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Shin SY, Song NR, Jung DH, Kim SJ, Park KM. The effect of platelet-derived growth factor-aa (PDGFA) conjugated with low-molecular-weight protamine (LMWP) on hair loss improvement effect. Biochem Biophys Res Commun 2025; 742:151110. [PMID: 39647454 DOI: 10.1016/j.bbrc.2024.151110] [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: 11/27/2024] [Accepted: 12/01/2024] [Indexed: 12/10/2024]
Abstract
Platelet-derived growth factor-AA (PDGFA) is known to play an important role in hair loss and hair growth by involving in the anagen phase of the hair follicle growth cycle. In this study, we synthesized skin-permeable recombinant low-molecular-weight protamine (LMWP)-conjugated PDGFA (LMWP-PDGFA) by linking LMWP to the N terminus of PDGFA. We evaluated the hair loss improvement effect, wound healing efficacy, and skin permeability of LMWP-PDGFA. LMWP-PDGFA showed higher cell proliferation, cell permeability, 5α-reductase inhibition activity and IGF-1 activity than PDGFA in human hair follicle dermal papilla cells (HFDPC). We also found that LMWP-PDGFA increased cell migration and collagen synthesis better than PDGFA. These results indicate that LMWP-PDGFA can be a good candidate as a hair treatment agent with superior cell permeability than PDGFA. Additionally, it is expected that the efficacy of the protein can be maximized by combining LMWP with other functional proteins.
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Affiliation(s)
- Seo Yeon Shin
- Department of Pharmaceutical & Cosmetics, Dongshin University, 185, gunjae-ro, Naju, Jeonnam, 58245, Republic of Korea.
| | - Nu Ri Song
- Department of Pharmaceutical & Cosmetics, Dongshin University, 185, gunjae-ro, Naju, Jeonnam, 58245, Republic of Korea.
| | - Dai Hyun Jung
- BIO-FD&C Co., Ltd., 106, Sandan-gil, Hwasun, Jeonnam, 58141, Republic of Korea.
| | - Su Jung Kim
- BIO-FD&C Co., Ltd., 106, Sandan-gil, Hwasun, Jeonnam, 58141, Republic of Korea.
| | - Kyung Mok Park
- Department of Pharmaceutical & Cosmetics, Dongshin University, 185, gunjae-ro, Naju, Jeonnam, 58245, Republic of Korea.
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2
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Park S, Park HW, Seo DB, Yoo DS, Bae S. In vitro hair growth-promoting effects of araliadiol via the p38/PPAR-γ signaling pathway in human hair follicle stem cells and dermal papilla cells. Front Pharmacol 2024; 15:1482898. [PMID: 39691387 PMCID: PMC11649413 DOI: 10.3389/fphar.2024.1482898] [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: 08/19/2024] [Accepted: 11/18/2024] [Indexed: 12/19/2024] Open
Abstract
Background Scalp hair plays a crucial role in social communication by expressing personal appearance and self-identity. Consequently, hair loss often leads to a perception of unattractiveness, negatively impacting an individual's life and mental health. Currently, the use of Food and Drug Administration (FDA)-approved drugs for hair loss is associated with several side effects, highlighting the need for identifying new drug candidates, such as plant-derived phytochemicals, to overcome these issues. Objective This study investigated the hair growth-promoting effects of araliadiol, a polyacetylene compound found in plants such as Centella asiatica. Methods We employed an in vitro model comprising human hair follicle stem cells (HHFSCs) and human dermal papilla cells (HDPCs) to evaluate the hair growth-promoting effects of araliadiol. The proliferation-stimulating effects of araliadiol were assessed using water-soluble tetrazolium salt assay, adenosine triphosphate content assay, and crystal violet staining assay. In addition, we performed luciferase reporter assay, polymerase chain reaction analysis, cell fractionation, Western blot analysis, and enzyme-linked immunosorbent assay (ELISA) to elucidate the mechanism underlying the hair growth-inductive effects of araliadiol. Results Araliadiol exhibited both proliferation- and hair growth-promoting effects in HHFSCs and HDPCs. Specifically, it increased the protein expression of cyclin B1 and Ki67. In HHFSCs, it elevated the expression of hair growth-promoting factors, including CD34, vascular endothelial growth factor (VEGF), and angiopoietin-like 4. Similarly, araliadiol increased the expression of hair growth-inductive proteins such as fibroblast growth factor 7, VEGF, noggin, and insulin-like growth factor 1 in HDPCs. Subsequent Western blot analysis and ELISA using inhibitors such as GW9662 and SB202190 confirmed that these hair growth-promoting effects were dependent on the p38/PPAR-γ signaling in both HHFSCs and HDPCs. Conclusion Araliadiol promotes hair growth through the p38/PPAR-γ signaling pathway in human hair follicle cells. Therefore, araliadiol can be considered a novel drug candidate for the treatment of alopecia.
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Affiliation(s)
- Seokmuk Park
- Department of Cosmetics Engineering, Konkuk University, Seoul, Republic of Korea
| | | | | | | | - Seunghee Bae
- Department of Cosmetics Engineering, Konkuk University, Seoul, Republic of Korea
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Bin Rubaian NF, Alzamami HFA, Amir BA. An Overview of Commonly Used Natural Alternatives for the Treatment of Androgenetic Alopecia, with Special Emphasis on Rosemary Oil. Clin Cosmet Investig Dermatol 2024; 17:2495-2503. [PMID: 39524109 PMCID: PMC11549889 DOI: 10.2147/ccid.s470989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 10/22/2024] [Indexed: 11/16/2024]
Abstract
Androgenetic alopecia is a chronic dermatological condition in which genetically predisposed individuals undergo progressive hair loss secondary to the effects of circulating androgens. It has been well documented that dihydrotestosterone binds to the androgenic receptors prevalent in the scalp, thus inducing miniaturization of the hair follicle. To date, the only FDA approved medications for the treatment of androgenetic alopecia are finasteride and minoxidil. A plethora of studies have been conducted testing the efficacy of various herbal compounds, but additional research is needed to further establish the concrete efficacy of such natural remedies in treating androgenetic alopecia. Of late, rosemary oil has gained mass popularity as a promising natural alternative. This review article will not only provide a detailed background on this ancient herbal component but will additionally overview all other major herbal alternatives including peppermint oil, tea tree oil, green tea, pumpkin seed oil, saw palmetto, and lavender oil and will summarize the latest clinical studies, which have tested their efficacy for the management of androgenetic alopecia.
