{
  "abstract": "Androgenetic alopecia (AGA) is primarily explained by genetic susceptibility and androgen-dependent signaling in dermal papilla cells. This mini-review examines whether low-grade, regionally heterogeneous perifollicular inflammation interacts with extracellular matrix remodeling as a complementary component of AGA pathobiology, without implying an autoimmune mechanism. Human AGA scalp studies report upper-follicular and perifollicular CD4+ lymphocytes, mast cells, immune-enriched transcriptional states, connective tissue sheath abnormalities, and fibrosis in subsets of patients. Patient-derived cells, ex vivo follicles, animal models, and cross-disease studies provide additional support for transforming growth factor-β, interleukin-6, prostaglandin D2, Wnt antagonism, oxidative stress, mitochondrial dysfunction, and cellular senescence. These signals could recruit or retain immune cells and shift dermal sheath cells or perifollicular fibroblasts toward matrix-producing and contractile states. Collagen accumulation, altered matrix turnover, stiffness, vascular restriction, and impaired epithelial–mesenchymal crosstalk may then reduce regenerative plasticity and stabilize miniaturization. Human evidence is strongest for androgen-dependent follicular stress and regional inflammatory or fibrotic changes. Specific immune-to-fibroblast circuits, mechanotransduction pathways, and their temporal sequence are supported mainly by experimental models or cross-disease evidence. Spatially resolved inflammation–fibrosis endotypes may help explain variation in treatment response and guide biomarker-enriched trials, but would not by themselves imply an autoimmune pathogenesis.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Regenerative Medicine, and Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University , , ,"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yi Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoyue Wan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yun Geng"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenlong Zhu"
    },
    {
      "affs": [
        0
      ],
      "name": "Hui Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuyun Xiong"
    },
    {
      "affs": [
        0
      ],
      "name": "Yunwen Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Yumei Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2mhwcnsky4yb7.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1960477",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662793/?tool=EBI",
  "id": "2mhwcnsky4yb7",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13662793",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2748|Hair Growth and Disorders"
    ]
  ],
  "openalex": "W7214966688",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662793/pdf/?tool=EBI",
  "pmcid": "PMC13662793",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/2mhwcnsky4yb7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:21Z",
      "native_id": "PMC:PMC13662793",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13662793"
    },
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1960477",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1960477/full"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Inflammation–fibrosis coupling in androgenetic alopecia: evidence and mechanistic hypotheses for progressive hair follicle miniaturization",
  "title_text": "Inflammation–fibrosis coupling in androgenetic alopecia: evidence and mechanistic hypotheses for progressive hair follicle miniaturization",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:15Z",
  "url": "https://research.draconitic.com/paper/2mhwcnsky4yb7",
  "venue": "Frontiers in immunology",
  "versions": []
}