Evaluation of the therapeutic effects of AGA drugs by measuring finasteride, dutasteride, and dihydrotestosterone in hair

BACKGROUND

Androgenetic alopecia (AGA) is treated by 5α-reductase inhibitors (5ARI) such as finasteride and dutasteride, which are widely used as therapeutic agents. However, their pharmacokinetics in target organs (scalp and hair follicles) have not yet been investigated.

PURPOSE

To confirm the effective action of finasteride and dutasteride in the hair follicle tissues, we developed a method to measure these concentrations in hair.

RESULTS

Compared to the non-detection (N.D.) group, the dihydrotestosterone (DHT) concentrations decreased significantly in both the finasteride and dutasteride groups. The dutasteride group showed significantly lower DHT concentrations among all groups.

CONCLUSIONS

Measurement of finasteride, dutasteride, and DHT concentrations in hair would aid in evaluating the drug pharmacokinetics and its therapeutic effects on AGA patients.

Serum thyroglobulin evaluation on LC-MS/MS and immunoassay in TgAb-positive patients with papillary thyroid carcinoma

OBJECTIVE

This study aimed to elucidate disproportionately low serum thyroglobulin (Tg) values in Tg antibody (TgAb)-positive patients with structural recurrence of papillary thyroid carcinoma (PTC) using liquid chromatography-tandem mass spectrometry (LC-MS/MS).

DESIGN

A retrospective study was performed on 176 patients in whom Tg and TgAb levels were measured between 2016 and 2021. Several comprehensive analyses of Tg-LC-MS/MS with an electrochemiluminescence immunoassay for Tg (Tg-ECLIA) were conducted using serum samples.

METHODS

TgAb-positive patients who underwent total thyroidectomy with multiple lung metastases due to PTC were evaluated using Tg-LC-MS/MS and Tg-ECLIA. Tg expression in lymph node metastases and metastatic lesions was evaluated by immunohistochemistry and Tg levels of aspiration washouts were also evaluated. Two in vitro assays were performed to elucidate TgAb interference.

RESULTS

Tg concentrations of negative TgAb in both assays were similar (R2 = 0.99; n = 52). Patients with structural recurrence showed higher Tg values with Tg-LC-MS/MS than with Tg-ECLIA. The undetectable proportion was significantly lower with Tg-LC-MS/MS (31.6%, 6/19) than with Tg-ECLIA (68.4%, 13/19; P = 0.023). The spike-recovery rate and Tg concentrations determined by the serum mixture text (n = 29) were significantly reduced to 75.0% (118.3-88.7%) and 81.3% (107.0-87.0%), respectively, with TgAb using Tg-ECLIA (both P > 0.001) confirming assay interference but not using Tg-LC-MS/MS (91.8-92.3%, P = 0.77 and 98.4-100.8%, P = 0.18, respectively).

CONCLUSIONS

TgAb had no effect on the Tg-LC-MS/MS assay but yielded 19-25% lower values in Tg-ECLIA. Tg-LC-MS/MS is preferable for monitoring serum Tg levels in TgAb-positive patients, although those with structural recurrence often had disproportionally low Tg values.

Analysis of hair steroid hormone concentrations at different parts of the head by liquid chromatography-tandem mass spectrometry

BACKGROUND

Steroid hormones are known to be associated with diseases like androgenetic alopecia (AGA) resulting in hair loss. The lack of a detailed analysis of the local concentration of steroids in different parts of the head underlies the rationale and purpose of this study.

METHODS

To evaluate the concentration distributions of steroid hormones in hair in different parts of the head, hair samples of 8 healthy men from 9 point-areas covering the frontal, parietal, and occipital regions were collected. Eight steroid hormones were measured by using the LC-MS/MS and region-wise comparison for different hormones was done using the mean z-score and Tukey's HSD.

RESULTS

Five of the 8 hormones had a high concentration in the parietal region, with dihydrotestosterone (DHT) showing a peak in the central parietal region (z = 1.59) suggesting a correlation with AGA's clinical presentation. Whereas, no significant differences were observed for testosterone and cortisol between the parietal and occipital regions. Higher DHT levels at the parietal region were also verified with a small group of AGA patients.

CONCLUSIONS

This research expands upon the role of steroid hormones in hair follicle tissue elucidating their relationship with disease, thus contributing to disease management.

Measurement of steroid hormones by liquid chromatography-tandem mass spectrometry with small amounts of hair

Steroid hormone levels in hair reflect the integrated values (average values) of hormone secretion over the past few months. We have used a method to evaluate diseases and chronic stress, discrimination of banned drug use, and so on. In contrast, the hair analysis methods reported so far required at least 10 mg (about 50 to 100 hair strands) of hair to analyze multiple steroid hormones from the same sample. Here, we developed a new method for measuring steroid hormones in hair by liquid chromatography-tandem mass spectrometry, which identifies multiple steroid hormones from 5 to 10 (about 1 mg) hair strands. Ten steroid hormones (cortisol, cortisone, testosterone, dihydrotestosterone, dehydroepiandrosterone, androstenedione, progesterone, pregnenolone, androstenediol and estradiol) covering from sex hormones to stress hormones were derivatized and measured by four different measuring systems. The method showed good linearity for all steroids with correlation coefficients of 0.999 or more. The accuracy and precision of intra- and inter-assay ranged from 96.0 to 106.4% and 4.8 to 8.1% for intra-assay, and from 96.9 to 104.9% and 6.9 and 10.6% for inter-assay, respectively. A mixed solution containing 0.1 M trifluoroacetic acid and 50% acetonitrile was used to extract hair and to enhance the cortisol extraction efficiency approximately twice compared to the previously reported extraction with methanol. This method has the potential to clarify the relationship between steroid hormone levels and diseases that show alopecia such as chronic stress and androgenetic alopecia.