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Alopecia , Colitis Ulcerosa , Compuestos Heterocíclicos con 3 Anillos , Humanos , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/complicaciones , Alopecia/tratamiento farmacológico , Alopecia/etiología , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Femenino , Masculino , Persona de Mediana Edad , AdultoAsunto(s)
Alopecia , Liquen Plano , Naltrexona , Humanos , Alopecia/tratamiento farmacológico , Alopecia/patología , Liquen Plano/tratamiento farmacológico , Liquen Plano/diagnóstico , Liquen Plano/patología , Naltrexona/administración & dosificación , Naltrexona/uso terapéutico , Femenino , Administración Oral , Persona de Mediana Edad , Resultado del Tratamiento , Masculino , Adulto , Fibrosis/tratamiento farmacológico , Anciano , Antagonistas de Narcóticos/administración & dosificación , Antagonistas de Narcóticos/uso terapéuticoRESUMEN
More than 80 million people in the United States are affected by hair loss, also known as alopecia. Nonscarring alopecias are categorized as diffuse, patterned, or focal. Diffuse alopecias include telogen and anagen effluvium, are usually self-limited, and depend on stopping the underlying cause (e.g., stress). Patterned hair loss, specifically androgenetic alopecia, is the most common form of alopecia; it is typically genetic, and first-line treatment is minoxidil. Oral finasteride is another treatment available for male patients. Focal hair loss includes alopecia areata, which is typically self-limited and treated with intralesional corticosteroid or oral immunosuppressant therapy; tinea capitis, which is treated with oral antifungals; and traction alopecia, which is treated by decreasing tension on the hair. Hair loss can be caused by several systemic diseases. A comprehensive history and physical examination, with targeted laboratory testing, may elucidate malnutrition, autoimmune diseases, and endocrine disease. Patients with moderate to severe hair loss are more likely to have accompanying anxiety, depression, and lower work productivity and quality-of-life scores. Educating patients about expected hair changes, treatment options, and realistic outcomes can help patients feel that they are being listened to and that their hair loss is being taken seriously.
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Alopecia , Minoxidil , Humanos , Alopecia/diagnóstico , Alopecia/terapia , Alopecia/tratamiento farmacológico , Alopecia/etiología , Minoxidil/uso terapéutico , Masculino , Finasterida/uso terapéutico , FemeninoRESUMEN
This study aimed to assess the impact of a combination of probiotic strains of Lactiplantibacillus on the treatment of androgenic alopecia (AGA). To this end, 136 individuals with AGA (62 men and 74 women) aged 18-65 years were enrolled in a double-blind, parallel-group clinical trial. A total of 115 individuals (57 in the probiotic group and 58 in the placebo group) completed this study within a 16-week intervention period. Capillary density, thickness, and length of hair were analyzed before and after the intervention using FotoFinder Trichoscale Pro. In addition, the gut microbiota was assessed by paired-end sequencing on the Illumina MiSeq platform (2 × 300 bp). At the conclusion of the treatment period, a notable decline (p < 0.05) in the number of telogen hairs was evident in the probiotic group while hair thickness decreased in the placebo group (p < 0.05). However, the remaining variables did not exhibit any statistically significant changes. In the probiotic-treated group, individuals aged less than 37.5 years exhibited a reduction in the number and density of telogen hair (p = 0.0693 and p = 0.0669, respectively) and an increase in hair length (p = 0.0871). Furthermore, a notable decline in the number and density of vellus hair (p < 0.05) was observed, and this was accompanied by no change in the hair thickness. The probiotic-treated group exhibited a significantly higher abundance of Lactobacillus (p-adjusted < 0.05, DEseq2 test) and demonstrated a notable reduction in the number and density of telogen hair, and this was accompanied by an increase in the percentage of anagen hair. The probiotic mixture was well tolerated by the participants, with a treatment adherence rate of 90%. In light of this study's limitations, it can be concluded that a mixture of three strains of Lactiplantibacillus promotes the presence of terminal follicles, preventing their gradual miniaturization, which is a characteristic of AGA.
