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Bi L, Wang C, Du Y, Lu C, Zhao M, Ding Y, Sun W, Fan W. Causal Effects of Lipids-Related Metabolites on Androgenic Alopecia: A Mendelian Randomization Study. Clin Cosmet Investig Dermatol 2024; 17:409-416. [PMID: 38371329 PMCID: PMC10871140 DOI: 10.2147/ccid.s445453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024]
Abstract
Purpose To investigate whether increased levels of lipids-related metabolites (LRMs) result in androgenic alopecia (AGA). Patients and Methods A two-sample Mendelian randomization (MR) study was designed, and single nucleotide polymorphisms (SNPs) respectively related to nine LRMs were selected from the genome-wide association study (GWAS) dataset. An MR analysis was performed to assess the causal association between LRMs and AGA. Results Through the fixed-effect inverse variance weighting (IVW) method, MR analysis indicated that Apolipoprotein B (ApoB), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) had a causal relationship with AGA. No obvious heterogeneity or pleiotropy was observed. Conclusion The risk of AGA increases significantly when the serum levels of ApoB, LDL, and VLDL increase. This causal relationship is solid and free of interference from confounding factors.
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Affiliation(s)
- Lingbo Bi
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Chaofan Wang
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Yimei Du
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Changpei Lu
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Min Zhao
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Yunbu Ding
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Weiling Sun
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
| | - Weixin Fan
- Department of Dermatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China
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Phuwaraks K, Rutnin S, Suchonwanit P. Lichen Sclerosus of the Labial Mucosa: A Case Report and Literature Review. Clin Cosmet Investig Dermatol 2024; 17:253-258. [PMID: 38318493 PMCID: PMC10840517 DOI: 10.2147/ccid.s448367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Abstract
Lichen sclerosus (LS) is an uncommon, chronic, inflammatory mucocutaneous disorder found predominantly in females with unknown etiology. It presents as a white sclerotic plaque commonly located on the anogenital area. Extragenital LS is less prevalent, and LS affecting the oral mucosa is extremely rare, with only 39 biopsy-confirmed cases reported in the literature. Due to its several mimicking conditions, histological examination is usually required for a definitive diagnosis, particularly in patients with oral LS. Current evidence-based treatment recommendations for oral LS are unavailable; however, most cases tend to improve after treatment with topical or intralesional corticosteroids. We report a case of a 58-year-old female referred from the otolaryngology department for evaluating an asymptomatic whitish sclerotic plaque on the lower lip mucosa that had existed for 1 year. Following a punch biopsy, the patient was diagnosed with LS of labial mucosa. The condition improved after 2 months of treatment with topical and intralesional corticosteroids. The present case report raises awareness in recognizing oral LS and contributes to knowledge of this rare disorder.
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Affiliation(s)
- Koramon Phuwaraks
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Tejapira K, Sakpuwadol N, Pomsoong C, Ratanapokasatit Y, Suchonwanit P. Trichoscopic Features of Syphilitic Alopecia and Alopecia Areata: A Comparative Study. Clin Cosmet Investig Dermatol 2023; 16:2259-2269. [PMID: 37608922 PMCID: PMC10441631 DOI: 10.2147/ccid.s424054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023]
Abstract
Background Syphilitic alopecia (SA) and alopecia areata (AA) are two distinct conditions that frequently present diagnostic difficulties, especially when differentiating between them due to their similar clinical presentations. Trichoscopy may help in differential diagnosis, but a comparison between trichoscopic features of SA and AA is yet to be researched. Objective To compare trichoscopic features between SA and AA and determine their discriminative values. Methods Electronic medical records and trichoscopic images of patients diagnosed with SA or AA between January 2000 and February 2022 were retrieved. Trichoscopic features were statistically compared, and their discriminative values were demonstrated as sensitivity, specificity, predictive value, likelihood ratio, and area under the receiver operating characteristic curve (AUC). Results A total of 69 patients were included: 23 SA and 46 AA cases were matched with a 1:2 ratio. Black dots, broken hairs, pigtail hairs, exclamation mark hairs, tapered hairs, angulated hairs, and non-pigmented regrowing hairs were significantly more prevalent in AA than in SA (all P<0.05), whereas erythematous background was more prevalent in SA than in AA patients (P=0.008). Among the aforementioned trichoscopic features, exclamation mark hairs and non-pigmented regrowing hairs had a high positive likelihood ratio for AA (16.17 and 8.34, respectively); however, only exclamation mark hairs revealed high AUC (AUC=0.816). Conclusion Despite the presence of several similar trichoscopic features between SA and AA, trichoscopy can aid in distinguishing between the two diseases. Exclamation mark hairs are the only trichoscopic feature that can be used to differentiate patients with clinically suspicious SA from those with AA.
