Van Neste D
Skinterface, Tournai, Belgium.
Skin Pharmacol Physiol. 2006;19(3):168-76. doi: 10.1159/000093051. Epub 2006 May 4.
Using contrast-enhanced phototrichogram (CE-PTG) at monthly intervals during 48 months, we measured the duration of the hair cycle, i.e. anagen, catagen and telogen at the exclusion of exogen. Exogen, a recently identified phase of the hair cycle, is characterized by weakening of anchorage of the club hair to the surrounding epithelium. The processing of the club hair terminates at the time of exogen hair release, i.e. hair shedding. We combined a noninvasive exogen sampling before each CE-PTG so that the area contained only anagen, catagen and telogen hair or empty follicular openings. During the first 24 months of this study, natural regression of hair cycling in early i.e. preclinical stages of androgenetic alopecia (AGA) in androgen sensitive areas was documented. Shortening of the hair cycle of thicker hair characterized progression of AGA. During the next 24 months, finasteride (1 mg/day) was introduced into the system. Shortening of the hair cycle was reversed by finasteride in androgen sensitive sites as long as the affected follicle was able to produce a thick hair fiber at the time of treatment initiation. Compared to the baseline period, responding follicles did not produce thicker hair. On average, they initiated active growth more rapidly by reducing the duration of the lag phase by 40%. The duration of the anagen phase of thick hair showed an average 23% increase. In this particular experiment, the already miniaturized follicles producing thinner hair (<40 microm thickness) at the time of finasteride introduction regressed further on treatment. Our results seem to indicate that reversal of 'hair loss' by finasteride probably means that the terminal type follicles that are functionally deficient--a stage of reversible hypotrophy--will be reactivated by two non-mutually exclusive mechanisms: faster regrowth followed by extension of the duration of anagen. In our study, there was no clear evidence in favour of reversal of miniaturized hair into terminal hair. This new interpretation indicates that miniaturized hair follicles may be an important diagnostic marker of AGA in males but also that it might be less contributive to the therapeutic response to finasteride. Our results highlight that precise measurement of terminal type hair follicle functionalities opens up avenues for the selection of 'drug-responsive organs' in the human scalp in vivo and these may possibly serve to predict 'quality of response to treatment'.
在48个月内每月使用一次对比增强光毛发生长图(CE-PTG),我们测量了毛发周期的时长,即生长期、退行期和休止期,不包括脱落期。脱落期是最近发现的毛发周期阶段,其特征是杵状毛与周围上皮细胞的附着减弱。杵状毛的处理在脱落期毛发脱落时终止,即毛发脱落。我们在每次CE-PTG之前进行无创性脱落期采样,以便该区域仅包含生长期、退行期和休止期毛发或空的毛囊开口。在本研究的前24个月,记录了雄激素性脱发(AGA)早期即临床前阶段雄激素敏感区域毛发周期的自然消退情况。较粗毛发的毛发周期缩短是AGA进展的特征。在接下来的24个月中,将非那雄胺(1毫克/天)引入系统。只要受影响的毛囊在开始治疗时能够产生粗毛发纤维,非那雄胺就能逆转雄激素敏感部位毛发周期的缩短。与基线期相比,有反应的毛囊没有产生更粗的毛发。平均而言,它们通过将延迟期的时长缩短40%,更快地开始活跃生长。粗毛发的生长期时长平均增加了23%。在这个特定实验中,在引入非那雄胺时已经产生较细毛发(<40微米粗细)的小型化毛囊在治疗后进一步退化。我们的结果似乎表明,非那雄胺使“脱发”逆转可能意味着功能缺陷的终末型毛囊——一种可逆性萎缩阶段——将通过两种并非相互排斥的机制重新激活:更快的再生长,随后是生长期时长的延长。在我们的研究中,没有明确证据支持小型化毛发逆转为终末毛发。这种新的解释表明,小型化毛囊可能是男性AGA的重要诊断标志物,但也可能对非那雄胺的治疗反应贡献较小。我们的结果强调,对终末型毛囊功能进行精确测量为在人体头皮体内选择“药物反应性器官”开辟了途径,这些器官可能有助于预测“治疗反应质量”。