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Affiliation(s)
- Nouf F Bin Rubaian
- Dermatology Department of King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
| | - Haya Fahad Abdulaziz Alzamami
- Dermatology Department of King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
| | - Baraa Abdulrazack Amir
- College of Medicine, Department of Medicine, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
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Muangsanguan A, Ruksiriwanich W, Arjin C, Jamjod S, Prom-u-Thai C, Jantrawut P, Rachtanapun P, Hnorkaew P, Satsook A, Sainakham M, Castagnini JM, Sringarm K. Comparison of In Vitro Hair Growth Promotion and Anti-Hair Loss Potential of Thai Rice By-Product from Oryza sativa L. cv. Buebang 3 CMU and Sanpatong. PLANTS (BASEL, SWITZERLAND) 2024; 13:3079. [PMID: 39519997 PMCID: PMC11548315 DOI: 10.3390/plants13213079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 10/26/2024] [Accepted: 10/30/2024] [Indexed: 11/16/2024]
Abstract
The bioactive compounds in herbal extracts may provide effective hair loss treatments with fewer side effects compared to synthetic medicines. This study evaluated the effects of Buebang 3 CMU and Sanpatong rice bran extracts, macerated with dichloromethane or 95% ethanol, on hair growth promotion and hair loss prevention. Overall, Buebang 3 CMU extracts contained significantly higher levels of bioactive compounds, including γ-oryzanol, tocopherols, and various polyphenols such as phytic acid, ferulic acid, and chlorogenic acid, compared to Sanpatong extracts. Additionally, ethanolic extracts demonstrated greater bioactive content and antioxidant activities than those extracted with dichloromethane. These compounds enhanced the proliferation of human hair follicle dermal papilla cells (HFDPCs) by 124.28 ± 1.08% (p < 0.05) and modulated anti-inflammatory pathways by reducing nitrite production to 3.20 ± 0.36 µM (p < 0.05). Key hair growth signaling pathways, including Wnt/β-catenin (CTNNB1), Sonic Hedgehog (SHH, SMO, GLI1), and vascular endothelial growth factor (VEGF), were activated by approximately 1.5-fold to 2.5-fold compared to minoxidil. Also, in both human prostate cancer (DU-145) and HFDPC cells, the ethanolic Buebang 3 CMU extract (Et-BB3-CMU) suppressed SRD5A1, SRD5A2, and SRD5A3 expression-key pathways in hair loss-by 2-fold and 1.5-fold more than minoxidil and finasteride, respectively. These findings suggest that Et-BB3-CMU holds promise for promoting hair growth and preventing hair loss.
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Affiliation(s)
- Anurak Muangsanguan
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (A.M.); (P.J.); (M.S.)
| | - Warintorn Ruksiriwanich
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (A.M.); (P.J.); (M.S.)
- Center of Excellence in Agro Bio-Circular-Green Industry (Agro BCG), Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand;
| | - Chaiwat Arjin
- Department of Animal and Aquatic Sciences, Faculty of Agriculture, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sansanee Jamjod
- Department of Plant and Soil Sciences, Faculty of Agriculture, Chiang Mai University, Chiang Mai 50200, Thailand; (S.J.); (C.P.-u.-T.)
- Lanna Rice Research Center, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chanakan Prom-u-Thai
- Department of Plant and Soil Sciences, Faculty of Agriculture, Chiang Mai University, Chiang Mai 50200, Thailand; (S.J.); (C.P.-u.-T.)
- Lanna Rice Research Center, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pensak Jantrawut
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (A.M.); (P.J.); (M.S.)
- Center of Excellence in Agro Bio-Circular-Green Industry (Agro BCG), Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand;
| | - Pornchai Rachtanapun
- Center of Excellence in Agro Bio-Circular-Green Industry (Agro BCG), Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand;
- School of Agro-Industry, Faculty of Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand
| | - Patipan Hnorkaew
- Office of Research Administration, Chiang Mai University, Chiang Mai 50200, Thailand; (P.H.); (A.S.)
| | - Apinya Satsook
- Office of Research Administration, Chiang Mai University, Chiang Mai 50200, Thailand; (P.H.); (A.S.)
| | - Mathukorn Sainakham
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand; (A.M.); (P.J.); (M.S.)
| | - Juan Manuel Castagnini
- Research Group in Innovative Technologies for Sustainable Food (ALISOST), Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Avenida Vicent Andrés Estellés s/n, 46100 Burjassot, Spain;
| | - Korawan Sringarm
- Center of Excellence in Agro Bio-Circular-Green Industry (Agro BCG), Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand;
- Department of Animal and Aquatic Sciences, Faculty of Agriculture, Chiang Mai University, Chiang Mai 50200, Thailand;
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Kim HR, Park JU, Lee SH, Park JY, Lee W, Choi KM, Kim SY, Park MH. Hair Growth Effect and the Mechanisms of Rosa rugosa Extract in DHT-Induced Alopecia Mice Model. Int J Mol Sci 2024; 25:11362. [PMID: 39518915 PMCID: PMC11545796 DOI: 10.3390/ijms252111362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/19/2024] [Accepted: 10/20/2024] [Indexed: 11/16/2024] Open
Abstract
Rosa rugosa is a medicinal plant known for its potential anti-inflammatory, antioxidant, anti-cancer, and antimicrobial benefits. The pharmacological effects of Rosa rugosa extract on hair loss have not yet been documented. This research sought to assess the inhibitory effects and mechanisms of action of Rosa rugosa water extract (RWE) in a mouse model of dihydrotestosterone (DHT)-induced alopecia. The study was conducted using C57BL/6 mice, which were assigned to five groups: control, DHT-treated, Rosa rugosa water extract (RWE) at doses of 25 mg/kg and 100 mg/kg body weight, and bicalutamide-treated. To induce hair loss, dihydrotestosterone (1 mg/day per body weight) was administered via intraperitoneal injections, and dorsal hair removal was timed to align with the telogen phase. Each group received oral treatments for a period of 23 days. In this study, we assessed hair growth activity, examined histological changes, and performed immunoblot analysis. We noted improvements in hair length and thickness. Additionally, the protein expression of growth factors associated with hair growth, including vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and insulin-like growth factor-1 (IGF-1), showed significant increases in the group treated with RWE. Additionally, treatment with RWE suppressed the protein expression of hair growth inhibitory factors, including dickkopf WNT signaling pathway inhibitor 1 (DKK1) and interleukin (IL)-6. Moreover, hair growth regulatory pathway related factors, including ERK, AKT, and GSK-3β, were activated. These findings indicate that RWE could serve as a promising natural therapy for preventing hair loss by enhancing the production of factors that promote hair growth while inhibiting those that suppress it.
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Affiliation(s)
- Ha-Rim Kim
- Jeonju AgroBio-Materials Institute, Wonjangdong-gil 111-27, Deokjin-gu, Jeonju-si 54810, Jeonbuk-do, Republic of Korea; (H.-R.K.); (S.-H.L.); (J.Y.P.)
| | - Jung Up Park
- Division of Practical Research, Honam National Institute of Biological Resources, 99, Gohadoan-gil, Mokpo-si 58762, Jeollanam-do, Republic of Korea; (J.U.P.); (W.L.); (K.-M.C.)
- Advanced Research Center for Island Wildlife Biomaterials, Honam National Institute of Biological Resources, 99, Gohadoan-gil, Mokpo-si 58762, Jeollanam-do, Republic of Korea
| | - Seung-Hyeon Lee
- Jeonju AgroBio-Materials Institute, Wonjangdong-gil 111-27, Deokjin-gu, Jeonju-si 54810, Jeonbuk-do, Republic of Korea; (H.-R.K.); (S.-H.L.); (J.Y.P.)
| | - Jae Young Park
- Jeonju AgroBio-Materials Institute, Wonjangdong-gil 111-27, Deokjin-gu, Jeonju-si 54810, Jeonbuk-do, Republic of Korea; (H.-R.K.); (S.-H.L.); (J.Y.P.)
| | - Wonwoo Lee
- Division of Practical Research, Honam National Institute of Biological Resources, 99, Gohadoan-gil, Mokpo-si 58762, Jeollanam-do, Republic of Korea; (J.U.P.); (W.L.); (K.-M.C.)
