SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Inflammation
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1648868
This article is part of the Research TopicRecruitment of Leukocytes During Resolution of InflammationView all 3 articles
A meta-analysis of chemokines in alopecia areata: Recruiting immune cells towards the hair follicle
Provisionally accepted
- 1Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Belgium, Ghent, Belgium
- 2Universiteit Gent, Ghent, Belgium
- 3Universitair Ziekenhuis Gent, Ghent, Belgium
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
A deeper understanding of the immune-based pathogenesis of alopecia areata is essential for the development of novel targeted therapies. Compared to cytokines, chemokines exhibit substantially higher serum concentrations, offering a more robust approach for large-scale immune profiling. However, the complexity of chemokine interactions presents challenges in defining their precise roles in AA. To explore these dynamics, we conducted a scoping review and meta-analysis of 46 original research articles examining chemokine expression in skin and blood samples from AA patients; meta-analysis was performed when three or more studies assessed the same chemokine in comparable groups. Th1-associated chemokines-including CXCL9, CXCL10, CCL5, and CXCL11-were consistently elevated in AA, reflecting the known IFN-γ-driven response. A distinct Th2 chemokine signature was also observed, with increased levels of CCL13, CCL17, CCL22, and CX3CL1. Additionally, elevated levels of CCL2, CCL3, CCL4 (monocyte/dendritic cell recruitment), and CCL11, CCL24, and CCL26 (eosinophil recruitment) suggest the involvement of immune pathways beyond classical T helper subsets. Meta-analysis confirmed significantly elevated serum levels of CXCL9 (p = 0.003), CXCL10 (p = 0.004), CXCL8 (p < 0.001), and CCL17 (p < 0.001). These findings reveal a complex chemokine profile in AA, dominated by Th1 activity but also implicating Th2 and other immune pathways, highlighting the potential benefit of broader immunomodulatory strategies to address the multifaceted immune dysregulation underlying the disease.
Keywords: Alopecia Aerata (AA), chemokine, Pathogenesis, CXCL, biomarker, Scoping review, Meta- analysis, Th1 & Th2
Received: 17 Jun 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Van Caelenberg, Belpaire, van Geel and Speeckaert. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Elise Van Caelenberg, Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Belgium, Ghent, Belgium
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.