三七总皂苷对雄激素性脱发小鼠的改善作用及机制研究

目的：明确三七总皂苷（PNS）对雄激素性脱发（AGA）小鼠的治疗效果及其作用机理。方法：40只C57BL/6雄性小鼠随机分为空白组、模型组、阳性组、三七总皂苷组,每组10只。除空白组外其余各组小鼠皮下注射丙酸睾酮溶液建立雄激素性脱发模型后,每组给予相应试剂或蒸馏水处理。对每组脱发区的毛囊数目、终毛毛囊、毳毛毛囊进行计数并计算终毛/毳毛的比值。测定小鼠血清睾酮、血管内皮生长因子（VEGF）的含量以及小鼠皮肤组织VEGF、转化生长因子-β1 （TGF-β1）表达量。结果：与空白组比较,模型组小鼠背部毛发明显稀疏,总毛囊数目、终毛毛囊数目、终毛/毳毛比值、血清和皮肤组织中VEGF表达量明显下降,皮肤组织中TGF-β1表达量显著上升（均P<0.01）;与模型组比较,三七总皂苷组小鼠毛发增多可见大量新生绒毛;小鼠皮肤总毛囊数目、终毛毛囊数目明显增加,终毛/毳毛比值升高;小鼠血清和皮肤组织VEGF表达量明显升高;TGF-β1表达量降低,差异均有统计学意义(均P<0.05)。结论：三七总皂苷对C57BL/6AGA小鼠模型有改善作用,其作用机制可能与上调血清和皮肤组织中VEGF表达以及下调皮肤组织中TGF-β1表达有关。     

复方透骨草酊对睾酮的抑制及促进毛发生长作用的初步研究

目的 探究复方透骨草酊对睾酮诱导的C57BL/6病理脱发模型小鼠的性激素水平、毛发生长及毛囊细胞凋亡情况的作用.方法 将40只小鼠随机分为空白对照组、模型对照组、米诺地尔酊组、复方透骨草酊组,分别在脱毛区外给药,摘眼球取血法检测小鼠血清睾酮、雌二醇、双氢睾酮水平,原位杂交技术原位末端标记法(TUNEL)评价毛囊细胞凋亡...     

雄激素受体与雌激素性脱发关系的研究进展

目的：毛囊单位的雄激素受体（AR）在雄激素性脱发的发病中起着重要的作用，在遗传易感性个体，由于局部头皮AR的差异，对正常或偏高的雄激素产生放大效应，从而导致脱发。本综述了AR的结构、功能、定位、作用机制、AR与雄激素性脱发关系的实验研究等，以进一步了解雄激素性脱发的机理。     

非那雄胺与米诺地尔治疗男性雄激素性秃发疗效比较

目的:比较1 mg非那雄胺、5%米诺地尔及两者联合治疗男性雄激素性秃发(AGA)的疗效.方法:观察206例Hamilton-Norwood分级为Ⅲv、Ⅳ和Ⅴ级的男性AGA患者,分别给予1 mg非那雄胺(68例)、5%米诺地尔(74例)、1 mg非那雄胺和5%米诺地尔联合治疗(64例),疗程6个月.结果:治疗3个月时,联合治疗组有效率优于非那雄胺组.6个月时非那雄胺组、米诺地尔组及联合治疗组有效率分别为67.65%、62.16%和81.25%,联合治疗组优于米诺地尔组.脱发程度和病程不同者有效率差异均具有统计学意义(P < 0.05).结论:非那雄胺和米诺地尔联合治疗男性AGA起效较早,病程较短、脱发程度较轻、疗程较长者治疗效果较好.     