- Advanced Research Center for Island Wildlife Biomaterials, Honam National Institute of Biological Resources, 99, Gohadoan-gil, Mokpo-si 58762, Jeollanam-do, Republic of Korea
| | - Kyung-Min Choi
- Division of Practical Research, Honam National Institute of Biological Resources, 99, Gohadoan-gil, Mokpo-si 58762, Jeollanam-do, Republic of Korea; (J.U.P.); (W.L.); (K.-M.C.)
- Advanced Research Center for Island Wildlife Biomaterials, Honam National Institute of Biological Resources, 99, Gohadoan-gil, Mokpo-si 58762, Jeollanam-do, Republic of Korea
| | - Seon-Young Kim
- Jeonju AgroBio-Materials Institute, Wonjangdong-gil 111-27, Deokjin-gu, Jeonju-si 54810, Jeonbuk-do, Republic of Korea; (H.-R.K.); (S.-H.L.); (J.Y.P.)
| | - Mi Hee Park
- Jeonju AgroBio-Materials Institute, Wonjangdong-gil 111-27, Deokjin-gu, Jeonju-si 54810, Jeonbuk-do, Republic of Korea; (H.-R.K.); (S.-H.L.); (J.Y.P.)
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Asencio CJ, Palme R, Ferrari HR, Lattanzi ML, Eguizábal GV, Busso JM. Faecal Glucocorticoid Metabolites and Hair Cortisone/Cortisol Measurements in Domestic Pigs Exposed to Road Transportation and Dexamethasone Treatment. Animals (Basel) 2024; 14:2700. [PMID: 39335289 PMCID: PMC11429306 DOI: 10.3390/ani14182700] [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: 08/14/2024] [Revised: 09/11/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Pig homeostasis is challenged by stressful production practices, like road transportation. Glucocorticoids (GCs) are mediators of reactive homeostasis, and their concentrations are frequently used as a stress indicator. The adrenocortical activity of fattening female and castrated male pigs was monitored over a 5-day longitudinal study. A bi-factorial experimental design was applied on day 2; 18 pigs in pen 1 were transported for 3 h (T; 1.2 m2/pig), and 18 pigs were kept in pen 2 (NT). Ten pigs from each pen were treated with dexamethasone (T-D or NT-D), and eight with saline solution (T-SS or NT-SS). Adrenocortical activity was assessed by measuring the levels of faecal glucocorticoid metabolites (FGMs) and hair cortisol and cortisone. In T-SS pigs, the level of FGMs was higher after transportation than in NT-SS pigs. The level of FGMs of T-D pigs initially increased but then reached similar levels to those of NT-SS sooner than T-SS. In contrast, hair cortisol and cortisone did not respond to the treatments. Nevertheless, the hair cortisone/cortisol ratio increased due to transport and decreased after dexamethasone administration. Daily faecal sampling proved still more reliable than 60-day hair sampling for assessing adrenocortical activity. Transported pigs recovered their adrenocortical baseline levels within 24 h. Dexamethasone attenuated the response to transport.
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Affiliation(s)
- Camila J. Asencio
- Instituto de Investigaciones Biológicas y Tecnológicas (IIBYT), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Facultad de Ciencias Exactas, Físicas y Naturales (FCEFyN), Universidad Nacional de Córdoba (UNC), Av. Vélez Sarsfield 1611, Córdoba X5016GCA, Argentina; (C.J.A.); (G.V.E.)
- Instituto de Ciencia y Tecnología de los Alimentos, FCEFyN-UNC Av. Vélez Sarsfield 1611, Córdoba X5016GCA, Argentina
| | - Rupert Palme
- Department of Biological Sciences and Pathobiology, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - Héctor R. Ferrari
- Cátedra de Bienestar Animal, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Av. Chorroarín 280, Buenos Aires C1427CWO, Argentina;
| | - Mariano L. Lattanzi
- Instituto Nacional de Tecnología Agropecuaria (INTA), EEA Marcos Juárez, Marcos Juárez X2580, Argentina;
| | - Gabina V. Eguizábal
- Instituto de Investigaciones Biológicas y Tecnológicas (IIBYT), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Facultad de Ciencias Exactas, Físicas y Naturales (FCEFyN), Universidad Nacional de Córdoba (UNC), Av. Vélez Sarsfield 1611, Córdoba X5016GCA, Argentina; (C.J.A.); (G.V.E.)
- Instituto de Ciencia y Tecnología de los Alimentos, FCEFyN-UNC Av. Vélez Sarsfield 1611, Córdoba X5016GCA, Argentina
| | - Juan M. Busso
- Instituto de Investigaciones Biológicas y Tecnológicas (IIBYT), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)-Facultad de Ciencias Exactas, Físicas y Naturales (FCEFyN), Universidad Nacional de Córdoba (UNC), Av. Vélez Sarsfield 1611, Córdoba X5016GCA, Argentina; (C.J.A.); (G.V.E.)
- Instituto de Ciencia y Tecnología de los Alimentos, FCEFyN-UNC Av. Vélez Sarsfield 1611, Córdoba X5016GCA, Argentina
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Ru Q, Huang K, Yu R, Wu X, Shen J. Effects of Camellia oleifera seed shell polyphenols and 1,3,6-tri-O-galloylglucose on androgenic alopecia via inhibiting 5a-reductase and regulating Wnt/β-catenin pathway. Fitoterapia 2024; 177:106116. [PMID: 38977254 DOI: 10.1016/j.fitote.2024.106116] [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: 02/27/2024] [Revised: 07/05/2024] [Accepted: 07/05/2024] [Indexed: 07/10/2024]
Abstract
Androgenetic alopecia (AGA) is the leading cause of hair loss in adults. Its pathogenesis remains unclear, but studies have shown that the androgen-mediated 5α-reductase-AR receptor pathway and the Wnt/β-catenin signaling pathway play significant roles. Camellia oleifera is an oil plant, and its fruits have been documented in folklore as having a hair cleansing effect and preventing hair loss. In this study, we used UPLC-Q-TOF-MS/MS to identify the structure of the substances contained in the polyphenols of Camellia oleifera seed shell. These polyphenols are mainly used for shampooing and anti-hair loss purposes. Next, we used molecular docking technology to dock 41 polyphenols and steroidal 5 alpha reductase 2 (SRD5A2). We found that the docking scores and docking sites of 1,3,6-tri-O-galloylglucose (TGG) and finasteride were similar. We constructed a mouse model of DHT-induced AGA to evaluate the effects of Camellia oleifera seed shell polyphenols (CSSP) and TGG in vivo. Treatment with CSSP and TGG alleviated alopecia symptoms and reduced DHT levels. Additionally, CSSP and TGG were able to reduce androgen levels by inhibiting the SRD5A2-AR receptor signaling pathway. Furthermore, by regulating the secretion of growth factors and activating the Wnt/β-catenin signaling pathway, CSSP and TGG were able to extend the duration of hair growth. In conclusion, our study showed that CSSP and TGG can improve AGA in C57BL/6 J mice and reduce the effect of androgen on hair follicle through the two signaling pathways mentioned above. This provides new insights into the material basis and mechanism of the treatment of AGA by CSSP.