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Affiliation(s)
- Kasama Tejapira
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nawara Sakpuwadol
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cherrin Pomsoong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yanisa Ratanapokasatit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Sakpuwadol N, Tejapira K, Kositkuljorn C, Pomsoong C, Suchonwanit P. Differences in Demographic and Clinical Characteristics Among Subtypes of Female Pattern Hair Loss. Clin Cosmet Investig Dermatol 2023; 16:2073-2082. [PMID: 37575151 PMCID: PMC10417682 DOI: 10.2147/ccid.s422335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
Background Female pattern hair loss (FPHL) is the most common hair loss disorder in women that can be classified into three patterns, including Ludwig, Olsen, and Hamilton-Norwood subtypes. Information regarding the comparison of demographics, clinical characteristics, and associated comorbidities among subtypes of FPHL is scarce and contradictory. Objective To evaluate and compare the epidemiology, clinical manifestations, and comorbid conditions of FPHL subtypes and determine their associated factors. Methods This retrospective study included patients who were diagnosed with FPHL between January 2000 and November 2021. Participants were classified into three subtypes, namely Ludwig, Olsen, and Hamilton-Norwood, and were statistically compared. Variables significantly associated with each FPHL subtype were identified using multivariable multinomial logistic regression analysis. Results Among the 519 patients with FPHL, the Ludwig subtype was the most prevalent (51.1%), followed by the Olsen (32.9%) and Hamilton-Norwood (16%) subtypes. The Hamilton-Norwood subtype revealed significantly higher frequencies of early disease onset (61.4%), menstrual irregularity (22.9%), polycystic ovary syndrome (PCOS, 18.1%), and seborrhea (30.1%) but lower frequencies of overweight (24.1%) and type 2 diabetes mellitus (DM, 2.4%). Multivariable multinomial regression analysis demonstrated that the Hamilton-Norwood subtype was a predictor for early disease onset and PCOS compared to Ludwig (early onset: odds ratio (OR) = 2.14, 95% confidence interval (CI) = 1.39-4.22, P = 0.02; PCOS: OR = 2.02, 95% CI = 1.55-4.84, P = 0.03), and Olsen (early onset: OR = 1.89, 95% CI = 1.03-3.92, P = 0.04; PCOS: OR = 2.24, 95% CI = 1.89-5.31, P = 0.01). In contrast, the Hamilton-Norwood pattern was at decreased risk for type 2 DM compared to Ludwig (OR = 0.51, 95% CI = 0.03-0.82, P = 0.02), and Olsen (OR = 0.68, 95% CI = 0.04-0.79, P = 0.03). Conclusion The Ludwig pattern was found to be the most prevalent FPHL subtype among Thai patients. Moreover, the Hamilton-Norwood subtype was associated with early disease onset and PCOS, whereas the Ludwig and Olsen subtypes were associated with type 2 DM.
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Affiliation(s)
- Nawara Sakpuwadol
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kasama Tejapira
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaninan Kositkuljorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cherrin Pomsoong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Arora G, Mishra A, Gaurav, Chandra N, Kesharwani P, Jain GK. In Vitro and In Vivo Scalp Retention and Penetration of 99mTc-Minoxidil Solution. J Pharm Sci 2023; 112:230-236. [PMID: 36181874 DOI: 10.1016/j.xphs.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 10/14/2022]
Abstract
The present study assessed the effect of retention on ex vivo skin and in vivo scalp penetration of radiolabeled minoxidil formulations (5% w/v). Minoxidil was radiolabeled with technetium (99mTc) with an efficiency of 99.1% using 0.2% stannous chloride as reducing agent at pH 6 and incubation temperature of 40 °C. Three different 99mTc-minoxidil formulations were prepared using aqueous ethanolic solution as vehicle. Formulation A contains 99mTc-minoxidil dissolved in vehicle, formulation B contains 10% propylene glycol (PG) and formulation C contains 10% hydroxypropyl cellulose (HPC), in addition. Results showed that addition of HPC resulted in enhanced viscosity (400 mPa.s) and significantly higher ex vivo retention (p < 0.05) and permeation (0.75±0.12%, 8 h). PG does not improve the permeation and the results (0.44±0.05%, 8 h) were not significantly different from vehicle alone (0.40±0.05%, 8 h). The results of the in vivo human scalp studies corroborated with the ex vivo results and addition of hydroxypropyl cellulose (HPH) showed significantly higher (p < 0.05) scalp retention. Post 8 h application, scalp penetration in group treated with formulation C was nearly 2.8-fold and 2.2-fold higher than those treated with formulation A and B, respectively. Further, absence of minoxidil in systemic circulation during study duration indicates safety. In conclusion, our results showed that increasing contact time of minoxidil with scalp by modifying viscosity results in reduced frequency of application and improved efficacy.
