达基因（DEG）。与扁平苔藓性毛发扁平苔藓活动指数（LPPAI）评分<4的患者相比，LPPAI评分≥4的患者活检组织在基线时[具体基因7]、[具体基因8]、[具体基因9]、[具体基因10]和[具体基因11]的表达显著更高。这些基因参与细胞外基质组织和M2或促纤维化巨噬细胞极化，这与毛囊瘢痕形成一致。我们的数据确定了LPPAI的潜在RNA生物标志物，并表明M2巨噬细胞可能在LPP免疫发病机制中起作用。
