Precision therapeutics in non-scarring alopecia: a systemic genomic and pathway-based framework for targeted interventions: Review paper

Rinky Kapoor; Depti Bellani; Raji Patil; Debalina Bose; Madhuri Pola; Prashant Anilkumar Singh; Mamata Mishra; Debraj Shome

doi:10.5599/admet.3030

Authors

Rinky Kapoor Department of Dermatology, Cosmetic Dermatology & Dermato-Surgery, The Esthetic Clinics, Mumbai, Maharashtra, India https://orcid.org/0009-0002-2443-878X
Depti Bellani Department of Medical Affairs, The Esthetic Creations International Pvt. Ltd. (ECIPL), Mumbai, Maharashtra, India https://orcid.org/0000-0003-1045-9758
Raji Patil Department of Medical Affairs, The Esthetic Creations International Pvt. Ltd. (ECIPL), Mumbai, Maharashtra, India. https://orcid.org/0009-0003-2725-7578
Debalina Bose Department of Research, The Esthetic Clinics Clinical Research Organization (TECCRO), Mumbai, Maharashtra, India https://orcid.org/0009-0005-0350-3839
Madhuri Pola Department of Research, The Esthetic Clinics Clinical Research Organization (TECCRO), Mumbai, Maharashtra, India https://orcid.org/0000-0003-3959-0223
Prashant Anilkumar Singh Department of Medical Affairs, The Esthetic Creations International Pvt. Ltd. (ECIPL), Mumbai, Maharashtra, India https://orcid.org/0009-0006-0427-6866
Mamata Mishra Department of Research, The Esthetic Clinics Clinical Research Organization (TECCRO), Mumbai, Maharashtra, India https://orcid.org/0000-0003-3797-7133
Debraj Shome Department of Facial Plastic Surgery & Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, Maharashtra, India https://orcid.org/0009-0007-8026-4629

DOI:

https://doi.org/10.5599/admet.3030

Keywords:

Androgenetic alopecia, alopecia areata, genome-wide association studies and next-generation sequencing, wingless-related integration sit/beta-catenin signalling pathway, Janus kinase-signal transducer and activator of transcription pathway, artificial intelligence

Abstract

Background and purpose: Non-scarring alopecia, principally androgenetic alopecia and alopecia areata is highly prevalent and psychologically burdensome; androgenetic alopecia is androgen-driven, whereas alopecia areata is autoimmune. This review synthesizes genetic architecture and pathway biology to outline a precision framework for targeted interventions. Experimental approach: We reviewed full-text studies from the past decade across PubMed, Web of Science and Google Scholar, applying explicit inclusion/exclusion criteria; emphasis was placed on Genome wide association studies and Next generation sequencing findings, immune and androgen-axis biology, environmental modifiers, and therapeutic evidence (conventional, targeted, and regenerative), alongside artificial Intelligence-enabled diagnostics. Key results: Androgenetic alopecia risk converges on androgen-receptor signalling and related loci, with perifollicular inflammation and oxidative stress as modifiers; finasteride remains a cornerstone therapy. Alopecia areata reflects polygenic immune dysregulation (e.g. Human leukocyte antigen/cytokine axes) with Janus Kinase-pathway inhibition yielding robust regrowth; across phenotypes, wingless-related integration sit/β-catenin and stem-cell programs are central targets. Regenerative options (Protein Rich Plasma, stem-cell/exosome approaches) and artificial Intelligence-assisted stratification are emerging adjuncts. Conclusion: A pathway-guided, genotype and phenotype-informed strategy, targeting the androgen axis for androgenetic alopecia, immune circuits for alopecia areata, and adding regenerative or microenvironmental therapies where indicated-promises earlier diagnosis and more durable, individualized outcomes, especially as genome-wide association study/next-generation sequencing and artificial Intelligence tools are integrated into care.

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