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Yan A, Drake L, Hadsall S, Gaurav A, Xia E, Mostaghimi A. Evaluating the sources and types of dietary and nutritional advice for patients with alopecia areata. Arch Dermatol Res 2024; 316:283. [PMID: 38796551 DOI: 10.1007/s00403-024-02940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/09/2024] [Accepted: 04/26/2024] [Indexed: 05/28/2024]
Abstract
Although there are now two Food and Drug Administration (FDA)-approved treatments for severe alopecia areata (AA), many patients still resort to non-medical therapies and lifestyle modifications such as diet and nutrition. The goal of this study was to evaluate the sources and types of dietary and nutritional advice for patients with AA. We distributed a cross-sectional national survey using the National Alopecia Areata Foundation's email list-serv between August 2022 and January 2023. Most respondents were White (76.3%), employed (58.3%) females (84.4%) with a mean age of 52 years. 163 (19.1%) respondents reported receiving diet and/or nutritional advice and 418 (49.5%) respondents reported searching for diet and/or nutritional advice to help with their AA; the most common source of advice was online. The most common dietary changes were the use of vitamins or supplements (30.6%), adherence to diets (23.2%), and the addition of specific foods (21.4%). 209 (50.2%) respondents reported no change in their disease and 197 (47.4%) respondents reported no change in how they felt about their disease compared to before they tried the change. Many AA patients search for or receive unsolicited dietary and nutritional advice and subsequently modify their behavior to manage their disease. However, the efficacy of these changes is unclear. Providers should be mindful of the sources through which patients obtain treatment information as well as the lifestyle changes patients make to counsel patients with evidence-based information. Further investigation is needed to better characterize the direct and indirect costs of dietary and nutritional modification in the treatment of AA.
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Affiliation(s)
- Allison Yan
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lara Drake
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Sophia Hadsall
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Ahana Gaurav
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Medical College of Georgia, Augusta, GA, USA
| | - Eric Xia
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA.
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Xu W, Xie B, Wei D, Song X. Dissecting hair breakage in alopecia areata: the central role of dysregulated cysteine homeostasis. Amino Acids 2024; 56:36. [PMID: 38772922 PMCID: PMC11108903 DOI: 10.1007/s00726-024-03395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/16/2024] [Indexed: 05/23/2024]
Abstract
In the initial stages of Alopecia Areata (AA), the predominance of hair breakage or exclamation mark hairs serves as vital indicators of disease activity. These signs are non-invasive and are commonly employed in dermatoscopic examinations. Despite their clinical salience, the underlying etiology precipitating this hair breakage remains largely uncharted territory. Our exhaustive review of the existing literature points to a pivotal role for cysteine-a key amino acid central to hair growth-in these mechanisms. This review will probe and deliberate upon the implications of aberrant cysteine metabolism in the pathogenesis of AA. It will examine the potential intersections of cysteine metabolism with autophagy, ferroptosis, immunity, and psychiatric manifestations associated with AA. Such exploration could illuminate new facets of the disease's pathophysiology, potentially paving the way for innovative therapeutic strategies.
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Affiliation(s)
- Wen Xu
- School of Medicine, Zhejiang University, Yuhangtang Rd 866, Hangzhou, 310009, People's Republic of China
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou Third Hospital, Affiliated to Zhejiang Chinese Medical University, West Lake Ave 38, Hangzhou, 310009, People's Republic of China
| | - Bo Xie
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou Third Hospital, Affiliated to Zhejiang Chinese Medical University, West Lake Ave 38, Hangzhou, 310009, People's Republic of China
| | - Dongfan Wei
- School of Medicine, Zhejiang University, Yuhangtang Rd 866, Hangzhou, 310009, People's Republic of China
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou Third Hospital, Affiliated to Zhejiang Chinese Medical University, West Lake Ave 38, Hangzhou, 310009, People's Republic of China
| | - Xiuzu Song
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou Third Hospital, Affiliated to Zhejiang Chinese Medical University, West Lake Ave 38, Hangzhou, 310009, People's Republic of China.