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Alopecia , Microbioma Gastrointestinal , Cabello , Probióticos , Humanos , Probióticos/administración & dosificación , Alopecia/tratamiento farmacológico , Alopecia/terapia , Masculino , Adulto , Femenino , Persona de Mediana Edad , Método Doble Ciego , Adulto Joven , Microbioma Gastrointestinal/efectos de los fármacos , Cabello/efectos de los fármacos , Anciano , Adolescente , Resultado del TratamientoRESUMEN
BACKGROUND: Minoxidil is an anti-hypertensive vasodilator increasingly used off-label for the treatment of alopecia. It is associated with an increased risk of pericardial effusions, with recent reports even in patients on low-dose oral minoxidil (LDOM) therapy. OBJECTIVE: To evaluate whether LDOM is associated with increased prevalence of pericardial effusions in patients with alopecia. METHODS: In this cross-sectional study, point-of-care ultrasound was used to screen alopecia patients at dermatology appointments. Scans were evaluated by two independent cardiologists for the presence and size of effusions. The prevalence of effusions was compared between patients on LDOM therapy and patients not on minoxidil therapy. RESULTS: A total of 100 patients were evaluated for pericardial effusion: 51 LDOM patients and 49 control patients. The two groups were similar in terms of age (53.7 vs 54.1; P=0.91), sex (86% vs 73% female; P=0.14), and race. Small pericardial effusions (<1 cm) were identified in 5.8% of LDOM patients and 6% of control patients (P=1), none of which were symptomatic. LIMITATIONS: This is a small, cross-sectional study with limitations on speculation of causality in confirmed cases. CONCLUSION: We did not find evidence of increased prevalence of pericardial effusions in a small group of alopecia patients on LDOM. J Drugs Dermatol. 2024;23(9):725-728. doi:10.36849/JDD.8029.
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Alopecia , Minoxidil , Derrame Pericárdico , Humanos , Alopecia/diagnóstico , Alopecia/epidemiología , Alopecia/tratamiento farmacológico , Minoxidil/administración & dosificación , Minoxidil/efectos adversos , Femenino , Estudios Transversales , Masculino , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/epidemiología , Prevalencia , Administración Oral , Vasodilatadores/administración & dosificación , Vasodilatadores/efectos adversos , Adulto , Ultrasonografía , AncianoRESUMEN
LDOM has enhanced treatment options for female AGA, yet its combined efficacy with therapies such as spironolactone, finasteride, or dutasteride remains inadequately explored. This study aims to compare the efficacy and safety of LDOM in combination with spironolactone versus LDOM with finasteride or dutasteride in women with AGA. Our analysis revealed that both combination therapies produced similar improvements in hair growth and had comparable safety profiles. Although the LDOM with finasteride/dutasteride group showed a greater average increase in hair width and density, these differences were not statistically significant. These results endorse the use of LDOM in combination with either spironolactone or finasteride/dutasteride for female AGA, and underscore the necessity for further research to validate these findings and assess long-term treatment outcomes.
