Gene Expression Profile of Central Centrifugal Cicatricial Alopecia

Background: Central Centrifugal Cicatricial Alopecia (CCCA) is a primary cicatricial alopecia that most commonly affects women of African descent. Like CCCA, fibroproliferative disorders (FPDs) such as keloids, atherosclerosis and fibroids, are characterized by low-grade inflammation and irritation resulting in end stage fibrosis. Objective: We sought to determine if fibroproliferative genes were upregulated in patients with CCCA Methods: Five patients with biopsy proven CCCA were recruited for this study. Two scalp biopsies were obtained from each patient; one from CCCA affected vertex scalp and one from the unaffected occipital scalp. Microarray analysis was performed to determine the differential gene expression patterns Results: Several pathways responsible for excess collagen deposition and aberrant wound healing were up-regulated in CCCA affected scalp when compared to unaffected scalp with patterns similar to other FPDs. Genes downregulated in CCCA affected tissue included those with roles in lipid metabolism and fatty acid biosynthesis. Limitations: Small sample size and the use of whole skin tissue for analysis. Conclusion: We have identified the up-regulation of critical genes implicated in fibroproliferative disorders in the gene expression profile of patients with CCCA. These findings may help identify future therapeutic targets for this otherwise difficult to treat condition. We performed gene expression microarrays on paired samples of affected and unaffected scalp tissue to assess markers of fibroblast activation in five patients with CCCA.