Sequential Immunotherapy for Alopecia Areata: Phase-Driven Immune Rebalancing

November 2025 in “ Expert Review of Clinical Immunology ”

Yetan Shi, Xiuzu Song

alopecia areata sequential immunotherapy immune privilege immunomodulatory interventions immune homeostasis immunosuppression immune tolerance hair follicles inflammatory responses AA

TLDR Sequential immunotherapy can effectively treat alopecia areata by managing inflammation and promoting hair regrowth.

Sequential immunotherapy offers a promising approach to treating alopecia areata (AA) by addressing the challenges of recurrence and treatment-resistant cases. This strategy involves temporally coordinated immunomodulatory interventions aimed at restoring immune privilege and homeostasis in hair follicles. For difficult-to-treat cases, alternative strategies are employed to promote hair regrowth. The review highlights the potential of sequential immunotherapy, which combines initial intensive immunosuppression with subsequent maintenance therapy, to effectively manage the dynamic progression of AA by modulating inflammatory responses and restoring immune tolerance.

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research Janus Kinase Inhibitors for Alopecia Areata: A Review of Clinical Data

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research The Relative Efficacy and Safety of Monotherapies for Alopecia Areata: A Network Meta-Analysis Study

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research Alopecia Areata: Understanding the Pathophysiology and Advancements in Treatment Modalities

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research Pathogenesis and Regenerative Therapy in Vitiligo and Alopecia Areata: Focus on Hair Follicle

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research Efficacy and Safety of Deuruxolitinib, an Oral Selective Janus Kinase Inhibitor, in Adults with Alopecia Areata: Results from the Phase 3 Randomized, Controlled Trial (THRIVE-AA1)

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research Comparative Efficacy of Oral Janus Kinase Inhibitors and Biologics in Adult Alopecia Areata: A Systematic Review and Bayesian Network Meta-Analysis

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research Inhibition of T-Cell Activity in Alopecia Areata: Recent Developments and New Directions

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research Alopecia Areata: Current Treatments and New Directions

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research Functional Interrogation of Lymphocyte Subsets in Alopecia Areata Using Single-Cell RNA Sequencing

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research The Potential of Regulatory T Cell-Based Therapies for Alopecia Areata

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research Baricitinib as the First Systemic Treatment for Severe Alopecia Areata

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research Alopecia Areata in Latin America: Where Are We and Where Are We Going?

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research Scalp Biomarkers During Dupilumab Treatment Support Th2 Pathway Pathogenicity in Alopecia Areata

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research Induction of T Cell Exhaustion by JAK1/3 Inhibition in the Treatment of Alopecia Areata

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research Alopecia Areata: An Update on Etiopathogenesis, Diagnosis, and Management

290 citations , August 2021 in “Clinical Reviews in Allergy & Immunology”

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research A Comprehensive Literature Review of JAK Inhibitors in the Treatment of Alopecia Areata

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research Frontiers in Alopecia Areata Pathobiology Research

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research The Effectiveness of Oral Mini-Pulse Methylprednisolone in the Treatment of Alopecia Areata in Vietnam

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research JAK Inhibitors and Alopecia Areata

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research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations , December 2018 in “Journal of autoimmunity”

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research Alopecia Areata: A Review of Disease Pathogenesis

191 citations , May 2018 in “British journal of dermatology/British journal of dermatology, Supplement”

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research The Changing Landscape of Alopecia Areata: The Therapeutic Paradigm

77 citations , June 2017 in “Advances in Therapy”

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research Adalimumab-Related Alopecia in a Patient Affected by Psoriasis

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research Vasoactive Intestinal Peptide, Whose Receptor-Mediated Signaling May Be Defective in Alopecia Areata, Provides Protection from Hair Follicle Immune Privilege Collapse

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research Calcitonin Gene-Related Peptide (CGRP) May Award Relative Protection from Interferon-γ-Induced Collapse of Human Hair Follicle Immune Privilege

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research Etiopathogenesis of Alopecia Areata: Why Do Our Patients Get It?

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research Maintenance of Hair Follicle Immune Privilege Is Linked to Prevention of NK Cell Attack

253 citations , December 2007 in “Journal of Investigative Dermatology”

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