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Alopecia , Quimioterapia Combinada , Dutasterida , Finasterida , Minoxidil , Espironolactona , Humanos , Femenino , Finasterida/administración & dosificación , Dutasterida/administración & dosificación , Espironolactona/administración & dosificación , Alopecia/tratamiento farmacológico , Minoxidil/administración & dosificación , Adulto , Resultado del Tratamiento , Quimioterapia Combinada/métodos , Persona de Mediana Edad , Inhibidores de 5-alfa-Reductasa/administración & dosificación , Administración Oral , Cabello/efectos de los fármacos , Cabello/crecimiento & desarrollo , Adulto Joven , Estudios RetrospectivosRESUMEN
BACKGROUND: Androgenetic alopecia (AGA) is a common form of hair loss. Androgens, such as testosterone and dihydrotestosterone, are the main causes of AGA. Extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) can reduce AGA. However, preparing therapeutic doses of MSCs for clinical use is challenging. Induced pluripotent stem cell-derived MSCs (iMSCs) are homogenous and easily expandable, enabling scalable production of EVs. Hyaluronic acid (HA) can exert various functions including free radical scavenging, immune regulation, and cell migration. Herein, we examined whether hyaluronic acid (HA) stimulation of iMSCs could produce EVs with enhanced therapeutic outcomes for AGA. METHODS: EVs were collected from iMSCs primed with HA (HA-iMSC-EVs) or without HA (iMSC-EVs). The characteristics of EVs were examined using dynamic light scattering, cryo-transmission electron microscopy, immunoblotting, flow cytometry, and proteomic analysis. In vitro, we compared the potential of EVs in stimulating the survival of hair follicle dermal papilla cells undergoing testosterone-mediated AGA. Additionally, the expression of androgen receptor (AR) and relevant growth factors as well as key proteins of Wnt/ß-catenin signaling pathway (ß-catenin and phosphorylated GSK3ß) was analyzed. Subsequently, AGA was induced in male C57/BL6 mice by testosterone administration, followed by repeated injections of iMSC-EVs, HA-iMSC-EVs, finasteride, or vehicle. Several parameters including hair growth, anagen phase ratio, reactivation of Wnt/ß-catenin pathway, and AR expression was examined using qPCR, immunoblotting, and immunofluorescence analysis. RESULTS: Both types of EVs showed typical characteristics for EVs, such as size distribution, markers, and surface protein expression. In hair follicle dermal papilla cells, the mRNA levels of AR, TGF-ß, and IL-6 increased by testosterone was blocked by HA-iMSC-EVs, which also contributed to the augmented expression of trophic genes related to hair regrowth. However, no notable changes were observed in the iMSC-EVs. Re-activation of Wnt/ß-catenin was observed in HA-iMSC-EVs but not in iMSC-EVs, as shown by ß-catenin stabilization and an increase in phosphorylated GSK3ß. Restoration of hair growth was more significant in HA-iMSC-EVs than in iMSC-EVs, and was comparable to that in mice treated with finasteride. Consistently, the decreased anagen ratio induced by testosterone was reversed by HA-iMSC-EVs, but not by iMSC-EVs. An increased expression of hair follicular ß-catenin protein, as well as the reduction of AR was observed in the skin tissue of AGA mice receiving HA-iMSC-EVs, but not in those treated with iMSC-EVs. CONCLUSIONS: Our results suggest that HA-iMSC-EVs have potential to improve AGA by regulating growth factors/cytokines and stimulating AR-related Wnt/ß-catenin signaling.
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Alopecia , Vesículas Extracelulares , Folículo Piloso , Ácido Hialurónico , Células Madre Mesenquimatosas , Vesículas Extracelulares/metabolismo , Alopecia/terapia , Alopecia/metabolismo , Alopecia/tratamiento farmacológico , Ácido Hialurónico/farmacología , Ácido Hialurónico/metabolismo , Animales , Ratones , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/efectos de los fármacos , Folículo Piloso/metabolismo , Folículo Piloso/efectos de los fármacos , Humanos , Vía de Señalización Wnt/efectos de los fármacos , Masculino , Receptores Androgénicos/metabolismo , Receptores Androgénicos/genética , Células Madre Pluripotentes Inducidas/metabolismo , Células Madre Pluripotentes Inducidas/citología , Testosterona/farmacología , Glucógeno Sintasa Quinasa 3 beta/metabolismo , Ratones Endogámicos C57BLAsunto(s)
Alopecia , Humanos , Alopecia/terapia , Alopecia/tratamiento farmacológico , Femenino , Resultado del TratamientoRESUMEN
Minoxidil (MXD) is the only topical over-the-counter medicine approved by the United States Food and Drug Administration for the treatment of androgenetic alopecia. For the purpose of targeting the delivery of MXD to dermal papilla in the hair follicle, MXD Pickering emulsion gels were fabricated based on the designability of deep eutectic solvent (DES) and the versatility of cellulose nanocrystal (CNC) and sodium carboxymethyl cellulose (CMC-Na). Structural studies and theoretical calculations results suggest that CNC can stabilize the interface between the MXD-DES and water, leading to the formation of Pickering emulsions. The rheological properties and stabilities of MXD Pickering emulsions were enhanced through gelation using CMC-Na, which highlights the good compatibility and effectiveness of natural polysaccharides in emulsion gels. Due to the particle size of emulsion droplets (679 nm) and the rheological properties of emulsion gel, the fabricated MXD formulations show in vivo hair regrowth promotion and hair follicle targeting capabilities. Interestingly, the MXD Pickering emulsion-based formulations exert therapeutic effects by upregulating the expression of hair growth factors. The proposed nanodrug strategy based on supramolecular strategies of CNC and CMC-Na provides an interesting avenue for androgenetic alopecia treatment.