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Affiliation(s)
- Gargi Arora
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, New Delhi 110017, India
| | - Abha Mishra
- Department of Physiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi 110029, India
| | - Gaurav
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, New Delhi 110017, India
| | - Nilesh Chandra
- Basic Medical Science Division, Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Science and Research, Jamia Hamdard, Hamdard Nagar, New Delhi 110062, India; Center for Transdisciplinary Research, Department Of Pharmacology, Saveetha Dental College , Saveetha Institute of Medical and Technical science, Chennai , India.
| | - Gaurav Kumar Jain
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, New Delhi 110017, India; Center for Advanced Formulation Technology, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, New Delhi 110017, India.
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Yongpisarn T, Namasondhi A, Iamsumang W, Rattanakaemakorn P, Suchonwanit P. Liver fibrosis prevalence and risk factors in patients with psoriasis: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1068157. [PMID: 36590962 PMCID: PMC9797863 DOI: 10.3389/fmed.2022.1068157] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Background Patients with psoriasis are more likely than matched controls in the general population to have advanced liver fibrosis; however, our understanding of these patients is limited. There is currently no systematic evaluation of the prevalence and risk factors of liver fibrosis in psoriasis patients. Objective To evaluate the prevalence of psoriasis patients who are at high or low risk for advanced liver fibrosis and determine the risk factors for developing liver fibrosis. Methods Electronic searches were conducted using the PubMed, Embase, Scopus, and Cochrane Library databases from the dates of their inception till May 2022, using the PubMed, Embase, Scopus, and Cochrane Library databases. Any observational study describing the prevalence and/or risk factors for liver fibrosis in patients with psoriasis was included. Results Patients with psoriasis at high risk for advanced liver fibrosis had a pooled prevalence of 9.66% [95% confidence interval (CI): 6.92-12.75%, I 2 = 76.34%], whereas patients at low risk for advanced liver fibrosis had a pooled prevalence of 77.79% (95% CI: 73.23-82.05%, I 2 = 85.72%). Studies that recruited methotrexate (MTX)-naïve patients found a lower prevalence of advanced liver fibrosis (4.44, 95% CI: 1.17-9.22%, I 2 = 59.34%) than those that recruited MTX-user cohorts (12.25, 95% CI: 6.02-20.08%, I 2 = 82.34%). Age, sex, BMI, PASI score, psoriasis duration, MTX cumulative dose, and the prevalence of obesity, MTX users, diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome were not identified as sources of heterogeneity by meta-regression analysis. The pooled odds ratios for age >50 years, BMI > 30, diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome were 2.20 (95% CI: 1.42-3.40, I 2 = 0%), 3.67 (95% CI: 2.37-5.68, I 2 = 48.8%), 6.23 (95% CI: 4.39-8.84, I 2 = 42.4%), 2.82 (95% CI: 1.68-4.74, I 2 = 0%), 3.08 (95% CI: 1.90-4.98, I 2 = 0%), and 5.98 (95% CI: 3.63-9.83, I 2 = 17%), respectively. Conclusion Approximately 10% of the population with psoriasis is at high risk for advanced liver fibrosis, while 78% are at low risk. Patients over the age of 50 with obesity, diabetes, hypertension, dyslipidemia, and/or metabolic syndrome have an increased risk of developing liver fibrosis, necessitating monitoring. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022303886], identifier [CRD42022303886].