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Shibato J, Takenoya F, Kimura A, Yamashita M, Hirako S, Rakwal R, Shioda S. DNA Microarray and Bioinformatic Analysis Reveals the Potential of Whale Oil in Enhancing Hair Growth in a C57BL/6 Mice Dorsal Skin Model. Genes (Basel) 2024; 15:627. [PMID: 38790256 PMCID: PMC11121295 DOI: 10.3390/genes15050627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Much research has been conducted to determine how hair regeneration is regulated, as this could provide therapeutic, cosmetic, and even psychological interventions for hair loss. The current study focused on the hair growth effect and effective utilization of fatty oil obtained from Bryde's whales through a high-throughput DNA microarray approach in conjunction with immunohistochemical observations. The research also examined the mechanisms and factors involved in hair growth. In an experiment using female C57BL/6J mice, the vehicle control group (VC: propylene glycol: ethanol: water), the positive control group (MXD: 3% minoxidil), and the experimental group (WO: 20% whale oil) were topically applied to the dorsal skin of the mouse. The results showed that 3% MXD and 20% WO were more effective than VC in promoting hair growth, especially 20% WO. Furthermore, in hematoxylin and eosin-stained dorsal skin tissue, an increase in the number of hair follicles and subcutaneous tissue thickness was observed with 20% WO. Whole-genome transcriptome analysis also confirmed increases for 20% WO in filaggrin (Flg), a gene related to skin barrier function; fibroblast growth factor 21 (Fgf21), which is involved in hair follicle development; and cysteine-rich secretory protein 1 (Crisp1), a candidate gene for alopecia areata. Furthermore, the results of KEGG pathway analysis indicated that 20% WO may have lower stress and inflammatory responses than 3% MXD. Therefore, WO is expected to be a safe hair growth agent.
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Affiliation(s)
- Junko Shibato
- Department of Functional Morphology, Shonan University of Medical Sciences, 16-48 Kamishinano, Totsuka-ku, Yokohama-shi 244-0806, Kanagawa, Japan;
| | - Fumiko Takenoya
- Department of Sport Sciences, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku 142-8501, Tokyo, Japan; (F.T.); (A.K.); (M.Y.)
| | - Ai Kimura
- Department of Sport Sciences, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku 142-8501, Tokyo, Japan; (F.T.); (A.K.); (M.Y.)
| | - Michio Yamashita
- Department of Sport Sciences, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku 142-8501, Tokyo, Japan; (F.T.); (A.K.); (M.Y.)
| | - Satoshi Hirako
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama-shi 339-8539, Saitama, Japan;
| | - Randeep Rakwal
- Institute of Health and Sport Sciences (TAIIKU), Global Sport Innovation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi 305-8574, Ibaraki, Japan;
| | - Seiji Shioda
- Department of Functional Morphology, Shonan University of Medical Sciences, 16-48 Kamishinano, Totsuka-ku, Yokohama-shi 244-0806, Kanagawa, Japan;
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Dudonné S, Kern C, Garcia C. Efficacy of a wheat polar lipid complex in reducing hair loss and improving hair growth in healthy women: A randomized, double-blind, placebo-controlled clinical study. Int J Cosmet Sci 2024; 46:284-296. [PMID: 37935579 DOI: 10.1111/ics.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE Hair loss is a major source of psychological distress for affected people. Safe and natural ingredients are therefore needed to help reduce hair loss and stimulate hair growth. This pilot clinical study aimed at exploring the efficacy of a wheat polar lipid complex (WPLC, Ceramosides™), containing sphingolipids and digalactosyl diglycerides, on hair characteristics improvement in women showing acute hair shedding. METHODS Sixty-six women presenting a proportion of hair in the telogen phase greater than 15% were recruited and allocated to two groups, each including at least 10 postmenopausal women. For 84 days, participants consumed 30 mg/day of the WPLC supplement, or the placebo. Their hair characteristics were assessed after 56 and 84 days using phototrichogram evaluations of hairs in anagen/telogen phases, measuring hair shedding by a pull test, hair diameter and elongation at break point, hair growth and scalp sebum content. Hair density and volume were also clinically evaluated. All these parameters were also investigated in the subgroup of postmenopausal women. RESULTS WPLC supplementation decreased telogen hair density/proportion while increasing the anagen hair density/proportion. These effects were significant compared with the placebo as early as within 56 days. It also led to reduced hair shedding upon pull test analyses. If no changes were evidenced in hair diameter, WPLC improved hair growth and resistance to breakage after 84 days. Clinical evaluations also showed hair density and volume improvement. Furthermore, supplementation decreased scalp sebum content in women with oily hair. The beneficial effects were also observed in the subgroup of postmenopausal women. Finally, WPLC supplementation improved participants' perception of their hair conditions. CONCLUSION Through a reducing effect on hair shedding and a stimulating effect on hair reappearance and growth, WPLC dietary supplementation was shown to significantly reduce hair loss in women.