自体浓缩生长因子联合毫火针激活 Wnt/β-catenin信号促进小鼠毛发生长

目的 探讨自体浓缩生长因子(concentrated growth factor, CGF)联合毫火针对雄激素性脱发(androgenetic alopecia, AGA)小鼠毛发生长的作用及机制。方法 将36只C57BL/6雄性小鼠随机分成6组(n=6),分别为CGF联合毫火针组、毫火针组、CGF组、米诺地尔阳性对照组、空白组与模型组，除空白组外，其余各组均给与睾酮涂抹建立雄激素性脱发小鼠模型，然后各组分别给予相应的治疗。肉眼评估小鼠背部皮肤毛发生长情况，HE染色后观察毛囊的形态变化及数量，Western blot及免疫组织化学检测Wnt10b、GSK-3β、β-catenin蛋白表达情况。结果 肉眼观察CGF联合毫火针可以促进小鼠毛发生长；HE染色显示毛囊数量增多，以终毛毛囊增多为著；免疫组织化学、Western blot证实Wnt10b、GSK-3β、β-catenin蛋白在上述所有组别毛囊中均有表达，且CGF联合毫火针组中Wnt10b、GSK-3β、β-catenin蛋白的表达与模型组、毫火针组、CGF组差异有统计学意义(P<0.05)。结论 CGF联合毫火针可通过激活β...     

米诺地尔外用对化疗后小鼠ICAM-1和ELAM-1的影响

目的: 评价米诺地尔对小鼠血清和毛囊ICAM-1和ELAM-1水平的影响.方法: 环磷酰胺静脉注射建立C57BL/6小鼠化疗后脱发模型.米诺地尔酊涂抹小鼠背部皮肤后,切取皮肤标本观察毛囊组织学变化;应用ELISA法和免疫组化法检测小鼠血清及毛囊内ICAM-1和ELAM-1水平.结果: 小鼠于注射环磷酰胺后4天出现明显的弥漫性脱毛,组织学上毛囊多为退行期,米诺地尔组多为生长期毛囊.造模后小鼠血清ICAM-1和ELAM-1的水平分别为(46.57±10.25)ng/mL和(28.57±6.03)ng/mL,高于对照组(P<0.05);米诺地尔涂抹后血清ICAM-1和ELAM-1水平分别为(27.21±5.62)ng/mL和(17.21±4.80)ng/mL,明显低于模型组(P<0.05).结论: 米诺地尔可减缓环磷酰胺导致的生长期毛囊细胞凋亡和退行性变,并降低血清和毛囊局部ICAM-1和ELAM-1水平,对环磷酰胺所致的脱发有一定的防治作用.     

5%米诺地尔联合口服抗雄药物治疗雄激素性秃发早期脱发现象的初步探讨

目的：探讨5%米诺地尔联合口服抗雄药物治疗雄激素性秃发（AGA）早期的脱发现象,观察16周内头发脱落数量及特征。方法：收集AGA患者治疗期间（1～16周）脱发量数据,探究脱发量的变化特点。结果：67例AGA患者使用药物后,第2～8周脱发量相对第1周（基线）均明显增加（P<0.05）;且分别与第1周和第2周比较,第3周均呈现出脱发量明显增加的情况（P<0.05）,由此将脱发量变化百分比>68.22%（第3周脱发量变化百分比的均值）的情况定义为“脱发明显”。据此将患者分为脱发明显组39例（58.21%）和非脱发明显组28例（41.79%）。脱发明显组中,患者脱发量明显增加发生于第3～5周,随后第12周降至基线水平。脱发明显组中脱发量的时间变化、严重程度在男女中差异均无统计学意义（P>0.05）,仅20.51%患者每周脱发量变化百分比中的最大数值（简称为最大百分比）较第1周>3倍。结论：“脱发明显”多发生于AGA患者用药后第3～5周,约于第12周降至第1周水平,持续时间短且男女间无明显差别。“脱发明显”是药物作用的一种表现,也预示着毛囊可能由休止期转入生长期的正...     

外用米诺地尔治疗女性雄激素性脱发的系统评价

为评价米诺地尔治疗女性雄激素性脱发的安全性和有效性,检索中国生物医学文摘数据库、网络数据库PubMed、Ovid、Web of Science、UMI、elsevier以及Cochrane图书馆的临床对照试验资料库,搜集相关的随机对照试验,对其逐个进行质量评价,并进行Meta-分析。结果：纳入4个高质量的研究,共治疗606例患者。对治疗有效率的Meta-分析结果显示：米诺地尔与安慰剂比较（患者评价）,OR合并=1.98[95%CI（1.43～2.74）,P〈0.0001];米诺地尔与安慰剂比较（调查员评价）,OR合并=2.31[95%CI（1.65～3.24）,P〈0.00001]。脱发评估区域1cm^2非毳毛计数的Meta-分析表明：米诺地尔与安慰剂比较（第32周）,WMD合并=18.00[95%CI（5.10～30.90）,P=0.006];米诺地尔与安慰剂比较（32周和0周的均数变化）,WMD合并=14.88[95%CI（7.46～22.31）,P〈0.0001]。所有的研究均未发现严重的副作用。结论：外用2%米诺地尔治疗女性雄激素性脱发是安全、有效的。     