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Jung DR, Yoo HY, Kim MJ, Singh V, Park SH, Jeong M, Park BJ, Shin JH. Comparative analysis of scalp and gut microbiome in androgenetic alopecia: A Korean cross-sectional study. Front Microbiol 2022; 13:1076242. [PMID: 36578576 PMCID: PMC9791053 DOI: 10.3389/fmicb.2022.1076242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Androgenetic alopecia (AGA) is a non-scarring and progressive form of hair loss occurring in both men and women. Although genetic predisposition and sex steroid hormones are the main causes, many factors remain unknown, and various extrinsic factors can negatively affect the lifespan of hair. We investigated skin-gut axis microorganisms as potential exogenous factors causing AGA, through comparative analyses of the scalp and gut microbiome in individuals with and without AGA in a Korean cohort. Using 16S rRNA gene sequencing, we characterized the scalp and gut microbiomes of 141 individuals divided into groups by sex and presence of AGA. Alpha diversity indices in the scalp microbiome were generally higher in individuals with AGA than in healthy controls. These indices showed a strong negative correlation with scalp-inhabitant bacteria (Cutibacterium and Staphylococcus), indicating that the appearance of non-inhabitant bacteria increases as hair loss progresses. No significant differences in diversity were observed between the gut microbiomes. However, bacterial functional differences, such as bile acid synthesis and bacterial invasion of epithelial cells, which are related to intestinal homeostasis, were observed. The networks of the scalp and gut microbiome were more complex and denser with higher values of the network topology statistic coefficient values (i.e., transitivity, density, and degree centrality) and more unique associations in individuals with AGA than in healthy controls. Our findings reveal a link between skin-gut microorganisms and AGA, indicating the former's potential involvement in the latter's development. Additionally, these results provide evidence for the development of cosmetics and therapeutics using microorganisms and metabolites involved in AGA.
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Affiliation(s)
- Da-Ryung Jung
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Hye-Young Yoo
- Skin and Natural Products Lab, Kolmar Korea Co., Ltd., Seoul, South Korea
| | - Min-Ji Kim
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Vineet Singh
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Sung-Ha Park
- Skin and Natural Products Lab, Kolmar Korea Co., Ltd., Seoul, South Korea
| | - Minsoo Jeong
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea
| | - Byoung-Jun Park
- Skin and Natural Products Lab, Kolmar Korea Co., Ltd., Seoul, South Korea,*Correspondence: Byoung-Jun Park,
| | - Jae-Ho Shin
- Department of Applied Biosciences, Kyungpook National University, Daegu, South Korea,Department of Integrative Biotechnology, Kyungpook National University, Daegu, South Korea,NGS Core Facility, Kyungpook National University, Daegu, South Korea,Jae-Ho Shin,
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Pena-Rodríguez E, García-Vega L, Lajarin Reinares M, Pastor-Anglada M, Pérez-Torras S, Fernandez-Campos F. Latanoprost-Loaded Nanotransfersomes Designed for Scalp Administration Enhance Keratinocytes Proliferation. Mol Pharm 2022; 20:2317-2325. [PMID: 36503244 PMCID: PMC10155202 DOI: 10.1021/acs.molpharmaceut.2c00796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Latanoprost (LAT) has been shown to have a hypertrichotic effect, which makes it a promising candidate for alopecia treatments. For the first time, LAT has been encapsulated in nanotransfersomes in order to increase its efficacy. Ex vivo skin biodistribution was studied by confocal laser microscopy both in human scalp and pig skin. Results showed that nanotransfersomes increase the penetration of two different fluorochromes, with similar patterns in both species, compared with fluorochrome solutions containing no nanotransfersomes. Nanotransfersomes were stable under accelerated conditions (40 °C/75% RH) and long-term conditions (25 °C/60% RH) for up to 1 year, with no differences in vesicle size and polydispersity when LAT was loaded. Nanotransfersomes increased the LAT cell proliferation effect in HaCaT cell via MAPK signaling pathway. Collectively, our results demonstrate LAT-nanotransfersomes formulation could be a promising therapy for hair growth disorders.