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Affiliation(s)
| | - Catherine Kern
- Seppic Research and Innovation, La Garenne Colombes, France
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Baker R, Dell'Acqua G, Richards A, Thornton MJ. Nutraceuticals known to promote hair growth do not interfere with the inhibitory action of tamoxifen in MCF7, T47D and BT483 breast cancer cell lines. PLoS One 2024; 19:e0297080. [PMID: 38408073 PMCID: PMC10896530 DOI: 10.1371/journal.pone.0297080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/26/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Hair loss/thinning is a common side effect of tamoxifen in estrogen receptor (ER) positive breast cancer therapy. Some nutraceuticals known to promote hair growth are avoided during breast cancer therapy for fear of phytoestrogenic activity. However, not all botanical ingredients have similarities to estrogens, and in fact, no information exists as to the true interaction of these ingredients with tamoxifen. Therefore, this study sought to ascertain the effect of nutraceuticals (+/- estrogen/tamoxifen), on proliferation of breast cancer cells and the relative expression of ERα/β. METHODS Kelp, Astaxanthin, Saw Palmetto, Tocotrienols, Maca, Horsetail, Resveratrol, Curcumin and Ashwagandha were assessed on proliferation of MCF7, T47D and BT483 breast cancer cell lines +/- 17β-estradiol and tamoxifen. Each extract was analysed by high performance liquid chromatography (HPLC) prior to use. Cellular ERα and ERβ expression was assessed by qRT-PCR and western blot. Changes in the cellular localisation of ERα:ERβ and their ratio following incubation with the nutraceuticals was confirmed by immunocytochemistry. RESULTS Estradiol stimulated DNA synthesis in three different breast cancer cell lines: MCF7, T47D and BT483, which was inhibited by tamoxifen; this was mirrored by a specific ERa agonist in T47D and BT483 cells. Overall, nutraceuticals did not interfere with tamoxifen inhibition of estrogen; some even induced further inhibition when combined with tamoxifen. The ERα:ERβ ratio was higher at mRNA and protein level in all cell lines. However, incubation with nutraceuticals induced a shift to higher ERβ expression and a localization of ERs around the nuclear periphery. CONCLUSIONS As ERα is the key driver of estrogen-dependent breast cancer, if nutraceuticals have a higher affinity for ERβ they may offer a protective effect, particularly if they synergize and augment the actions of tamoxifen. Since ERβ is the predominant ER in the hair follicle, further studies confirming whether nutraceuticals can shift the ratio towards ERβ in hair follicle cells would support a role for them in hair growth. Although more research is needed to assess safety and efficacy, this promising data suggests the potential of nutraceuticals as adjuvant therapy for hair loss in breast cancer patients receiving endocrine therapy.
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Affiliation(s)
- Richard Baker
- Centre for Skin Sciences, Faculty of Life Sciences, University of Bradford, Bradford, United Kingdom
| | | | | | - M Julie Thornton
- Centre for Skin Sciences, Faculty of Life Sciences, University of Bradford, Bradford, United Kingdom
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Sethupathi SK, Poole M, Darji K, Fehlman J. Cosmetic Dermatology Concerns in Older Adults. Clin Geriatr Med 2024; 40:197-210. [PMID: 38000860 DOI: 10.1016/j.cger.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
It is important to understand that each layer of facial tissue, from the underlying facial skeleton to the overlying skin, undergoes significant changes during the aging process. Bony support is lost along the mandible and maxilla and the orbital aperture widens. Superficial and deep fat pads undergo volume loss and migration and the overlying skin begins to reveal signs of both intrinsic aging with skin laxity and fine rhytids as well as extrinsic aging in the form of coarse, deeper rhytids and dyspigmentation.