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Celulosa , Emulsiones , Geles , Folículo Piloso , Minoxidil , Nanopartículas , Minoxidil/química , Minoxidil/administración & dosificación , Minoxidil/farmacología , Folículo Piloso/efectos de los fármacos , Nanopartículas/química , Emulsiones/química , Celulosa/química , Geles/química , Animales , Reología , Alopecia/tratamiento farmacológico , Sistemas de Liberación de Medicamentos , Tamaño de la Partícula , Ratas , Ratones , Masculino , Portadores de Fármacos/químicaAsunto(s)
Alopecia , Exosomas , Exosomas/metabolismo , Humanos , Alopecia/terapia , Alopecia/tratamiento farmacológico , Folículo PilosoRESUMEN
Curly textured hair presents unique diagnostic and therapeutic challenges because of its distinct properties. In the September issue of the Journal, we explore recent advancements in understanding and treating various hair disorders, focusing on the specific challenges and treatments for curly hair. We discuss whether glucagon-like peptide-1 agonists contribute to or alleviate hair loss and highlight a promising, innovative therapy using adipose stem cell-derived exosomes to promote hair growth. Additionally, we examine therapeutic options for managing filler-induced alopecia and treating folliculitis decalvans.
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Alopecia , Humanos , Alopecia/terapia , Alopecia/tratamiento farmacológico , Alopecia/diagnóstico , Exosomas , Rellenos Dérmicos/efectos adversos , Rellenos Dérmicos/administración & dosificación , Foliculitis/diagnóstico , Foliculitis/tratamiento farmacológico , Cabello/crecimiento & desarrollo , Cabello/efectos de los fármacos , Folículo Piloso , Tejido Adiposo , Péptido 1 Similar al Glucagón/agonistasRESUMEN
Androgenetic alopecia (AGA) significantly impacts patients' psychological well-being, and treatment options have historically been limited. However, the advent of low-dose oral minoxidil (LDOM) has revolutionized AGA management. This study compares the treatment response and safety of LDOM in patients with AGA alone versus those with AGA unmasked by telogen effluvium. Our findings indicate that LDOM is effective and safe for both groups, showing comparable efficacy and safety profiles. These results support the use of LDOM as a reliable treatment option for AGA, potentially improving patient outcomes and quality of life.
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Alopecia , Minoxidil , Humanos , Minoxidil/administración & dosificación , Femenino , Adulto , Alopecia/tratamiento farmacológico , Administración Oral , Masculino , Resultado del Tratamiento , Persona de Mediana Edad , Calidad de Vida , Adulto JovenRESUMEN
Low dose oral minoxidil (LDOM) is an efficacious and safe treatment for alopecia, however, a notable side effect is hypertrichosis. Spironolactone, known for treating hirsutism, is also used off-label for the treatment of certain forms of alopecia and may reduce LDOM-induced hypertrichosis. We performed a retrospective review of 54 patients seen at NYU Langone Health and compared hypertrichosis rates in female alopecia patients on LDOM monotherapy versus those on combination therapy with spironolactone. Among 54 patients, 37 received LDOM alone and 17 received the combination. Hypertrichosis developed in 33.3% of patients, with lower rates in the combination group (17.6% vs. 40.5% for monotherapy). Although not statistically significant, the trend suggests spironolactone may mitigate hypertrichosis. The study highlights the potential of combination therapy to address hypertrichosis and calls for larger studies to confirm these findings.