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Affiliation(s)
- Qi Ru
- Natural Products and Human Research Center, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Kun Huang
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, PO Box 217, Reading RG6 6AH, United Kingdom
| | - Ruining Yu
- Natural Products and Human Research Center, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Xiaoqin Wu
- Natural Products and Human Research Center, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Jianfu Shen
- Natural Products and Human Research Center, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
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Kim J, An J, Lee YK, Ha G, Ban H, Kong H, Lee H, Song Y, Lee CK, Kim SB, Kim K. Hair Growth Promoting Effects of Solubilized Sturgeon Oil and Its Correlation with the Gut Microbiome. Pharmaceuticals (Basel) 2024; 17:1112. [PMID: 39338277 PMCID: PMC11434952 DOI: 10.3390/ph17091112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/12/2024] [Accepted: 08/21/2024] [Indexed: 09/30/2024] Open
Abstract
Androgenetic alopecia is a common disease that occurs in both men and women. Several approved medications have been used to treat this condition, but they are associated with certain side effects. Therefore, use of extracts derived from natural products, such as Siberian sturgeon (Acipenser baerii), and the regulation of the gut microbiota have become important topics of research. Sturgeon is known for its high nutritional value and anti-inflammatory properties; however, its effects on androgenetic alopecia and gut microbiota remain uncharacterized. Here, we aimed to investigate whether solubilized sturgeon oil (SSO) promotes hair growth and regulates the gut microbiome. C57BL/6 mice were divided into four groups. Three groups received topical applications of distilled water, SSO, or minoxidil, and one group was orally administered SSO. Each treatment was administered over 4 weeks. Histopathological analysis revealed a significant increase in follicle number (p < 0.001) and follicle diameter (p < 0.05). Immunohistochemical analysis revealed upregulation of β-catenin and ERK-1, markers involved in hair growth-promoting pathways. Furthermore, microbiome analysis revealed that the reduced gut microbiota was negatively correlated with these markers. Our findings indicate that oral administration of SSO promotes hair growth and regulates the abundance of hair growth-promoting gut microbiota.
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Affiliation(s)
- Jihee Kim
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
| | - Jinho An
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
| | - Yong-kwang Lee
- Sturgeon Bio Co., Ltd., Cheongju 28581, Republic of Korea;
| | - Gwangsu Ha
- Department of Animal Life Resources, College of Science and Technology, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Hamin Ban
- Institute for Artificial Intelligence and Biomedical Research, Medicinal Bioconvergence Research Center, College of Pharmacy, Yonsei University, Incheon 21983, Republic of Korea;
| | - Hyunseok Kong
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
| | - Heetae Lee
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
| | - Youngcheon Song
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
| | - Chong-kil Lee
- Department of Manufacturing Pharmacy, College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea;
| | - Sang Bum Kim
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
| | - Kyungjae Kim
- Department of Pharmacy, College of Pharmacy, Sahmyook University, Seoul 01795, Republic of Korea; (J.K.); (J.A.); (H.K.); (H.L.); (Y.S.)
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Atrooz OM, Reihani N, Mozafari MR, Salawi A, Taghavi E. Enhancing hair regeneration: Recent progress in tailoring nanostructured lipid carriers through surface modification strategies. ADMET AND DMPK 2024; 12:431-462. [PMID: 39091900 PMCID: PMC11289513 DOI: 10.5599/admet.2376] [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: 05/13/2024] [Revised: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
Background and purpose Hair loss is a prevalent problem affecting millions of people worldwide, necessitating innovative and efficient regrowth approaches. Nanostructured lipid carriers (NLCs) have become a hopeful option for transporting bioactive substances to hair follicles because of their compatibility with the body and capability to improve drug absorption. Review approach Recently, surface modification techniques have been used to enhance hair regeneration by improving the customization of NLCs. These techniques involve applying polymers, incorporating targeting molecules, and modifying the surface charge. Key results The conversation focuses on how these techniques enhance stability, compatibility with the body, and precise delivery to hair follicles within NLCs. Moreover, it explains how surface-modified NLCs can improve the bioavailability of hair growth-promoting agents like minoxidil and finasteride. Furthermore, information on how surface-modified NLCs interact with hair follicles is given, uncovering their possible uses in treating hair loss conditions. Conclusion This review discusses the potential of altering the surface of NLCs to customize them for enhanced hair growth. It offers important information for upcoming studies on hair growth.
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Affiliation(s)
- Omar M. Atrooz
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan
- Department of Biological Sciences, Mutah University, Mutah, Jordan
| | - Nasim Reihani
- Australasian Nanoscience and Nanotechnology Initiative (ANNI), Monash University LPO, Clayton, Victoria 3800, Australia
| | - M. R. Mozafari
- Australasian Nanoscience and Nanotechnology Initiative (ANNI), Monash University LPO, Clayton, Victoria 3800, Australia
| | - Ahmad Salawi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Elham Taghavi
- Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, 21030 Kuala Nerus, Terengganu, Malaysia
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10
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Zhou SY, Giang NN, Kim H, Chien PN, Le LTT, Trinh TT, Nga PT, Kwon HJ, Ham JR, Lee WK, Gu YJ, Zhang XR, Jin YX, Nam SY, Heo CY. Assessing the efficacy of mesotherapy products: Ultra Exo Booster, and Ultra S Line Plus in hair growth: An ex vivo study. Skin Res Technol 2024; 30:e13780. [PMID: 39031929 PMCID: PMC11259544 DOI: 10.1111/srt.13780] [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: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 07/22/2024]
Abstract
In this study, scalp tissues from Korean adults between 20 and 80 without skin disease were used. Scalp tissues were processed, and hair follicles were isolated and cultured with different treatments (including Bioscalp, Ultra Exo Booster, and Ultra S Line Plus) from Ultra V company. Over 12 days, observations and measurements of hair follicle characteristics were recorded at intervals (Days 0, 3, 6, 9, and 12). The study assessed the impact of these substances on hair follicle growth and morphology. Bioscalp, combined with Ultra Exo Booster and Ultra S Line Plus, showed significant hair elongation in ex vivo. Preservation of hair bulb diameter was observed, indicating potential for sustained hair growth by exosome-based products. The hair growth cycle analysis suggested a lower transition to the catagen stage in test products from Ultra V compared to non-treated groups. The research findings indicated that the tested formulations, especially the combination of Bioscalp, Ultra Exo Booster, and Ultra S Line Plus, demonstrated significant effectiveness in promoting hair growth, maintaining the integrity of the hair bulb, and reducing the transition to the catagen stage. The study suggests promising alternative treatments for hair loss, illustrating results that were as good as those of the conventional testing product groups.