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Affiliation(s)
- Sheetal K Sethupathi
- Department of Dermatology, Saint Louis University, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Mackenzie Poole
- Saint Louis University School of Medicine, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Kavita Darji
- Department of Dermatology, Saint Louis University, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Jennifer Fehlman
- Saint Louis University SLU Care Physician Group -SSM Health, 2315 Dougherty Ferry Road, Suite 200C, Saint Louis, MO 63122, USA.
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Ufomadu P. Complementary and alternative supplements: a review of dermatologic effectiveness for androgenetic alopecia. Proc AMIA Symp 2023; 37:111-117. [PMID: 38174012 PMCID: PMC10761108 DOI: 10.1080/08998280.2023.2263829] [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: 08/15/2023] [Accepted: 09/23/2023] [Indexed: 01/05/2024] Open
Abstract
Background Androgenetic alopecia (AGA) is a dermatologic condition with no current cure. Treatments such as minoxidil have been proven to be effective; however, the side effects can be unpleasant. As a result, the utilization of natural remedies for treatment has increased over the years. There is limited scientific evidence that addresses the efficacy of these supplements in combating AGA. Methods A review was conducted of the effectiveness of popular complementary and alternative medicines (CAMs) in adult patients experiencing AGA. A literature search was performed for the period of 1993 to 2023 using PubMed, Embase, Google Scholar, Web of Science, and Cochrane. Results Natural ingredients like pumpkin seed oil, saw palmetto, melatonin extract, caffeine extract, and rosemary oil were effective in treating AGA either when compared to baseline or a definite AGA Western medication, such as minoxidil. These natural agents also presented minimal side effects. Conclusion Certain CAMs can be promising for hair loss treatment. There is a need for more scientific research to better explore the efficacy of currently identified CAMs in treating AGA.
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Affiliation(s)
- Promise Ufomadu
- Department of Dermatology and School of Medicine, Baylor College of Medicine, Houston, TX, USA
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Devjani S, Ezemma O, Kelley KJ, Senna MM. Use of supplements for hair loss in skin of color patients. JAAD Int 2023; 12:182-183. [PMID: 37533686 PMCID: PMC10393551 DOI: 10.1016/j.jdin.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Affiliation(s)
- Shivali Devjani
- Lahey Hospital & Medical Center Department of Dermatology, Burlington, Massachusetts
| | - Ogechi Ezemma
- Lahey Hospital & Medical Center Department of Dermatology, Burlington, Massachusetts
| | - Kristen J. Kelley
- Lahey Hospital & Medical Center Department of Dermatology, Burlington, Massachusetts
| | - Maryanne Makredes Senna
- Lahey Hospital & Medical Center Department of Dermatology, Burlington, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Naldi L, Garcia-Doval I, Williams HC. Nutritional Supplements and Hair Loss-Limitations to the Interpretation of Clinical Studies Before Implementation in Clinical Practice. JAMA Dermatol 2023; 159:892-893. [PMID: 37379000 DOI: 10.1001/jamadermatol.2023.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Luigi Naldi
- Department of Dermatology, AULSS8 Berica, Ospedale San Bortolo, Vicenza, Italy
| | - Ignacio Garcia-Doval
- Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Hywel C Williams
- Centre of Evidence-Based Dermatology, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, England
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Obijiofor C, Akoh CC, Lo Sicco K. Nutritional Supplements and Hair Loss-Limitations to the Interpretation of Clinical Studies Before Implementation in Clinical Practice. JAMA Dermatol 2023; 159:891-892. [PMID: 37379007 DOI: 10.1001/jamadermatol.2023.1776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Chinemelum Obijiofor
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York
| | - Christine C Akoh
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York
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Drake L, Huang K, Mostaghimi A. Nutritional Supplements and Hair Loss-Limitations to the Interpretation of Clinical Studies Before Implementation in Clinical Practice-Reply. JAMA Dermatol 2023; 159:893. [PMID: 37379006 DOI: 10.1001/jamadermatol.2023.1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Lara Drake
