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Jin SE, Sung JH. Delivery Strategies of siRNA Therapeutics for Hair Loss Therapy. Int J Mol Sci 2024; 25:7612. [PMID: 39062852 PMCID: PMC11277092 DOI: 10.3390/ijms25147612] [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: 05/01/2024] [Revised: 06/25/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Therapeutic needs for hair loss are intended to find small interfering ribonucleic acid (siRNA) therapeutics for breakthrough. Since naked siRNA is restricted to meet a druggable target in clinic,, delivery systems are indispensable to overcome intrinsic and pathophysiological barriers, enhancing targetability and persistency to ensure safety, efficacy, and effectiveness. Diverse carriers repurposed from small molecules to siRNA can be systematically or locally employed in hair loss therapy, followed by the adoption of new compositions associated with structural and environmental modification. The siRNA delivery systems have been extensively studied via conjugation or nanoparticle formulation to improve their fate in vitro and in vivo. In this review, we introduce clinically tunable siRNA delivery systems for hair loss based on design principles, after analyzing clinical trials in hair loss and currently approved siRNA therapeutics. We further discuss a strategic research framework for optimized siRNA delivery in hair loss from the scientific perspective of clinical translation.
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Affiliation(s)
- Su-Eon Jin
- Epi Biotech Co., Ltd., Incheon 21984, Republic of Korea
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Godse K, De A, Vedamurthy M, Shankar DSK, Shah B, Girdhar M, Bhat R, Ganjoo A, Tahiliani S, Patil A. Low-dose Oral Minoxidil in the Treatment of Alopecia: Evidence and Experience-based Consensus Statement of Indian Experts. Int J Trichology 2023; 15:91-97. [PMID: 38179013 PMCID: PMC10763725 DOI: 10.4103/ijt.ijt_70_23] [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: 06/04/2023] [Accepted: 10/09/2023] [Indexed: 01/06/2024] Open
Abstract
Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several treatment options are available for the treatment of alopecia with often unsatisfactory results resulting in psychological distress among such patients. Topical minoxidil is known to be effective in the treatment of alopecia. However, oral minoxidil is not currently approved for the treatment of alopecia. This expert consensus is prepared to provide guidance to the clinicians regarding the use of oral minoxidil in the treatment of alopecia. Extensive literature review was performed to prepare the draft consensus which was then revised based on the suggestions and comments from the experts. The final draft was circulated to the experts for review and approval. This consensus document provides overview of evidence related to oral minoxidil and consensus from the experts for its use in the treatment of minoxidil.
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Affiliation(s)
- Kiran Godse
- Department of Dermatology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Maya Vedamurthy
- RSV Skin and Research Centre, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - D. S. Krupa Shankar
- Department of Dermatology, Krupa Shankar Skin Care Center, Mallige Hospital, Bengaluru, India
| | - Bela Shah
- Department of Dermatology, BJ Medical College, Ahmedabad, Gujarat, India
| | - Mukesh Girdhar
- Department of Dermatology, Max Super Speciality Hospital, New Delhi, Delhi, India
| | - Ramesh Bhat
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Anil Ganjoo
- Department of Dermatology and Venereology, Saroj Hospital and Heart Institute, New Delhi, Delhi, India
| | - Sushil Tahiliani
- Department of Dermatology, Hinduja Hospital, Mumbai, Maharashtra, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
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Feldman PR, Gentile P, Piwko C, Motswaledi HM, Gorun S, Pesachov J, Markel M, Silver MI, Brenkel M, Feldman OJ, Kamen CL, Uleryk E, Guevara-Aguirre J, Fiebig KM. Hair regrowth treatment efficacy and resistance in androgenetic alopecia: A systematic review and continuous Bayesian network meta-analysis. Front Med (Lausanne) 2023; 9:998623. [PMID: 36755885 PMCID: PMC9900126 DOI: 10.3389/fmed.2022.998623] [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: 07/20/2022] [Accepted: 12/07/2022] [Indexed: 01/24/2023] Open
Abstract
Background Androgenetic alopecia (AGA) affects almost half the population, and several treatments intending to regenerate a normal scalp hair phenotype are used. This is the first study comparing treatment efficacy response and resistance using standardized continuous outcomes. Objective To systematically compare the relative efficacy of treatments used for terminal hair (TH) regrowth in women and men with AGA. Methods A systematic literature review was conducted (from inception to August 11, 2021) to identify randomized, Placebo-controlled trials with ≥ 20 patients and reporting changes in TH density after 24 weeks. Efficacy was analyzed by sex at 12 and 24 weeks using Bayesian network meta-analysis (B-NMA) and compared to frequentist and continuous outcomes profiles. Results The search identified 2,314 unique articles. Ninety-eight were included for full-text review, and 17 articles met the inclusion criteria for data extraction and analyses. Eligible treatments included ALRV5XR, Dutasteride 0.5 mg/day, Finasteride 1 mg/day, low-level laser comb treatment (LLLT), Minoxidil 2% and 5%, Nutrafol, and Viviscal. At 24 weeks, the B-NMA regrowth efficacy in TH/cm2 and significance (**) in women were ALRV5XR: 30.09**, LLLT: 16.62**, Minoxidil 2%: 12.13**, Minoxidil 5%: 10.82**, and Nutrafol: 7.32**, and in men; ALRV5XR: 21.03**, LLLT: 18.75**, Dutasteride: 18.37**, Viviscal: 13.23, Minoxidil 5%: 13.13**, Finasteride: 12.38, and Minoxidil 2%: 10.54. Two distinct TH regrowth response profiles were found; Continuous: ALRV5XR regrowth rates were linear in men and accelerated in women; Resistant: after 12 weeks, LLLT, Nutrafol, and Viviscal regrowth rates attenuated while Dutasteride and Finasteride plateaued; Minoxidil 2% and 5% lost some regrowth. There were no statistical differences for the same treatment between women and men. B-NMA provided more accurate, statistically relevant, and conservative results than the frequentist-NMA. Conclusion Some TH regrowth can be expected from most AGA treatments with less variability in women than men. Responses to drug treatments were rapid, showing strong early efficacy followed by the greatest resistance effects from flatlining to loss of regrowth after 12-16 weeks. Finasteride, Minoxidil 2% and Viviscal in men were not statistically different from Placebo. LLLT appeared more efficacious than pharmaceuticals. The natural product formulation ALRV5XR showed better efficacy in all tested parameters without signs of treatment resistance (see Graphical abstract). Systematic review registration www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021268040, identifier CRD42021268040.