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Affiliation(s)
- Shu Yi Zhou
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulSouth Korea
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Nguyen Ngan Giang
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of Medical Device DevelopmentCollege of MedicineSeoul National UniversitySeoulSouth Korea
| | - Hyunjee Kim
- Korean Institute of Nonclinical StudyH&Bio. Co. Ltd.SeongnamSouth Korea
| | - Pham Ngoc Chien
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Korean Institute of Nonclinical StudyH&Bio. Co. Ltd.SeongnamSouth Korea
| | - Linh Thi Thuy Le
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of Biomedical ScienceCollege of MedicineSeoul National UniversitySeoulSouth Korea
- Faculty of Medical TechniqueHai Phong University of Medicine and PharmacyHaiphongVietnam
| | - Thuy‐Tien Thi Trinh
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Korean Institute of Nonclinical StudyH&Bio. Co. Ltd.SeongnamSouth Korea
| | - Pham Thi Nga
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Korean Institute of Nonclinical StudyH&Bio. Co. Ltd.SeongnamSouth Korea
| | | | | | - Won Ku Lee
- UltraV Co., Ltd. R&D CenterSeoulSouth Korea
| | - Yeon Ju Gu
- UltraV Co., Ltd. R&D CenterSeoulSouth Korea
| | - Xin Rui Zhang
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulSouth Korea
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Yong Xun Jin
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulSouth Korea
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Sun Young Nam
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Chan Yeong Heo
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulSouth Korea
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of Medical Device DevelopmentCollege of MedicineSeoul National UniversitySeoulSouth Korea
- Korean Institute of Nonclinical StudyH&Bio. Co. Ltd.SeongnamSouth Korea
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11
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Sivamani P, Rajendran RL, Gangadaran P, Ahn BC. An induced pluripotent stem cell-based approach for hair follicle development and regeneration. Regen Ther 2024; 26:502-507. [PMID: 39140101 PMCID: PMC11321309 DOI: 10.1016/j.reth.2024.07.005] [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: 06/23/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 08/15/2024] Open
Abstract
Because hair loss is a common concern for many individuals, potential regenerative therapies of hair follicles have been extensively researched. Induced pluripotent stem cells (iPSCs) are a promising avenue for hair follicle regeneration. This review explores current iPSC-based approaches and highlights their potential applications and challenges in hair restoration. The principles of iPSC technology, iPSC differentiation into hair follicle precursor cells, and potential clinical implications for hair follicle regeneration are also discussed. This overview of iPSCs and their applications aims to contribute to our understanding of their role in hair restoration and potential future therapeutic applications.
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Affiliation(s)
- Poornima Sivamani
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India
| | - Ramya Lakshmi Rajendran
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
| | - Prakash Gangadaran
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
- BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical Sciences, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
- BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical Sciences, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
- Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea
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12
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Béke G, Lendvai A, Hollósi E, Braun N, Theek C, Kállai J, Lányi Á, Becker M, Völker JM, Schulze Zur Wiesche E, Bácsi A, Bíró T, Mihály J. Topically Applied N,N-Dimethylglycine Sodium Salt Enhances Human Skin Blood Flow by Inducing Endothelial Nitric Oxide Release. J Invest Dermatol 2024:S0022-202X(24)00383-X. [PMID: 38797323 DOI: 10.1016/j.jid.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/02/2024] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Gabriella Béke
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alexandra Lendvai
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Gyula Petrányi Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Debrecen, Hungary
| | - Erika Hollósi
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nicole Braun
- Eurofins DermaTronnier GmbH, Institute for Experimental Dermatology, Witten/Herdecke University, Witten, Germany
| | | | - Judit Kállai
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Árpád Lányi
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Maike Becker
- Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | | | - Erik Schulze Zur Wiesche
- Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany; Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany
| | - Attila Bácsi
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; HUN-REN-UD Allergology Research Group, Debrecen, Hungary
| | - Tamás Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Johanna Mihály
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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13
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Choi JY, Boo MY, Boo YC. Can Plant Extracts Help Prevent Hair Loss or Promote Hair Growth? A Review Comparing Their Therapeutic Efficacies, Phytochemical Components, and Modulatory Targets. Molecules 2024; 29:2288. [PMID: 38792149 PMCID: PMC11124163 DOI: 10.3390/molecules29102288] [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: 04/18/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
This narrative review aims to examine the therapeutic potential and mechanism of action of plant extracts in preventing and treating alopecia (baldness). We searched and selected research papers on plant extracts related to hair loss, hair growth, or hair regrowth, and comprehensively compared the therapeutic efficacies, phytochemical components, and modulatory targets of plant extracts. These studies showed that various plant extracts increased the survival and proliferation of dermal papilla cells in vitro, enhanced cell proliferation and hair growth in hair follicles ex vivo, and promoted hair growth or regrowth in animal models in vivo. The hair growth-promoting efficacy of several plant extracts was verified in clinical trials. Some phenolic compounds, terpenes and terpenoids, sulfur-containing compounds, and fatty acids were identified as active compounds contained in plant extracts. The pharmacological effects of plant extracts and their active compounds were associated with the promotion of cell survival, cell proliferation, or cell cycle progression, and the upregulation of several growth factors, such as IGF-1, VEGF, HGF, and KGF (FGF-7), leading to the induction and extension of the anagen phase in the hair cycle. Those effects were also associated with the alleviation of oxidative stress, inflammatory response, cellular senescence, or apoptosis, and the downregulation of male hormones and their receptors, preventing the entry into the telogen phase in the hair cycle. Several active plant extracts and phytochemicals stimulated the signaling pathways mediated by protein kinase B (PKB, also called AKT), extracellular signal-regulated kinases (ERK), Wingless and Int-1 (WNT), or sonic hedgehog (SHH), while suppressing other cell signaling pathways mediated by transforming growth factor (TGF)-β or bone morphogenetic protein (BMP). Thus, well-selected plant extracts and their active compounds can have beneficial effects on hair health. It is proposed that the discovery of phytochemicals targeting the aforementioned cellular events and cell signaling pathways will facilitate the development of new targeted therapies for alopecia.
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Affiliation(s)
- Joon Yong Choi
- Department of Biomedical Science, The Graduate School, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea;
- BK21 Plus KNU Biomedical Convergence Program, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
| | - Min Young Boo
- Ppeum Clinic Daegu, 39 Dongseong-ro, Jung-gu, Daegu 41937, Republic of Korea;
| | - Yong Chool Boo
- Department of Biomedical Science, The Graduate School, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea;
- BK21 Plus KNU Biomedical Convergence Program, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
- Cell and Matrix Research Institute, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Republic of Korea
- Lapivu Co., Ltd., 115 Dongdeok-ro, Jung-gu, Daegu 41940, Republic of Korea
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14
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Wróblewska-Kończalik K, Pawlaczyk M, Kolasiński J, Kolenda M, Miechowicz I, Seraszek-Jaros A, Kroma-Szal A, Gornowicz-Porowska J. Non-Cicatricial Alopecia and Its Association with Anthropometric Measurements and Nutritional Laboratory Markers. Life (Basel) 2024; 14:609. [PMID: 38792630 PMCID: PMC11122053 DOI: 10.3390/life14050609] [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: 04/11/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Alopecia constitutes one of the most common dermatological disorders, and its steadily increasing prevalence is a cause for concern. Alopecia can be divided into two main categories, cicatricial/scarring and non-cicatricial/non-scarring, depending on the causes of hair loss and its patterns. The aim of this study was to investigate the relationship between anthropometric and nutritional laboratory parameters in Caucasian adult women and men with non-cicatricial alopecia. A total of 50 patients (37 with non-cicatricial alopecia and 13 healthy controls) were included in the study. Clinical examination and scalp trichoscopy were performed. The anthropometric and nutritional laboratory parameters were collected and analyzed. No statistically significant differences in the laboratory findings were found. The patients with non-cicatricial alopecia were statistically significantly younger as compared to the controls. An elevated risk of hair loss, which was detected among the younger participants, might be associated with a modern lifestyle and the so-called 'Western diet'. It seems safe to assume that suboptimal nutrition and poor eating habits during childhood might constitute risk factors for early hair loss.