- Tufts University School of Medicine, Boston, Massachusetts
- Brigham and Women's Hospital, Department of Dermatology, Boston, Massachusetts
| | - Kathie Huang
- Brigham and Women's Hospital, Department of Dermatology, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Arash Mostaghimi
- Brigham and Women's Hospital, Department of Dermatology, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Frewen J, de Brito M, Pathak A, Barlow R, Williams HC. How to critically appraise a systematic review: an aide for the reader and reviewer. Clin Exp Dermatol 2023; 48:854-859. [PMID: 37119274 DOI: 10.1093/ced/llad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/01/2023]
Abstract
The number of published systematic reviews has soared rapidly in recent years. Sadly, the quality of most systematic reviews in dermatology is substandard. With the continued increase in exposure to systematic reviews, and their potential to influence clinical practice, we sought to describe a sequence of useful tips for the busy clinician reader to determine study quality and clinical utility. Important factors to consider when assessing systematic reviews include: determining the motivation to performing the study, establishing if the study protocol was prepublished, assessing quality of reporting using the PRISMA checklist, assessing study quality using the AMSTAR 2 critical appraisal checklist, assessing for evidence of spin, and summarizing the main strengths and limitations of the study to determine if it could change clinical practice. Having a set of heuristics to consider when reading systematic reviews serves to save time, enabling assessment of quality in a structured way, and come to a prompt conclusion of the merits of a review article in order to inform the care of dermatology patients.
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Affiliation(s)
- John Frewen
- Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | | | - Anjali Pathak
- Watford General Hospital, Watford, Hertfordshire, UK
| | - Richard Barlow
- Sandwell and West Birmingham Hospitals, Birmingham, UK
- Department of Dermatology, Birmingham City Hospital, Birmingham, UK
| | - Hywel C Williams
- Department of Dermatology, Queens Medical Centre, Nottingham, UK
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Zheng Y, Nie Y, Lu J, Yi H, Fu G. A novel predictive model for the recurrence of pediatric alopecia areata by bioinformatics analysis and a single-center prospective study. Front Med (Lausanne) 2023; 10:1189134. [PMID: 37359017 PMCID: PMC10285523 DOI: 10.3389/fmed.2023.1189134] [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: 03/18/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Background Alopecia areata (AA) is a disease featured by recurrent, non-scarring hair loss with a variety of clinical manifestations. The outcome of AA patients varies greatly. When they progress to the subtypes of alopecia totalis (AT) or alopecia universalis (AU), the outcome is unfavorable. Therefore, identifying clinically available biomarkers that predict the risk of AA recurrence could improve the prognosis for AA patients. Methods In this study, we conducted weighted gene co-expression network analysis (WGCNA) and functional annotation analysis to identify key genes that correlated to the severity of AA. Then, 80 AA children were enrolled at the Department of Dermatology, Wuhan Children's Hospital between January 2020 to December 2020. Clinical information and serum samples were collected before and after treatment. And the serum level of proteins coded by key genes were quantitatively detected by ELISA. Moreover, 40 serum samples of healthy children from the Department of Health Care, Wuhan Children's Hospital were used for healthy control. Results We identified four key genes that significantly increased (CD8A, PRF1, and XCL1) or decreased (BMP2) in AA tissues, especially in the subtypes of AT and AU. Then, the serum levels of these markers in different groups of AA patients were detected to validate the results of bioinformatics analysis. Similarly, the serum levels of these markers were found remarkedly correlated with the Severity of Alopecia Tool (SALT) score. Finally, a prediction model that combined multiple markers was established by conducting a logistic regression analysis. Conclusion In the present study, we construct a novel model based on serum levels of BMP2, CD8A, PRF1, and XCL1, which served as a potential non-invasive prognostic biomarker for forecasting the recurrence of AA patients with high accuracy.
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