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Affiliation(s)
- Eloy Pena-Rodríguez
- Laboratory Reig Jofre, R&D Department, 08970Sant Joan Despi, Barcelona, Spain
| | - Laura García-Vega
- Molecular Pharmacology and Experimental Therapeutics, Department of Biochemistry and Molecular. Biomedicine, Institute of Biomedicine (IBUB), University of Barcelona (IBUB), 08028Barcelona, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Carlos III Health Institute, 28029Madrid, Spain
- Sant Joan de Déu Research Institute (IR SJD-CERCA) Esplugues de Llobregat, 08950Barcelona, Spain
| | | | - Marçal Pastor-Anglada
- Molecular Pharmacology and Experimental Therapeutics, Department of Biochemistry and Molecular. Biomedicine, Institute of Biomedicine (IBUB), University of Barcelona (IBUB), 08028Barcelona, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Carlos III Health Institute, 28029Madrid, Spain
- Sant Joan de Déu Research Institute (IR SJD-CERCA) Esplugues de Llobregat, 08950Barcelona, Spain
| | - Sandra Pérez-Torras
- Molecular Pharmacology and Experimental Therapeutics, Department of Biochemistry and Molecular. Biomedicine, Institute of Biomedicine (IBUB), University of Barcelona (IBUB), 08028Barcelona, Spain
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Carlos III Health Institute, 28029Madrid, Spain
- Sant Joan de Déu Research Institute (IR SJD-CERCA) Esplugues de Llobregat, 08950Barcelona, Spain
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Tejapira K, Yongpisarn T, Sakpuwadol N, Suchonwanit P. Platelet-rich plasma in alopecia areata and primary cicatricial alopecias: A systematic review. Front Med (Lausanne) 2022; 9:1058431. [PMID: 36507528 PMCID: PMC9731377 DOI: 10.3389/fmed.2022.1058431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background Immune-mediated alopecias (IMAs), a group of hair disorders associated with immunological reactions, remain a therapeutic challenge since available treatments are generally unfavorable with potential side effects. Platelet-rich plasma (PRP) has been recently proposed as a treatment option based on several limited-quality studies; however, there is no systematic evaluation of PRP efficacy on IMAs in the literature. Objective To assess PRP's effects in treating IMAs using a systematic review. Methods Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases. A search strategy was designed to retrieve all studies exploring PRP in treating IMAs, including alopecia areata (AA) and primary cicatricial alopecias (PCAs). In addition, all randomized and non-randomized studies reporting subjective and/or objective outcomes of alopecia treatment with PRP were included. Results Thirty-two studies were included, comprising 621 patients with AA and 19 patients with PCAs. PRP had superior efficacy as monotherapy in five studies, comparable to intralesional corticosteroids in six studies in AA treatment. In addition, in the analysis of PCAs, including lymphocytic and neutrophilic subtypes, PRP was efficacious in alleviating disease progression in nine studies. Conclusion PRP is considered a promising treatment for AA and PCAs in patients who experienced unfavorable outcomes from conventional treatment. However, its clinical application remains to be standardized, and its recommendation as a treatment for IMAs could not be ascertained due to a lack of high-quality evidence. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353859], identifier [CRD42022353859].
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Kasmawati H, Mustarichie R, Halimah E, Ruslin R, Arfan A, Sida NA. Unrevealing the Potential of Sansevieria trifasciata Prain Fraction for the Treatment of Androgenetic Alopecia by Inhibiting Androgen Receptors Based on LC-MS/MS Analysis, and In-Silico Studies. Molecules 2022; 27:molecules27144358. [PMID: 35889232 PMCID: PMC9318048 DOI: 10.3390/molecules27144358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
Androgenetic Alopecia (AGA) occurs due to over-response to androgens causing severe hair loss on the scalp, and requires the development of new and efficient drugs to treat this condition. This study explores and identifies secondary metabolites from Sansevieriatrifasciata Prain using the LC-MS/MS and in-silico method. The inhibitory activity of bioactive compounds from S. trifasciata Prain against androgen receptors (PDB ID: 4K7A) was evaluated molecularly using docking and dynamics studies by comparing their binding energies, interactions, and stability with minoxidil. The results of the LC-MS/MS analysis identified Methyl pyrophaeophorbide A (1), Oliveramine (2), (2S)-3′, 4′-Methylenedioxy-5, 7-dimethoxyflavane (3), 1-Acetyl-β-carboline (4), Digiprolactone (5), Trichosanic acid (6) and Methyl gallate (7) from the leaves subfraction of this plant. Three alkaloid compounds (compounds 1, 3, and 4), and one flavonoid (compound 2), had lower docking scores of −7.0, −5.8, −5.2, and −6.3 kcal/mol, respectively. The prediction of binding energy using the MM-PBSA approach ensured that the potency of the four compounds was better than minoxidil, with energies of −66.13, −59.36, −40.39, and −40.25 kJ/mol for compounds 1, 3, 2, and 4, respectively. The dynamics simulation shows the stability of compound 1 based on the trajectory analysis for the 100 ns simulation. This research succeeded in identifying the compound and assessing the anti-alopecia activity of Sansevieria trifasciata Prain. Seven compounds were identified as new compounds never reported in Sansevieria trifasciata Prain. Four compounds were predicted to have better anti-alopecia activity than minoxidil in inhibiting androgen receptors through an in silico approach.