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Affiliation(s)
| | - Mariola Pawlaczyk
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medicinal Sciences, Rokietnicka 3, 60-806 Poznań, Poland; (M.P.); (J.G.-P.)
| | - Jerzy Kolasiński
- Kolasiński Clinic, Hair Clinic Poznan, 62-020 Swarzędz, Poland; (K.W.-K.); (M.K.)
| | - Małgorzata Kolenda
- Kolasiński Clinic, Hair Clinic Poznan, 62-020 Swarzędz, Poland; (K.W.-K.); (M.K.)
| | - Izabela Miechowicz
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Agnieszka Seraszek-Jaros
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Bukowska 70 Street, 60-812 Poznań, Poland;
| | - Anna Kroma-Szal
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medicinal Sciences, Rokietnicka 3, 60-806 Poznań, Poland; (M.P.); (J.G.-P.)
| | - Justyna Gornowicz-Porowska
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medicinal Sciences, Rokietnicka 3, 60-806 Poznań, Poland; (M.P.); (J.G.-P.)
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15
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Frydrych A, Jurowski K. Toxicity of minoxidil - Comprehensive in silico prediction of main toxicity endpoints: Acute toxicity, irritation of skin and eye, genetic toxicity, health effect, cardiotoxicity and endocrine system disruption. Chem Biol Interact 2024; 393:110951. [PMID: 38484827 DOI: 10.1016/j.cbi.2024.110951] [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: 01/26/2024] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
This article focusses on elucidating the toxicological profile of minoxidil, a widely used pharmacological agent for alopecia, through the application of in silico methods (Percepta ACD/Labs software). This research is driven by the need to understand key toxicological endpoints: acute toxicity, skin and eye irritation, genetic toxicity, cardiotoxicity, disruption of the endocrine system, and estimation of various health effects due to the lack of experimental data for this drug. These parameters are critically evaluated to meet the stringent requirements of the pharmaceutical industry's safety assessments. The results obtained for acute toxicity (LD50 for rats and mouse) indicate that minoxidil exhibits a species-dependent acute toxicity profile e.g. 51 mg/kg bw for intravenous administration in mice. The predicted health effects indicate a 93% risk to the gastrointestinal system, 54% for the kidneys, 52% for the liver, 42% for the blood and lungs, and 39% for the cardiovascular system. The prediction of genotoxicity suggests a moderate probability (48%) of inducing a positive Ames test result. Furthermore, moderate inhibition of the hERG channel indicates potential cardiac risks of Minoxidil. Based on the information obtained, we propose subjecting minoxidil to additional toxicological assessments. The successful adoption of these in silico methodologies aligns with the 3 R s principle (replacement, reduction, and refinement) in the field of modern toxicological studies of minoxidil, all without the use of laboratory animals for the novelty of our toxicity assessment.
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Affiliation(s)
- Adrian Frydrych
- Laboratory of Innovative Toxicological Research and Analyzes, Institute of Medical Studies, Medical College, Rzeszów University, Al. Mjr. W. Kopisto 2a, 35-959, Rzeszów, Poland
| | - Kamil Jurowski
- Laboratory of Innovative Toxicological Research and Analyzes, Institute of Medical Studies, Medical College, Rzeszów University, Al. Mjr. W. Kopisto 2a, 35-959, Rzeszów, Poland; Department of Regulatory and Forensic Toxicology, Institute of Medical Expertises in Łódź, Ul. Aleksandrowska 67/93, 91-205, Łódź, Poland.
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16
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Jibing C, Weiping L, Yuwei Y, Bingzheng F, Zhiran X. Exosomal microRNA-Based therapies for skin diseases. Regen Ther 2024; 25:101-112. [PMID: 38178928 PMCID: PMC10765304 DOI: 10.1016/j.reth.2023.12.005] [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: 08/09/2023] [Revised: 12/08/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024] Open
Abstract
Based on engineered cell/exosome technology and various skin-related animal models, exosomal microRNA (miRNA)-based therapies derived from natural exosomes have shown good therapeutic effects on nine skin diseases, including full-thickness skin defects, diabetic ulcers, skin burns, hypertrophic scars, psoriasis, systemic sclerosis, atopic dermatitis, skin aging, and hair loss. Comparative experimental research showed that the therapeutic effect of miRNA-overexpressing exosomes was better than that of their natural exosomes. Using a dual-luciferase reporter assay, the targets of all therapeutic miRNAs in skin cells have been screened and confirmed. For these nine types of skin diseases, a total of 11 animal models and 21 exosomal miRNA-based therapies have been developed. This review provides a detailed description of the animal models, miRNA therapies, disease evaluation indicators, and treatment results of exosomal miRNA therapies, with the aim of providing a reference and guidance for future clinical trials. There is currently no literature on the merits or drawbacks of miRNA therapies compared with standard treatments.
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Affiliation(s)
| | | | | | - Feng Bingzheng
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Xu Zhiran
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, Guangxi, China
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17
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Manole CG, Soare C, Ceafalan LC, Voiculescu VM. Platelet-Rich Plasma in Dermatology: New Insights on the Cellular Mechanism of Skin Repair and Regeneration. Life (Basel) 2023; 14:40. [PMID: 38255655 PMCID: PMC10817627 DOI: 10.3390/life14010040] [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: 10/23/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
The skin's recognised functions may undergo physiological alterations due to ageing, manifesting as varying degrees of facial wrinkles, diminished tautness, density, and volume. Additionally, these functions can be disrupted (patho)physiologically through various physical and chemical injuries, including surgical trauma, accidents, or chronic conditions like ulcers associated with diabetes mellitus, venous insufficiency, or obesity. Advancements in therapeutic interventions that boost the skin's innate regenerative abilities could significantly enhance patient care protocols. The application of Platelet-Rich Plasma (PRP) is widely recognized for its aesthetic and functional benefits to the skin. Yet, the endorsement of PRP's advantages often borders on the dogmatic, with its efficacy commonly ascribed solely to the activation of fibroblasts by the factors contained within platelet granules. PRP therapy is a cornerstone of regenerative medicine which involves the autologous delivery of conditioned plasma enriched by platelets. This is achieved by centrifugation, removing erythrocytes while retaining platelets and their granules. Despite its widespread use, the precise sequences of cellular activation, the specific cellular players, and the molecular machinery that drive PRP-facilitated healing are still enigmatic. There is still a paucity of definitive and robust studies elucidating these mechanisms. In recent years, telocytes (TCs)-a unique dermal cell population-have shown promising potential for tissue regeneration in various organs, including the dermis. TCs' participation in neo-angiogenesis, akin to that attributed to PRP, and their role in tissue remodelling and repair processes within the interstitia of several organs (including the dermis), offer intriguing insights. Their potential to contribute to, or possibly orchestrate, the skin regeneration process following PRP treatment has elicited considerable interest. Therefore, pursuing a comprehensive understanding of the cellular and molecular mechanisms at work, particularly those involving TCs, their temporal involvement in structural recovery following injury, and the interconnected biological events in skin wound healing and regeneration represents a compelling field of study.