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Affiliation(s)
- Peter R. Feldman
- Arbor Life Labs, Toronto, ON, Canada,Norwich Medical School, University of East Anglia, Norwich, United Kingdom,*Correspondence: Peter R. Feldman,
| | - Pietro Gentile
- Surgical Science Department, University of Rome Tor Vergata, Rome, Italy
| | | | - Hendrik M. Motswaledi
- Department of Dermatology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Samantha Gorun
- Faculty of Epidemiology and Biostatistics, Western University, London, ON, Canada,School or Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
| | - Jacob Pesachov
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michael Markel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Maxwell I. Silver
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada,Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Megan Brenkel
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Oriel J. Feldman
- Arbor Life Labs, Toronto, ON, Canada,Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Corey L. Kamen
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Jaime Guevara-Aguirre
- College of Medicine, Universidad San Francisco De Quito (USFQ), Quito, Ecuador,Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Institute of Endocrinology, Metabolism, and Reproduction (IEMYR), Quito, Ecuador,College of Medicine, University of Florida, Gainesville, FL, United States
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Feldman PR, Feldman OJ, Guevara-Aguirre J, Fiebig KM. Sex differences in clinical trials of ALRV5XR treatment of androgenetic alopecia and telogen effluvium. Front Med (Lausanne) 2022; 9:918058. [PMID: 36045927 PMCID: PMC9421616 DOI: 10.3389/fmed.2022.918058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionALRV5XR treatment of androgenetic alopecia (AGA) and telogen effluvium (TE) has early evidence of regenerating a normal scalp hair phenotype in both sexes.DesignWe performed two 24-week double-blinded placebo-controlled comparison trials, one in each sex, on the ALRV5XR treatment effect on hair regeneration, in AGA and TE, in 92 AGA subjects (24 also had TE). Forty-six women (age 24–64 years) and 46 men (age 22–63 years) were randomized 1:1 to either ALRV5XR or placebo regimens (one b.i.d. oral capsule and daily administration of shampoo, conditioner, and follicle serum).EvaluationPrimary outcomes: Absolute and relative changes in terminal hair (TH) density. Secondary outcomes: Response rate, changes in vellus hair (VH) density, TH/VH ratio, hair diameter, growth, and shedding rate.ResultsForty-one women (20 ALRV5XR, 21 placebo) and 36 men (17 ALRV5XR, 19 placebo) completed the trials. TH outcome was evaluable for 18 and 21 women and 11 and 11 men (ALRV5XR, placebo, respectively). Efficacy in women: 30.1 THs/cm2 (p = 0.0002) and 19.7% (p = 0.0016). Efficacy in men: 21.0 THs/cm2 (p = 0.0014) and 16.4% (p = 0.0012). 66.7% of women and 100% of men responded to ALRV5XR. TH/VH ratio for men increased 33.0% (p = 0.0033). Growth rate in women increased by 30.7 μm/24 h (p < 0.0001) and 10.0% (p < 0.0001). There were no adverse events reported.Conclusion and relevanceALRV5XR induced significant regrowth of TH. Accelerating regrowth by reactivation of dormant telogen follicles were the dominant effects in women. Thickening of miniaturized hair and regrowth of dormant telogen follicles contributed equally to the increased TH seen in men (see Graphical Abstract).
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Affiliation(s)
- Peter R. Feldman
- Arbor Life Labs, Toronto, ON, Canada
- *Correspondence: Peter R. Feldman,
| | - Oriel J. Feldman
- Arbor Life Labs, Toronto, ON, Canada
- Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Jaime Guevara-Aguirre
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Institute of Endocrinology, Metabolism, and Reproduction, Quito, Ecuador
- College of Medicine, University of Florida, Gainesville, FL, United States
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