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Affiliation(s)
- Henny Kasmawati
- Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
- Faculty of Pharmacy, Universitas Halu Oleo, Kendari 93232, Indonesia; (R.R.); (A.A.); (N.A.S.)
- Correspondence: (H.K.); (R.M.)
| | - Resmi Mustarichie
- Department of Analytical Pharmacy and Medicinal Chemistry, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
- Correspondence: (H.K.); (R.M.)
| | - Eli Halimah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia;
| | - Ruslin Ruslin
- Faculty of Pharmacy, Universitas Halu Oleo, Kendari 93232, Indonesia; (R.R.); (A.A.); (N.A.S.)
| | - Arfan Arfan
- Faculty of Pharmacy, Universitas Halu Oleo, Kendari 93232, Indonesia; (R.R.); (A.A.); (N.A.S.)
| | - Nurramadhani A. Sida
- Faculty of Pharmacy, Universitas Halu Oleo, Kendari 93232, Indonesia; (R.R.); (A.A.); (N.A.S.)
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Li X, Yang F, Yan H, Shi Y, Chang X, Zhang M, Zhang Y, Zhang M. Microbiota profiling on itchy scalp with undetermined origin. Arch Microbiol 2022; 204:446. [PMID: 35778621 DOI: 10.1007/s00203-022-03077-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
Scalp pruritus is a common skin problem that remains therapeutic challenge. The relationships between the dysbiosis of microbiota and skin diseases have caught attention recently. However, there are few reports about microbiota on itchy scalp. This study investigated scalp microbial characteristics of subjects with mild scalp pruritus of undetermined origin and preliminarily screened physiological factors and bacteria potentially related to pruritus. The pruritus severity of 17 qualified females was evaluated by Visual Analogue Scale (VAS). Microbiota collection was done at both itchy (n = 20) and non-itchy sites (n = 27) at occiput and crown of the same subject and Illumina sequencing was performed at the V3-V4 hypervariable regions of 16S rRNA. The corresponding sebum content, hydration, pH, trans-epidermal water loss, erythema index and porphyrin numbers were also measured by skin tester. We identified 3044 amplicon sequence variants from 821 genera. The itchy and non-itchy sites had different microbiota structures (p = 0.045, by multivariate analysis of variance), while there were large inter- and intra-individual variations. Both sites had Staphylococcus, Cutibacterium and Lawsonella as predominant genera, which were not significantly related to pruritus. The use of three genera Lactobacillus, Morganella and Pseudomonas, could well distinguish non-itchy from itchy groups, whereas different composition patterns existed inside each group. Our investigation indicated that though the bacterial community structure on itchy scalp was individual specific, there was difference between itchy and non-itchy sites. The study provides new insights into microbiota profiling on itchy scalp, which will help microbiota-targeted therapeutic experiment or products design for scalp pruritus.
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Affiliation(s)
- Xuejing Li
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Fang Yang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Haosong Yan
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yi Shi
- Henkel (China) Investment Co., Ltd, Shanghai, 200438, China
| | - Xiaowei Chang
- Henkel (China) Investment Co., Ltd, Shanghai, 200438, China
| | - Mengmeng Zhang
- Henkel (China) Investment Co., Ltd, Shanghai, 200438, China
| | - Yan Zhang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Menghui Zhang
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240, China.