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Alopecia , Quimioterapia Combinada , Hipertricosis , Minoxidil , Espironolactona , Humanos , Minoxidil/administración & dosificación , Minoxidil/efectos adversos , Femenino , Espironolactona/administración & dosificación , Espironolactona/efectos adversos , Alopecia/tratamiento farmacológico , Alopecia/diagnóstico , Hipertricosis/inducido químicamente , Hipertricosis/diagnóstico , Adulto , Estudios Retrospectivos , Quimioterapia Combinada/métodos , Persona de Mediana Edad , Resultado del Tratamiento , Administración Oral , Adulto Joven , AdolescenteRESUMEN
The etiology of alopecia is so complex that current therapies with single-mechanism and attendant side-effects during long-term usage, are insufficient for treatment. Panax notoginseng saponins (PNS) is supposed to treat alopecia with multiple mechanisms, but difficult to penetrate skin efficiently due to water-solubility. Here, we designed water-in-oil microemulsion (PNS ME) using jojoba oil, fractioned coconut oil, RH 40 + Span 80 and cosurfactant D-panthenol, to help PNS penetrating the skin. Particularly, D-panthenol not only enlarges the microemulsion area, reduces the usage amounts of surfactants thus relieves skin irritation, but stimulates the migration of dermal papilla cells (DPCs), displaying cooperative effects on anti-alopecia. PNS ME penetrates through sebum-rich corneum via high-affinity lipid fusion, targets to hair follicles (HFs), where it resides in skin for sustained drug release, accelerates angiogenesis to build well-nourished environment for HFs, and facilitates the proliferation and migration of DPCs in vitro. PNS ME markedly improved hair density, skin pigmentation, new hair weight, skin thickness, and collagen generation of telogen effluvium mice. Moreover, PNS also took outstanding curative effects on androgenetic alopecia mice. Upon further exploration, PNS ME caused dramatic upregulations of ß-catenin, VEGF and Ki67, suggesting it might function by triggering Wnt/ß-catenin pathway, accelerating vessels formation, and activating the hair follicle stem cells. Notably, PNS ME indicated longer-term safety than minoxidil tincture. Together, PNS ME provides a comprehensive strategy for alopecia, especially it avoids defects by high-proportioned surfactants in traditional microemulsion, exhibiting milder and safer, which shows bright prospect of applying microemulsion in hair growth promotion.
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Alopecia , Emulsiones , Folículo Piloso , Panax notoginseng , Saponinas , Tensoactivos , Alopecia/tratamiento farmacológico , Alopecia/inducido químicamente , Animales , Ratones , Saponinas/administración & dosificación , Saponinas/farmacología , Saponinas/química , Folículo Piloso/efectos de los fármacos , Panax notoginseng/química , Tensoactivos/química , Tensoactivos/administración & dosificación , Femenino , Piel/efectos de los fármacos , Piel/metabolismo , Movimiento Celular/efectos de los fármacos , Masculino , Absorción Cutánea/efectos de los fármacos , Agua/química , Administración CutáneaRESUMEN
Calcitonin gene-related peptide (CGRP) inhibitors, in the form of injectable monoclonal antibodies, are a newer class of drugs for the prevention of migraine headaches. In clinical trials, they have been found to be effective with good tolerance and few adverse effects. Alopecia has been increasingly noted as a post-marketing event associated with CGRP inhibitor injectables. Of the case reports available on this topic, alopecia has commonly been localised to the scalp and associated with erenumab use; however, not as much has been reported for fremanezumab nor for injection site-related alopecia. We report an occurrence of persistent lower extremity localised injection site alopecia in a patient within our headache clinic who used fremanezumab. The possible mechanism of alopecia may be related to the failure of hair follicle immune privilege in the absence of CGRP immunomodulatory effects.