不同深度微针联合外用米诺地尔酊治疗男性雄激素性脱发的疗效观察

目的 观察不同深度微针联合外用米诺地尔酊治疗男性雄激素性脱发的临床疗效以及安全性。方法 纳入2020年6月至2021年6月河南科技大学第一附属医院皮肤科门诊男性雄激素性脱发患者90例,随机分为A组(n=30)、B组(n=30)和C组(n=30)。A组仅外用5%米诺地尔酊治疗,B组予0.5 mm深度电动微针针刺联合外用米诺地尔酊治疗;C组予1 mm深度电动微针针刺联合外用米诺地尔酊治疗。治疗12周后观察临床疗效及不良反应情况。结果 治疗12周后,三组患者毛发密度、毛发直径均较治疗前明显改善(均P<0.05),B组和C组均明显优于A组(均P<0.05)。B组和C组患者治疗后自我评估头发生长改善评分均明显优于A组(均P<0.05)。A、B、C三组患者不良反应发生率分别为6.67%、6.67%和26.67%,C组明显高于A组和B组(χ²=6.92,P=0.031)。结论 0.5 mm深度微针针刺联合外用米诺地尔酊治疗男性雄激素性脱发疗效显著,安全性好,是男性雄激素性脱发患者新的治疗选择。     

螺内酯联合米诺地尔搽剂治疗女性雄激素源性脱发的疗效观察

目的:探讨螺内酯联合米诺地尔搽剂治疗女性雄激素源性脱发的临床疗效。方法:将84例女性雄激素源性脱发患者随机分成对照组(40例)和治疗组(44例)。对照组仅给予外用米诺地尔搽剂治疗;治疗组在外用米诺地尔搽剂治疗基础上给予口服螺内酯60 mg/d,连续服用6个月。治疗1、3、6个月后观察两组治疗效果及不良反应。结果:6个月后,治疗组有效率为59.09%,对照组有效率为37.50%,两组差异有统计学意义(2=3.91,P<0.05)。结论:螺内酯联合米诺地尔搽剂治疗女性雄激素源性脱发有效、安全,值得临床推广使用。     

Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese men

Minoxidil is efficacious in inducing hair growth in patients with androgenetic alopecia by inducing hair follicles to undergo transition from the early to late anagen phase. Although the efficacy of 1% topical minoxidil has been confirmed in Japan, no controlled study of 5% topical minoxidil has been conducted using male Japanese subjects. The objective of this trial was to verify the superiority in clinical efficacy of 5% topical minoxidil to 1% topical minoxidil in a double-blind controlled study with male, Japanese androgenetic alopecia patients as the subjects. The trial included 300 Japanese male patients aged 20 years or older with androgenetic alopecia who were administered either 5% topical minoxidil ( n  = 150) or 1% topical minoxidil ( n  = 150) for 24 weeks. The mean change from the baseline in non-vellus hair/cm², the primary efficacy variable, was 26.4 ( n  = 142) in the 5% topical minoxidil group and 21.2 ( n  = 144) in the 1% topical minoxidil group at 16 weeks, the main time point for the evaluation. The difference between the groups was significant ( P  = 0.020). The incidence of adverse events was 8.7% (13/150) in the 5% group and 5.3% (8/150) in the 1% group, with no significant difference between the groups (χ²-test: P  = 0.258). Our findings confirmed the superiority of 5% topical minoxidil to 1% topical minoxidil in treating Japanese men with androgenetic alopecia.     