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Gupta AK, Venkataraman M, Talukder M, Bamimore MA. Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis. JAMA Dermatol 2022; 158:266-274. [PMID: 35107565 PMCID: PMC8811710 DOI: 10.1001/jamadermatol.2021.5743] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
IMPORTANCE There are knowledge gaps regarding the relative efficacy of 3 commonly used drugs for androgenetic alopecia (AGA), namely, minoxidil and the two 5-α reductase inhibitors dutasteride and finasteride. OBJECTIVE To examine the relative efficacy of any dose and administration route of minoxidil, dutasteride, and finasteride for the treatment of male AGA. DATA SOURCES Systematic searches were performed in PubMed on March 5, 2021, without date restrictions. STUDY SELECTION Eligible studies included those that investigated monotherapy with any dose and administration route of minoxidil, dutasteride, and finasteride. DATA EXTRACTION AND SYNTHESIS Data on the mean (SD) difference and sample size were used for the bayesian network meta-analyses. League tables and surface under the cumulative ranking curve values were used to examine the relative efficacy of the interventions. MAIN OUTCOMES AND MEASURES Study end points were change in total and terminal hair count after 24 and 48 weeks of therapy. The 4 end points were quantified in hairs per square centimeters. RESULTS The PubMed search yielded 848 records; after the 2 stages of screening, 23 studies were eligible for quantitative analyses. Mean (SD) age of patients ranged from 22.8 (3.3) years to 41.8 (12.3) years. The greatest increase in total hair count at 24 weeks (ie, first end point) was with 0.5 mg/d of dutasteride, which was significantly more efficacious than 1 mg/d of finasteride (mean difference, 7.1 hairs/cm2; 95% CI, 5.1-9.3 hairs/cm2) and minoxidil (0.25 mg/d [mean difference, 23.7 hairs/cm2; 95% CI, 9.5-38.0 hairs/cm2], 5 mg/d [mean difference, 15.0 hairs/cm2; 95% CI, 3.9-26.1 hairs/cm2], and 2% solution [mean difference, 8.5 hairs/cm2; 95% CI, 4.8-12.3 hairs/cm2]). The greatest increase in terminal hair count at 24 weeks (ie, second end point) was with 5 mg/d of minoxidil, which was significantly more efficacious than the 0.25-mg/d dose (mean difference, 43.6 hairs/cm2; 95% CI, 29.7-57.7 hairs/cm2) and its topical forms (in 2% [mean difference, 29.3 hairs/cm2; 95% CI, 21.1-37.5 hairs/cm2] and 5% [mean difference, 29.8 hairs/cm2; 95% CI, 19.7-39.8 hairs/cm2]); 5 mg/d of minoxidil was significantly more efficacious than 1 mg/d of finasteride (mean difference, 10.4 hairs/cm2; 95% CI, 2.2-18.6 hairs/cm2). The greatest increase in total hair count at 48 weeks (ie, third end point) was with 5 mg/d of finasteride, which was significantly more efficacious than 2% topical minoxidil (mean difference, 20.7 hairs/cm2; 95% CI, 9.5-31.9 hairs/cm2). The greatest increase in terminal hair count at 48 weeks (ie, fourth end point) was with 1 mg/d of finasteride, which was significantly more effective than topical minoxidil (in 2% [mean difference, 32.1 hairs/cm2; 95% CI, 23.9-40.3 hairs/cm2] and 5% [mean difference, 26.2 hairs/cm2; 95% CI, 16.2-36.2 hairs/cm2]). CONCLUSIONS AND RELEVANCE As efficacy data from head-to-head trials accumulate, there could be a better sense of the relative efficacy of the different doses of the 5-α reductase inhibitors and minoxidil. The findings of this meta-analysis contribute to the comparative effectiveness literature for AGA therapies with regard to the compared interventions.
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Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc, London, Ontario, Canada,Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
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Khunkhet S, Chanprapaph K, Rutnin S, Suchonwanit P. Histopathological Evidence of Occipital Involvement in Male Androgenetic Alopecia. Front Med (Lausanne) 2021; 8:790597. [PMID: 34881276 PMCID: PMC8645552 DOI: 10.3389/fmed.2021.790597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The occipital region of the scalp is generally accepted as an unaffected area of androgenetic alopecia (AGA) for both genders. However, evidence of AGA involving the occipital scalp has been demonstrated in women; meanwhile, it is unclear whether occipital involvement also occurs in men. Objective: We aimed to determine if there is occipital involvement in men with AGA. Methods: This case-control study compared hair counts of scalp biopsy specimens from the occipital region of 82 men with Hamilton-Norwood III-VII and 82 unaffected men. Results: The mean ages of men with AGA and controls were 40.1 ± 8.9 and 38.6 ± 10.5 years, respectively (P = 0.291). A significant decrease in total hair follicles, terminal hair follicles, follicular units and terminal to vellus (T:V) ratio, along with a significant increase in follicular stelae was indicated in the AGA group compared to controls (all P < 0.05). Subgroup analyses revealed that average counts of total hair follicles, terminal hair follicles and T:V ratios were also significantly lower in males with Hamilton-Norwood VI and VII than in controls (all P < 0.05). There were no correlations between increasing age and hair count parameters, but a significant negative association was found between total follicle numbers and disease duration (r = -0.23, P = 0.02). Conclusions: AGA can involve the occipital area of male patients with advanced disease. Therefore, the occiput of particular cases should not be used to determine reference data for normal scalp hair, and preoperative measurements of miniaturized hairs in the donor site are strongly recommended in all persons undergoing hair transplantation.
