Dissecting hair breakage in alopecia areata: the central role of dysregulated cysteine homeostasis

Abstract In the initial stages of Alopecia Areata (AA), the predominance of hair breakage or exclamation mark hairs serves as vital indicators of disease activity. These signs are non-invasive and are commonly employed in dermatoscopic examinations. Despite their clinical salience, the underlying et...

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Bibliographic Details
Main Authors: Wen Xu, Bo Xie, Dongfan Wei, Xiuzu Song
Format: Article
Language:English
Published: Springer 2024-05-01
Series:Amino Acids
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Online Access:https://doi.org/10.1007/s00726-024-03395-5
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Summary:Abstract In the initial stages of Alopecia Areata (AA), the predominance of hair breakage or exclamation mark hairs serves as vital indicators of disease activity. These signs are non-invasive and are commonly employed in dermatoscopic examinations. Despite their clinical salience, the underlying etiology precipitating this hair breakage remains largely uncharted territory. Our exhaustive review of the existing literature points to a pivotal role for cysteine—a key amino acid central to hair growth—in these mechanisms. This review will probe and deliberate upon the implications of aberrant cysteine metabolism in the pathogenesis of AA. It will examine the potential intersections of cysteine metabolism with autophagy, ferroptosis, immunity, and psychiatric manifestations associated with AA. Such exploration could illuminate new facets of the disease's pathophysiology, potentially paving the way for innovative therapeutic strategies.
ISSN:1438-2199