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Affiliation(s)
- Catalin G. Manole
- Department of Cellular and Molecular Biology and Histology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Ultrastructural Pathology Laboratory, “Victor Babeș” National Institute of Pathology, 050096 Bucharest, Romania
| | - Cristina Soare
- Department of Oncological Dermatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Laura Cristina Ceafalan
- Department of Cellular and Molecular Biology and Histology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Cell Biology, Neurosciences and Experimental Myology Laboratory, “Victor Babeș” National Institute of Pathology, 050096 Bucharest, Romania
| | - Vlad M. Voiculescu
- Department of Oncological Dermatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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18
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Roets B. Potential application of PBM use in hair follicle organoid culture for the treatment of androgenic alopecia. Mater Today Bio 2023; 23:100851. [PMID: 38024838 PMCID: PMC10663892 DOI: 10.1016/j.mtbio.2023.100851] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023] Open
Abstract
Androgenic alopecia is a hereditary condition of pattern hair loss in genetically susceptible individuals. The condition has a significant impact on an individual's quality of life, with decreased self-esteem, body image issues and depression being the main effects. Various conventional treatment options, such as minoxidil, finasteride and herbal supplements, aim to slow down hair loss and promote hair growth. However, due to the chronic nature of the condition the financial cost of treatment for androgenic alopecia is very high and conventional treatment options are not universally effective and come with a host of side effects. Therefore, to address the limitations of current treatment options a novel regenerative treatment option is required. One promising approach is organoids, organoids are 3D cell aggregates with similar structures and functions to a target organ. Hair follicle organoids can be developed in vitro. However, the main challenges are to maintain the cell populations within the organoid in a proliferative and inductive state, as well as to promote the maturation of organoids. Photobiomodulation is a form of light therapy that stimulates endogenous chromophores. PBM has been shown to improve cell viability, proliferation, migration, differentiation and gene expression in dermal papilla cells and hair follicle stem cells. Therefore, photobiomodulation is a potential adjunct to hair follicle organoid culture to improve the proliferation and inductive capacity of cells.
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Affiliation(s)
- Brendon Roets
- Biomedical Science, Faculty of Health Science, University of Johannesburg, Johannesburg, 2028, South Africa
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19
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Woo MJ, Kang HY, Paik SJ, Choi HJ, Uddin S, Lee S, Kim SY, Choi S, Jung SK. The In Vivo and In Vitro Effects of Terminalia bellirica (Gaertn.) Roxb. Fruit Extract on Testosterone-Induced Hair Loss. J Microbiol Biotechnol 2023; 33:1467-1474. [PMID: 37482816 DOI: 10.4014/jmb.2306.06004] [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: 06/05/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
Due to the continuous increase in patients with androgenetic alopecia (AGA) and psychological disorders such as depression and anxiety, the demand for hair loss treatment and effective hair growth materials has increased. Terminalia bellirica (Gaertn.) Roxb. (TBE) reportedly exerts anti-inflammatory, hepatoprotective, and antidiabetic effects, among others, but its effects on testosterone (TS)-inhibited hair growth remains unclear. In this study, we evaluated the effects of TBE on TS-induced hair growth regression in human follicle dermal papilla cells (HFDPCs) and C57BL/6 mice. Oral administration of TBE increased TS-induced hair growth retardation. Interestingly, effects were greater when compared with finasteride, a commercial hair loss treatment product. Histological analyses revealed that oral TBE administration increased hair follicles in the dorsal skin of C57BL/6 mice. Additionally, western blotting and immunofluorescence showed that oral TBE administration recovered the TS-induced inhibition of cyclin D1, proliferating cell nuclear antigen (PCNA), and Ki67 expression in vivo. Using in vitro proliferation assays, TBE promoted HFDPC growth, which was suppressed by TS treatment. Thus, TBE may be a promising nutraceutical for hair health as it promoted hair growth in AGA-like in vitro and in vivo models.
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Affiliation(s)
- Min Jeong Woo
- School of Food Science and Biotechnology, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Ha Yeong Kang
- School of Food Science and Biotechnology, Kyungpook National University, Daegu 41566, Republic of Korea
| | - So Jeong Paik
- School of Food Science and Biotechnology, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Hee Jung Choi
- School of Food Science and Biotechnology, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Salah Uddin
- Ethnobotanical Database of Bangladesh (EDB), 7/I, B.F.D.C Road, Tejgaon, Dhaka-1208, Bangladesh
| | - Sangwoo Lee
- International Biological Material Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon 34141, Republic of Korea
| | - Soo-Yong Kim
- International Biological Material Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon 34141, Republic of Korea
| | - Sangho Choi
- International Biological Material Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon 34141, Republic of Korea
| | - Sung Keun Jung
- School of Food Science and Biotechnology, Kyungpook National University, Daegu 41566, Republic of Korea
- Research Institute of Tailored Food Technology, Kyungpook National University, Daegu 41566, Republic of Korea
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20
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Wu X, Du YZ. Nanodrug Delivery Strategies to Signaling Pathways in Alopecia. Mol Pharm 2023; 20:5396-5415. [PMID: 37817669 DOI: 10.1021/acs.molpharmaceut.3c00620] [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: 10/12/2023]
Abstract
Over 50% of the global population suffers from hair loss. The mixed results in the treatment of hair loss reveal the limitations of conventional commercial topical drugs. One the one hand, the definite pathogenesis of hair loss is still an enigma. On the other hand, targeted drug carriers ensure the drug therapeutic effect and low side effects. This review highlights the organization and overview of nine crucial signaling pathways associated with hair loss, as well as the development of nanobased topical delivery systems loading the clinical drugs, which will fuel emerging hair loss treatment strategies.
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Affiliation(s)
- Xiaochuan Wu
- Jinhua Institute of Zhejiang University, Jinhua, Zhejiang 321299, China
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yong-Zhong Du
- Jinhua Institute of Zhejiang University, Jinhua, Zhejiang 321299, China
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
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21
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Kim MH, Jin SC, Baek HK, Yang WM. Astragalus membranaceus and Cinnamomum cassia Stimulate the Hair Follicle Differentiation-Related Growth Factor by the Wnt/β-Catenin Signaling Pathway. Curr Issues Mol Biol 2023; 45:8607-8621. [PMID: 37998718 PMCID: PMC10670826 DOI: 10.3390/cimb45110541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/25/2023] Open
Abstract
Astragalus membranaceus and Cinnamomum cassia are used as spices and flavorful ingredients, or medicinal herbs with pharmacological effects. In this study, the hair-growth-promoting effects of the YH complex, a newly developed formula consisting of membranaceus and C. cassia, are investigated with the prediction of its molecular mechanism. The target gene of the YH complex was about 74.8% overlapped with the gene set of 'Hair growth' on the GO Biological Process database. The oral administration of the YH complex promoted hair regrowth and increased hair-shaft thickness in depilated hair loss mice. In addition, the anagen/telogen hair follicle ratio was significantly increased by the YH complex. The growth factors affecting the growth of hair follicles were dose-dependently increased by treatment with the YH complex. The Wnt/β-catenin signaling pathway expressions in skin tissues were apparently increased by the administration of the YH complex. In conclusion, the YH complex consisting of A. membranaceus and C. cassia induced hair follicle differentiation and preserved the growing-anagen phase by increasing growth factors and the Wnt/β-catenin signaling pathway, leading to the restoration of hair loss. The YH complex can be a remedy for hair loss diseases, such as alopecia areata, androgenetic alopecia, telogen effluvium, and chemotherapy-induced alopecia.
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Affiliation(s)
- Mi Hye Kim
- College of Korean Medicine, Woosuk University, Wanju 55338, Republic of Korea;
| | - Seong Chul Jin
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (S.C.J.); (H.K.B.)
| | - Hee Kyung Baek
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (S.C.J.); (H.K.B.)
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (S.C.J.); (H.K.B.)