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Affiliation(s)
- Saranya Khunkhet
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Skin Center, Srinakharinwirot University, Bangkok, Thailand
| | - Kumutnart Chanprapaph
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Suchonwanit P, Kositkuljorn C, Pomsoong C. Alopecia Areata: An Autoimmune Disease of Multiple Players. Immunotargets Ther 2021; 10:299-312. [PMID: 34350136 PMCID: PMC8328385 DOI: 10.2147/itt.s266409] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/17/2021] [Indexed: 12/12/2022] Open
Abstract
Alopecia areata (AA) is an autoimmune disease of the hair follicles. It is characterized by a well-defined non-scarring alopecic patch or patches that may extend to the entire scalp or lead to total body hair loss. Due to its unpredictable clinical course, AA causes substantial psychological harm. Despite the high prevalence of this disease and extensive research, its exact pathomechanism is unclear, and current treatments have a high relapse rate that has deemed AA incurable. Over the past few decades, researchers have investigated multiple potential factors that may help alleviate its pathogenesis and provide effective treatment. Given its complex immunopathogenesis, AA is considered an autoimmune disease with multiple factors. This review gathers current evidence that emphasizes molecular mechanisms, possible causative etiologies, and targeted immunotherapies for AA. Understanding its underlying mechanisms may shed light on new strategies to effectively manage AA in the future.
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Affiliation(s)
- Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaninan Kositkuljorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cherrin Pomsoong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Thadanipon K, Suchonwanit P. Measuring Patient Quality of Life Following Treatment for Alopecia. Patient Prefer Adherence 2021; 15:1601-1610. [PMID: 34295154 PMCID: PMC8292623 DOI: 10.2147/ppa.s282399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/10/2021] [Indexed: 01/03/2023] Open
Abstract
Alopecia is a challenging problem for both physicians and patients in terms of diagnosis and treatment. Alopecia usually has negative effects on patients' emotional and psychological well-being. Several studies have examined the effect of alopecia on patients' health-related quality of life (HRQoL) and have consistently reported poor scores. However, deeper insight into the impact of alopecia on affected individuals and its measurement using HRQoL questionnaires is lacking in the literature. In this article, the methods for measuring the HRQoL of patients with alopecia were comprehensively reviewed. Their applications and limitations were also discussed.
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Affiliation(s)
- Kunlawat Thadanipon
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Rattanakaemakorn P, Triyangkulsri K, Iamsumang W, Suchonwanit P. 308-nm Excimer Lamp vs. Combination of 308-nm Excimer Lamp and 10% Liquor Carbonis Detergens in Patients With Scalp Psoriasis: A Randomized, Single-Blinded, Controlled Trial. Front Med (Lausanne) 2021; 8:677948. [PMID: 34211988 PMCID: PMC8240808 DOI: 10.3389/fmed.2021.677948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/24/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Scalp psoriasis is usually refractory to treatment. Excimer devices have been proved to be a promising therapeutic option in psoriasis. Greater efficacy of phototherapy can be achieved by concurrent use of coal tar derivatives. Objective: We aimed to compare efficacy and safety between 308-nm excimer lamp monotherapy and a combination of 308-nm excimer lamp and 10% liquor carbonis detergens in the treatment of scalp psoriasis. Methods: In this randomized, evaluator-blinded, prospective, comparative study, 30 patients with scalp psoriasis received either 308-nm excimer lamp monotherapy or a combination of 308-nm excimer lamp and 10% liquor carbonis detergens twice per week until complete remission of the scalp or for a total of 30 sessions. Efficacy was evaluated by the improvement of Psoriasis Scalp Severity Index (PSSI) score, itch score, and Scalpdex score. Results: Both treatments induced significant improvement in PSSI score with greater reduction observed in the combination group. At 30th visit, a 75% reduction in PSSI (PSSI75) was attained by 4 (28.6%) and 9 (69.2%) patients treated with monotherapy and combination therapy, respectively (P < 0.05). Conclusions: Excimer lamp is well-tolerated in patients with scalp psoriasis and liquor carbonis detergens can be used as a combination therapy to improve the efficacy of excimer lamp.
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Affiliation(s)
- Ploysyne Rattanakaemakorn
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Korn Triyangkulsri
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wimolsiri Iamsumang
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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