{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:00:03Z","timestamp":1790773203072,"version":"4.1.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    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,\n                    <jats:italic>ex vivo<\/jats:italic>\n                    follicles, animal models, and cross-disease studies provide additional support for transforming growth factor-\u03b2, 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\u2013mesenchymal 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\u2013fibrosis endotypes may help explain variation in treatment response and guide biomarker-enriched trials, but would not by themselves imply an autoimmune pathogenesis.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1960477","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:28:27Z","timestamp":1790771307000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inflammation\u2013fibrosis coupling in androgenetic alopecia: evidence and mechanistic hypotheses for progressive hair follicle miniaturization"],"prefix":"10.3389","volume":"17","author":[{"given":"Yi","family":"Li","sequence":"first","affiliation":[{"name":"Institute of Regenerative Medicine, and Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Wan","sequence":"additional","affiliation":[{"name":"Institute of Regenerative Medicine, and Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Geng","sequence":"additional","affiliation":[{"name":"Institute of Regenerative Medicine, and Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Institute of Regenerative Medicine, and Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, 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