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22
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Perinelli DR, Cambriani A, Antognini G, Agostinacchio G, Marliani A, Cespi M, Torregiani E, Bonacucina G. Quantification of Squalene and Lactic Acid in Hair Bulbs with Damaged Sheaths: Are They Metabolic Wastes in Alopecia? Biomedicines 2023; 11:2493. [PMID: 37760935 PMCID: PMC10525989 DOI: 10.3390/biomedicines11092493] [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: 07/31/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Alopecia is a pathological and multifactorial condition characterised by an altered hair growth cycle and ascribed to different pathogenic causes. Cell energetic imbalances in hair follicles occurring in this disorder could lead to the production of some "metabolic wastes", including squalene and lactic acid, which could be involved in the clinically observed sheath damage. The aim of this work was the extraction and analytical quantification of squalene and lactic acid from hair bulbs of subjects with clinical alopecia in comparison with controls, using HPLC-DAD and HPLC-MS techniques. The analytical quantification was performed after a preliminary observation through a polarised optical microscope to assess sheath damage and morphological alterations in the cases group. A significantly larger amount of squalene was quantified only in subjects affected by alopecia (n = 31) and with evident damage to hair sheaths. For lactic acid, no statistically significant differences were found between cases (n = 21) and controls (n = 21) under the experimental conditions used. Therefore, the obtained results suggest that squalene can represent a metabolic and a pathogenic marker for some alopecia conditions.
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Affiliation(s)
- Diego Romano Perinelli
- Chemistry, Interdisciplinary Project (ChIP), School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (D.R.P.); (A.C.); (G.B.)
| | - Alessandra Cambriani
- Chemistry, Interdisciplinary Project (ChIP), School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (D.R.P.); (A.C.); (G.B.)
| | - Gianluigi Antognini
- S.I.Tri.—Italian Society for Hair Science and Restoration, Via San Domenico 107, 50133 Florence, Italy; (G.A.); (G.A.)
| | - Gaetano Agostinacchio
- S.I.Tri.—Italian Society for Hair Science and Restoration, Via San Domenico 107, 50133 Florence, Italy; (G.A.); (G.A.)
| | - Andrea Marliani
- S.I.Tri.—Italian Society for Hair Science and Restoration, Via San Domenico 107, 50133 Florence, Italy; (G.A.); (G.A.)
| | - Marco Cespi
- Chemistry, Interdisciplinary Project (ChIP), School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (D.R.P.); (A.C.); (G.B.)
| | - Elisabetta Torregiani
- Chemistry, Interdisciplinary Project (ChIP), School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (D.R.P.); (A.C.); (G.B.)
| | - Giulia Bonacucina
- Chemistry, Interdisciplinary Project (ChIP), School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 62032 Camerino, Italy; (D.R.P.); (A.C.); (G.B.)
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23
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Dettmer AM, Novak MA, Meyer JS. Are hair cortisol levels dependent on hair growth rate? A pilot study in rhesus macaques. Gen Comp Endocrinol 2023; 340:114308. [PMID: 37244411 PMCID: PMC10330586 DOI: 10.1016/j.ygcen.2023.114308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/24/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
Research incorporating the analysis of glucocorticoids, specifically cortisol, in hair samples has exploded over the past 10-15 years, yet factors contributing to the accumulation of cortisol in hair are not yet fully characterized. In particular, it is not clear whether cortisol accumulation in hair is dependent on hair growth rate, a possibility raised by prior rodent studies reporting glucocorticoid-mediated inhibition of hair growth. Using rhesus macaque monkeys (Macaca mulatta), an extensively studied nonhuman primate species, the present pilot study evaluated the hypothesis that hair cortisol accumulation is inversely related to hair growth rate (i.e., slower hair growth leading to elevated cortisol levels). Hair samples were collected from 19 adult female macaques and 17 infants (9 males) 3 months apart using a shave-reshave procedure from the same site below the posterior vertex of the scalp. The second hair samples were measured to the nearest millimeter (mm) for growth rate over the previous 3 months and assayed for hair cortisol concentrations (HCCs) using enzyme immunoassay. Because of the possibility of age-related differences in hair growth rate, correlational analyses were performed separately for adults and infants to determine whether HCC values were associated with growth rate in each age group. These analyses revealed that neither group displayed a significant correlation of HCCs with hair growth. The results additionally showed that overall, adults had a faster hair growth rate than infants and, as expected from previous studies, had lower HCCs than infants. Our results suggest that higher HCCs within the non-stress range do not result from cortisol-mediated inhibition of hair growth. Moreover, similarities between humans and macaque monkeys in both HPA axis regulation and hair growth rates argue that these findings are relevant for human hair cortisol studies. Extrapolation to other species in which the features of hair growth and the relevant regulatory mechanisms are less well understood should be done with caution.
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Affiliation(s)
- Amanda M Dettmer
- Yale Child Study Center, Yale School of Medicine, 230 S. Frontage Road, New Haven, CT 06519, USA.
| | - Melinda A Novak
- Department of Psychological & Brain Sciences, 135 Hicks Way, University of Massachusetts Amherst, Amherst, MA 01003, USA.
| | - Jerrold S Meyer
- Department of Psychological & Brain Sciences, 135 Hicks Way, University of Massachusetts Amherst, Amherst, MA 01003, USA.
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24
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Pitton Rissardo J, Fornari Caprara AL, Casares M, Skinner HJ, Hamid U. Antiseizure Medication-Induced Alopecia: A Literature Review. MEDICINES (BASEL, SWITZERLAND) 2023; 10:35. [PMID: 37367730 DOI: 10.3390/medicines10060035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
Background: Adverse effects of antiseizure medications (ASMs) remain one of the major causes of non-adherence. Cosmetic side effects (CSEs) are among the most commonly reported side effects of ASMs. In this context, alopecia is one of the CSEs that has a high intolerance rate leading to poor therapeutical compliance. Methods: We performed a literature review concerning alopecia as a secondary effect of ASMs. Results: There are 1656 individuals reported with ASM-induced alopecia. Valproate (983), lamotrigine (355), and carbamazepine (225) have been extensively reported. Other ASMs associated with alopecia were cenobamate (18), levetiracetam (14), topiramate (13), lacosamide (7), vigabatrin (6), phenobarbital (5), gabapentin (5), phenytoin (4), pregabalin (4), eslicarbazepine (3), brivaracetam (2), clobazam (2), perampanel (2), trimethadione (2), rufinamide (2), zonisamide (2), primidone (1), and tiagabine (1). There were no reports of oxcarbazepine and felbamate with drug-induced alopecia. Hair loss seen with ASMs was diffuse and non-scarring. Telogen effluvium was the most common cause of alopecia. A characteristic feature was the reversibility of alopecia after ASM dose adjustment. Conclusions: Alopecia should be considered one important adverse effect of ASMs. Patients reporting hair loss with ASM therapy should be further investigated, and specialist consultation is recommended.
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Affiliation(s)
- Jamir Pitton Rissardo
- Medicine Department, Federal University of Santa Maria, Santa Maria 97105-900, Brazil
| | | | - Maritsa Casares
- AdventHealth Orlando Neuroscience Institute, 615 E Princeton Street, Suite 540, Orlando, FL 32803, USA
| | - Holly J Skinner
- AdventHealth Epilepsy at Orlando, 615 E Princeton Street, Suite 540, Orlando, FL 32803, USA
| | - Umair Hamid
- Department of Neurology, College of Medicine, University of Illinois, Peoria, IL 61605, USA
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