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Alopecia , Anticuerpos Monoclonales , Trastornos Migrañosos , Humanos , Alopecia/inducido químicamente , Alopecia/tratamiento farmacológico , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales/administración & dosificación , Trastornos Migrañosos/tratamiento farmacológico , Femenino , Reacción en el Punto de Inyección , Péptido Relacionado con Gen de Calcitonina/antagonistas & inhibidores , Péptido Relacionado con Gen de Calcitonina/inmunología , Persona de Mediana Edad , AdultoRESUMEN
OBJECTIVE: It still needs to be determined if platelet-rich plasma (PRP) has any added advantage over Minoxidil in treating androgenetic alopecia. We reviewed randomized controlled trials (RCTs) comparing scalp injections of PRP plus Minoxidil vs Minoxidil alone for managing androgenetic alopecia. METHODS: All RCTs published on Embase, Cochrane Library, and PubMed comparing PRP plus Minoxidil vs. Minoxidil alone were eligible. The literature search was completed on 5 March 2024. The review was registered on PROSPERO (CRD42024509826). RESULTS: Of five included RCTs, three had a high risk of bias, while one had some concerns. A systematic review of the studies showed that all trials reported better outcomes with PRP plus Minoxidil than with Minoxidil alone. Meta-analysis showed that hair density at one month (MD: 11.07 95% CI: 1.20, 20.94 I2 = 0%), three months (MD: 21.81 95% CI: 10.64, 33.00 I2 = 57%) and 5/6 months (MD: 17.80 95% CI: 7.91, 27.69 I2 = 80%) of follow-up was significantly better in the PRP plus Minoxidil vs the Minoxidil alone group. Meta-analysis of adverse events showed that the risk of adverse events was comparable in both groups (OR: 0.55 95% CI: 0.22, 1.36 I2 = 0%). The certainty of evidence on the GRADE assessment was "low to very low." CONCLUSION: Very low-quality evidence shows that the addition of injectable PRP to topical Minoxidil may improve outcomes in patients with androgenetic alopecia. The addition of PRP was found to improve hair density and patient satisfaction significantly. However, the small number of studies with a high risk of bias and heterogeneity in PRP preparation methods are significant limitations of current evidence. Further studies with larger sample sizes and uniform PRP preparation protocols are needed.
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Administración Tópica , Alopecia , Minoxidil , Plasma Rico en Plaquetas , Alopecia/tratamiento farmacológico , Humanos , Minoxidil/administración & dosificación , Minoxidil/uso terapéutico , Resultado del Tratamiento , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Androgenetic alopecia (AGA) is a common type of hair loss in men and efficacy and safety of current medical treatment remain limited. Therefore, the present study aimed to investigate the efficacy and safety of botulinum toxin type A (BTA) combined with Minoxidil in patients with AGA. 60 male patients were included in this study and control group received topical 5% Minoxidil and the treatment group received BTA combined with topical 5% Minoxidil. BTA injections (60-70 U) were administered at 30-35 scalp sites. Head photographs were taken at baseline, 2nd, 4th, and 6th months. Clinical descriptions recorded scalp conditions, and patient satisfaction along with Dermatology Life Quality Index scores were documented. The treatment group (TG) showed significant hair growth differences compared to the control group (CG) at the 4th month (P < 0.001) and 6th month (P = 0.0046) post-treatment. TG had improved Investigator Global Assessment (IGA) scores in the 4th month (P = 0.0001) and 6th month (P = 0.0259) compared to CG. Patient satisfaction in TG for hair growth and scalp improvement was higher than CG (all P < 0.05). TG exhibited substantial quality of life improvement at the 4-month (P = 0.0009) and 6-month (P = 0.0099). No adverse reactions were observed post-botulinum toxin injection. BTA combined with Minoxidil effectively promotes hair growth, enhances the quality of life, and alleviates scalp symptoms in male AGA patients at 4th and 6th months, with no adverse effects compared to Minoxidil alone.Trial registration number: Ethics Committee of Shanghai Tongji Hospital (ID: K-2018-026).