Topical fulvestrant solution has no effect on male and postmenopausal female androgenetic alopecia: results from two randomized, proof-of-concept studies

BACKGROUND: Androgenetic alopecia (pattern baldness) affects approximately half of all white-skinned men and women over the age of 40 years. Based on preclinical studies in mice in which topical fulvestrant (ICI182,780, an anti-oestrogen) caused telogen hair follicles to enter anagen, thereby causing hair growth, a topical formulation of fulvestrant was developed for the potential treatment of androgenetic alopecia. OBJECTIVES: To evaluate the efficacy of fulvestrant solution in stimulating hair growth in men and postmenopausal women with androgenetic alopecia in two randomized, phase II, minoxidil- and/or vehicle-controlled studies. METHODS: One hundred and two white-skinned men aged 18-50 years with Norwood/Hamilton grades III, IIIv, IV, V or Va androgenetic alopecia received topical fulvestrant 70 mg mL(-1) solution, vehicle or minoxidil 2% solution twice daily for 16 weeks. Seventy postmenopausal women with Ludwig grade 1 or 2 androgenetic alopecia received topical fulvestrant 70 mg mL(-1) solution or vehicle twice daily for 16 weeks. The endpoints in both studies were hair density, cumulative hair thickness and hair growth rate, measured by TrichoScan analysis of digital images. RESULTS: There were no statistically significant differences favouring fulvestrant over vehicle at study end (day 113) for any of the efficacy parameters in men or women. Statistically significant differences in favour of minoxidil over fulvestrant were seen from day 57 onwards for hair density, cumulative hair thickness and hair growth rate in men. CONCLUSIONS: These results indicate a lack of effect of topical fulvestrant in the treatment of subjects with androgenetic alopecia. The reasons for this lack of effect remain unclear.     

A randomized, placebo-controlled trial of 1% topical minoxidil solution in the treatment of androgenetic alopecia in Japanese women

Minoxidil is effective in inducing hair growth in patients with androgenetic alopecia by stimulating hair follicles to undergo transition from early to late anagen phase. However, there have been no controlled studies of topical minoxidil in Asian women. The objective of this trial was to investigate the efficacy of 1% topical minoxidil for androgenetic alopecia in Japanese female patients using a double-blind controlled method. This trial included 280 Japanese female patients aged 20 years or older with androgenetic alopecia who were administered either 1% topical minoxidil (n = 140) or placebo (n = 140) for 24 weeks. The primary efficacy variable was mean change from baseline in non-vellus hair count/cm(2). The mean change was 8.15 in the 1% topical minoxidil group and 2.03 in the placebo group, with a significant difference between groups (p < 0.001) [difference: 6.12 (two-sided 95% confidence interval (CI): 3.29-8.96)]. Secondary variables included investigators' assessments and patients' self-assessments. As assessed by investigators, 29.2% (40/137) of the patients had moderate or better improvement in the 1% topical minoxidil group compared to 11.8% (16/136) in the placebo group (p < 0.001 versus placebo). The effect on hair growth was assessed as improved or better by 36.5% (50/137) of the patients themselves in the 1% topical minoxidil group compared to 23.5% (32/136) in the placebo group (p = 0.019 versus placebo). The patients tolerated treatment with 1% topical minoxidil well without significant adverse effects.     

Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia

ABSTRACT

Background: In treating androgenetic alopecia, 5% minoxidil is a commonly used topical drug. By using electrodynamic microneedle at the same time may increase absorption of minoxidil and further stimulate hair growth.

Objective: A 24-week, randomized, evaluator blinded, comparative study was performed to evaluate the efficacy of treating Chinese male androgenetic alopecia using microneedle combined with 5% minoxidil topical solution. Methods: Randomized subjects received topical 5% minoxidil (group 1, n = 20), local electrodynamic microneedle treatments (group 2, n = 20), or local electrodynamic microneedle treatments plus topical 5% minoxidil (group 3, n = 20). A total of 12 microneedle treatments were performed every 2 weeks with 2ml 5% minoxidil delivery in group three during each microneedle treatment. Patient receiving topical 5% minoxidil applied 1 ml of the solution twice daily over the course of the study. A total of 60 Chinese male subjects with Norwood-Hamilton type III-VI androgenetic alopecia were treated.

Results: The mean improvement in total hair density from baseline to 24 weeks was 18.8/cm² in group 1, 23.4/cm² in group 2, and 38.3/cm² in group 3. The hair growth in the three groups was significantly different (P = 0.002), but there were no significant differences in toxicity found between the three groups.

Conclusions: Treatment with microneedle plus topical 5% minoxidil was associated with the best hair growth.     

