Tape-Strip RNA Sequencing Offers Minimally Invasive AA Analysis

Scalp tape-strips may represent a new, minimally invasive means by which to assess disease activity and treatment response in patients with alopecia areata (AA). A new report published in the journal Allergy suggests tape-strip RNA sequencing has wider applicability in AA beyond identifying immune signatures.¹

Janus kinase (JAK) inhibitors have transformed the treatment of AA, the authors explained, but noted, “Despite these advances, clinical responses remain heterogeneous and often delayed, with meaningful hair regrowth typically requiring 24-36 weeks of continuous therapy.”

Thus, early identification of molecular treatment response could help clinicians and patients make better treatment decisions, thereby improving patient adherence and therapeutic cost-effectiveness, they said.

The investigators said significant evidence has helped to explain the immune processes at play in the pathogenesis of AA. However, they said most of the molecular insights into the disease have been based on scalp biopsies, which are invasive and not conducive to longitudinal monitoring.

Previous research has demonstrated the feasibility of tape-strip–based molecular profiling in AA, which includes the ability to predict treatment response to topical immunotherapy based on targeted cytokine analyses.²

“However, these approaches do not integrate validation against paired lesional scalp biopsies or assess longitudinal molecular responses to targeted systemic therapy,” they said.

In an effort to determine whether scalp tape-strip RNA sequencing could capture immune pathways linked with disease severity and treatment response, the authors analyzed 61 RNA-sequencing profiles. Of those, 46 were from tape-strip samples, including 19 from healthy controls, 17 from patients with active AA, and 10 from patients who had received baricitinib (Olumiant) therapy for AA. Half of the post-baricitinib samples came from patients who responded to baricitinib, and half came from non-responders. In addition, the investigators analyzed RNA sequencing profiles from 15 lesional scalp biopsies. Their data set included 9 pairs of tape-strip and biopsy samples obtained from the same scalp region.

The tape strips were a useful tool, the authors found. They were able to capture immune and follicular molecular signatures, and also identify progressive immune activation and epithelial loss, which the authors said were linked with increasing disease severity.

“Baricitinib responders showed partial normalization of inflammatory signatures, whereas non-responders retained persistent immune activation, consistent with molecular non-response,” they wrote.

Nonresponse to baricitinib was not solely defined by the persistence of interferon signaling, they noted.

“Instead, non-responders exhibited a broader transcriptional state characterized by sustained innate immune activation, proteolytic activity, and impaired epithelial and follicular recovery,” they wrote.

The authors added that results from tape-strip transcriptomes had high concordance with biopsy transcriptomes, especially for adaptive immune, epithelial, and follicular pathways.

“Although concordance for innate modules was slightly lower—likely reflecting their predominant dermal localization—the overall correlation demonstrates that most disease-relevant functional programs in AA are accessible through tape-stripping sampling,” the authors said.

The findings are particularly beneficial for the prospect of longitudinal sampling, as they offer a non-invasive, easily replicable tool. The authors noted their work may also have applications in translational research and drug development. However, they also noted that tape-strip sampling “primarily samples the superficial epidermis and upper follicular regions, potentially underrepresenting deeper dermal, mesenchymal, or vascular processes.”

Still, the authors concluded that tape-strip sampling can be a powerful tool in the treatment and monitoring of AA, and potentially other follicle-centered inflammatory disorders.

References

1. Mochón-Jiménez C, Gay-Mimbrera J, Dávila-Flores V, et al. Non-Invasive Scalp Tape-Strip RNA Sequencing Captures Disease Activity and Treatment-Response Signatures in Alopecia Areata. Allergy. Published online March 13, 2026. doi:10.1111/all.70293

2. Mochón Jiménez C, De Luque Fernández J, Rivera Ruiz I, et al. Tape strip transcriptomics enables non-invasive molecular profiling across the clinical spectrum of alopecia areata [abstract]. J Invest Dermatol. 2025;145(11 Suppl):e73. doi:10.1016/j.jid.2025.09.271