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Alopecia , Toxinas Botulínicas Tipo A , Minoxidil , Satisfacción del Paciente , Calidad de Vida , Humanos , Masculino , Minoxidil/administración & dosificación , Minoxidil/efectos adversos , Alopecia/tratamiento farmacológico , Toxinas Botulínicas Tipo A/administración & dosificación , Toxinas Botulínicas Tipo A/efectos adversos , Adulto , Resultado del Tratamiento , Persona de Mediana Edad , Administración Tópica , Quimioterapia Combinada/métodos , Cabello/crecimiento & desarrollo , Cabello/efectos de los fármacos , Cuero Cabelludo , Adulto JovenRESUMEN
18-ß-Glycyrrhetinic acid, a major component of licorice, stimulated the proliferation of both dermal papilla cells and outer root sheath cells isolated from human hair follicles. Thus, suggesting that this compound promotes hair growth. Furthermore, this compound inhibited the activity of testosterone 5α-reductase, an enzyme responsible for converting androgen to dihydroandrogen, with an IC50 of 137.1 µM. 18-ß-Glycyrrhetinic acid also suppressed the expression of transforming growth factor-ß1 (TGF-ß1), which shifts the hair cycle from the anagen phase to the telogen phase. It suggested that this compound may prolong the anagen phase. Based on these findings, this compound could be a potentially effective treatment for androgenetic alopecia.
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Inhibidores de 5-alfa-Reductasa , Proliferación Celular , Ácido Glicirretínico , Folículo Piloso , Ácido Glicirretínico/farmacología , Ácido Glicirretínico/análogos & derivados , Humanos , Proliferación Celular/efectos de los fármacos , Folículo Piloso/efectos de los fármacos , Folículo Piloso/citología , Inhibidores de 5-alfa-Reductasa/farmacología , Células Cultivadas , Cabello/crecimiento & desarrollo , Cabello/efectos de los fármacos , Factor de Crecimiento Transformador beta1/metabolismo , Alopecia/tratamiento farmacológico , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/metabolismo , 3-Oxo-5-alfa-Esteroide 4-Deshidrogenasa/genéticaRESUMEN
BACKGROUND: Alopecia areata (AA) is an autoimmune pathology manifested by loss of hair. OBJECTIVE: To evaluate and compare the efficacy and safety of tofacitinib and azathioprine in patients with AA and variants. METHODS: In this double-blind randomized controlled trail (RCT) carried out at the Department of Dermatology, Medical Teaching Institute-Lady Reading Hospital (MTI-LRH), Peshawar, Pakistan, patients aged ≥ 12 years diagnosed with AA, alopecia totalis (AT) or alopecia universalis (AU) with minimum 50% scalp hair loss for a period ≥ 06 years were included. Patients were randomly assigned to receive oral tofacitinib 5 mg twice daily (Group I) or oral azathioprine 2 mg/kg body weight once daily (Group II). The primary endpoint was Severity of Alopecia Tool (SALT) score, evaluated at baseline and 06 months follow-up. Safety was consistently assessed during the study. RESULTS: A total of 104 patients underwent random allocation into either the tofacitinib group (n = 52) or the azathioprine group (n = 52). The mean (SD) age of patients was 20.23 (7.14) years and 22.26 (8.07) years, while the mean (SD) disease duration was 6.59 (4.01) years and 7.98 (4.40) years in in Group I and II, respectively. Overall, 40 (38.5%) patients were adolescents while 70 (67.3%) were male. 52 (50%) had AA, 37 (35.5%) had AT and 15 (14.5%) had AU. Mean baseline SALT score in tofacitinib group was 91.02 ± 10.21 and azathioprine group was 91.02 ± 10.63, which at 06 months follow-up improved to 14.1 ± 24.6 and 63.9 ± 33.9, respectively (difference, 11.5 points; 95% confidence interval, 38.3-61.3, p < 0.0001). Overall, no major adverse effects and no difference among the minor adverse effects in the two groups (04 adverse events for tofacitinib group and 08 for azathioprine group: p = 0.23) was observed. CONCLUSIONS: Efficacy of tofacitinib was significantly higher than azathioprine, whilst both drugs were well-tolerated in patients with AA and variants.