Three percent topical minoxidil therapy for female androgenetic alopecia

Effective treatment of female androgenetic alopecia involves cessation of hair shedding and promotion of normal anagen hair growth. The topical use of hormones such as progesterone or an androgen receptor-binding drug such as spironolactone has not been associated with significant hair regrowth.¹ In contrast, the topical use of minoxidil has resulted in decreased hair shedding and hair growth promotion, particularly in men with androgenetic alopecia.² To investigate the usefulness of topical minoxidil therapy in female androgenetic alopecia, we studied the efficacy and safety of 3% topical minoxidil in 25 affected women. Results were correlated with disease extent and activity.     

毛发老化及处理

毛发老化包括毛干风化和毛囊老化,后者表现为黑素细胞功能降低或毛发灰化、雄激素源性脱发和衰老性秃发.头皮受内在(生理性老化)以及外界因素(吸烟及紫外线辐射等)的影响.实验表明,在毛发和皮肤老化中,氧化应激发挥重要作用.目前用于治疗雄激素源性脱发的方法有:米诺地尔局部外用,口服非那雄胺和自体头发移植.在无法逆转头发变灰的情况下,着色剂是恢复头发颜色的主要方法.     

The clinical effect of JetpPeel-assisted topical minoxidil in the treatment of androgenetic alopecia: A randomized pilot study

Objective: We used JetPeel, combined with topical minoxidil to treat patients with AGA, in order to observe whether the JetPeel can accelerate the recovery of the disease and find a new method for AGA treatment. Method: Thirty patients who met the standard were included in the study. The patients were randomly divided into three groups. The first group was treated with JetPeel-assisted topical minoxidil. The second group received topical minoxidil monotherapy. The third group was not given any treatment. We used objective evaluation (amount and diameter of hair, oil secretion level) and subjective evaluation (hair growth score marked by dermatologist and patient) to evaluate the hair growth condition before treatment and every other month. The calculated p values of less than 0.05 were accepted as significant. Result: All of the 30 patients finished the study. There was no difference in age, sex, and duration and severity of the disease among groups prior to treatment (p > 0.05). And there was greater improvement in scores of hair growth in the first group compared to the second and third group, which was statistically significant (p < 0.05). Conclusion: Compared with topical minoxidil monotherapy, JetPeel-assisted topical minoxidil is more effective during the treatment of androgenetic alopecia.     

A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical,histopathological, and physicochemical study

Topical minoxidil 5% are effective in androgenetic alopecia (AGA). Spironolactone acts as an androgen antagonist by competitively blocking androgen receptors. Studying the effect of topical minoxidil 5% gel and spironolactone gel 1% in management of AGA. The study includes 60 patients diagnosed as AGA; (group I): treated with topical minoxidil gel 5%, (group II): with topical spironolactone gel 1% and group (III) treated with combined minoxidil 5% and spironolactone 1% gel. All patients were followed up monthly throughout the treatment period. Scalp biopsy was taken before and after 12 months. In group I, the clinical response was in 90% of patients with variable degrees in improvement, in group II, the clinical response was in 80% of patients, meanwhile, in group III the clinical response was in all patients (100%). Histopathological examination of skin biopsy after treatment revealed significant increase in anagen hair on the other hand, both telogen and vellus hair was significantly decreased meanwhile, the T/V ratio was significantly increased. The results of this work revealed that topical minoxidil gel 5% and topical spironolactone gel 1% were effective in treatment of AGA, while the combination of two agents was better in treatment.     

Clinical utility and validity of minoxidil response testing in androgenetic alopecia

Clinical response to 5% topical minoxidil for the treatment of androgenetic alopecia (AGA) is typically observed after 3–6 months. Approximately 40% of patients will regrow hair. Given the prolonged treatment time required to elicit a response, a diagnostic test for ruling out nonresponders would have significant clinical utility. Two studies have previously reported that sulfotransferase enzyme activity in plucked hair follicles predicts a patient's response to topical minoxidil therapy. The aim of this study was to assess the clinical utility and validity of minoxidil response testing. In this communication, the present authors conducted an analysis of completed and ongoing studies of minoxidil response testing. The analysis confirmed the clinical utility of a sulfotransferase enzyme test in successfully ruling out 95.9% of nonresponders to topical minoxidil for the treatment of AGA.