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已发表论文
雄激素性脱发中毛囊细菌组和真菌组改变：72 例患者和24 名健康对照的横断面研究
Authors Miao B, Zou X, Yang S, Zhou Z , Geng Y, Zhang S, Gong J, Ran M
Received 22 December 2025
Accepted for publication 23 March 2026
Published 20 April 2026 Volume 2026:19 590873
DOI https://doi.org/10.2147/CCID.S590873
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Anne-Claire Fougerousse
Beibei Miao,1,2,* Xueke Zou,3,* Shuxia Yang,4 Zixing Zhou,5 Yuanyuan Geng,1,2 Shu Zhang,1,2 Jie Gong,1,2,6 Menglong Ran4
1National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China; 2National Institute for Communicable Disease Control and Prevention Joint Laboratory of Pathogenic Fungi, Peking University First Hospital, Beijing, People’s Republic of China; 3Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 4Department of Dermatology and Venereology, Peking University First Hospital; National Clinical Research Center for Skin and Sexually Transmitted Diseases; Key Laboratory of Molecular Diagnosis on Dermatoses; NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, People’s Republic of China; 5School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 6Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-Founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Menglong Ran, Department of Dermatology and Venereology, Peking University First Hospital; National Clinical Research Center for Skin and Sexually Transmitted Diseases; Key Laboratory of Molecular Diagnosis on Dermatoses; NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, People’s Republic of China, Tel +86 10 83573273, Fax +86 10 83573103, Email rss-47@163.com
Purpose: Androgenetic alopecia (AGA) is characterized by perifollicular micro-inflammation, although its precise trigger remains elusive. Given that the hair follicle harbors a distinct microbiota which may modulate local immune responses, this study aimed to comprehensively profile the bacterial and fungal microbiome within the deep hair follicles of AGA patients versus healthy controls, and to evaluate the influence of disease severity, age, sex, and geographical environment.
Patients and Methods: We recruited 96 subjects (72 AGA patients and 24 healthy controls), collecting a total of 192 plucked hair follicle samples from the vertex and occipital scalp. Bacterial 16S rRNA (V3–V4) and fungal ITS regions were sequenced using the Illumina HiSeq platform. Bioinformatics pipelines were employed to analyze α- and β-diversity, as well as taxonomic composition, across multiple stratifications: disease stage, scalp region, age, sex, and geographical location.
Results: Bacterial community structure showed relative stability between groups. In contrast, fungal communities were markedly dysbiotic in AGA. A key finding was the significant depletion of the commensal yeast Malassezia in AGA follicles compared to controls (p < 0.01). Conversely, opportunistic taxa such as Thermomyces and Bifidobacterium were enriched in advanced disease stages. Notably, microbial α-diversity increased with both disease severity and age, indicating a disruption of the follicular niche (“niche collapse”). Male AGA patients exhibited distinct fungal shifts compared to females, and geographical location significantly shaped the follicular microbiome in patients but not in healthy controls.
Conclusion: Androgenetic alopecia involves fungal dysbiosis with loss of commensal Malassezia and gain of opportunistic microbes. Driven by host and environmental factors, this reframes AGA as an ecological imbalance, opening avenues for microbiome-targeted therapies.
Keywords: androgenetic alopecia, hair follicle, microbiome, Malassezia, micro-inflammation, dysbiosis
1National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China; 2National Institute for Communicable Disease Control and Prevention Joint Laboratory of Pathogenic Fungi, Peking University First Hospital, Beijing, People’s Republic of China; 3Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China; 4Department of Dermatology and Venereology, Peking University First Hospital; National Clinical Research Center for Skin and Sexually Transmitted Diseases; Key Laboratory of Molecular Diagnosis on Dermatoses; NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, People’s Republic of China; 5School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 6Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-Founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Menglong Ran, Department of Dermatology and Venereology, Peking University First Hospital; National Clinical Research Center for Skin and Sexually Transmitted Diseases; Key Laboratory of Molecular Diagnosis on Dermatoses; NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, People’s Republic of China, Tel +86 10 83573273, Fax +86 10 83573103, Email rss-47@163.com
Purpose: Androgenetic alopecia (AGA) is characterized by perifollicular micro-inflammation, although its precise trigger remains elusive. Given that the hair follicle harbors a distinct microbiota which may modulate local immune responses, this study aimed to comprehensively profile the bacterial and fungal microbiome within the deep hair follicles of AGA patients versus healthy controls, and to evaluate the influence of disease severity, age, sex, and geographical environment.
Patients and Methods: We recruited 96 subjects (72 AGA patients and 24 healthy controls), collecting a total of 192 plucked hair follicle samples from the vertex and occipital scalp. Bacterial 16S rRNA (V3–V4) and fungal ITS regions were sequenced using the Illumina HiSeq platform. Bioinformatics pipelines were employed to analyze α- and β-diversity, as well as taxonomic composition, across multiple stratifications: disease stage, scalp region, age, sex, and geographical location.
Results: Bacterial community structure showed relative stability between groups. In contrast, fungal communities were markedly dysbiotic in AGA. A key finding was the significant depletion of the commensal yeast Malassezia in AGA follicles compared to controls (p < 0.01). Conversely, opportunistic taxa such as Thermomyces and Bifidobacterium were enriched in advanced disease stages. Notably, microbial α-diversity increased with both disease severity and age, indicating a disruption of the follicular niche (“niche collapse”). Male AGA patients exhibited distinct fungal shifts compared to females, and geographical location significantly shaped the follicular microbiome in patients but not in healthy controls.
Conclusion: Androgenetic alopecia involves fungal dysbiosis with loss of commensal Malassezia and gain of opportunistic microbes. Driven by host and environmental factors, this reframes AGA as an ecological imbalance, opening avenues for microbiome-targeted therapies.
Keywords: androgenetic alopecia, hair follicle, microbiome, Malassezia, micro-inflammation, dysbiosis