Guo Hongwei, Gao Wendi Victor, Endo Hiromi, McElwee Kevin John
a Department of Dermatology and Skin Science , University of British Columbia , Vancouver , Canada.
b Department of Dermatology , Affiliated Hospital of Guangdong Medical University , Zhanjiang , China.
Expert Opin Investig Drugs. 2017 Aug;26(8):917-932. doi: 10.1080/13543784.2017.1353598. Epub 2017 Jul 12.
Treatments for androgenetic alopecia constitute a multi-billion-dollar industry, however, currently available therapeutic options have variable efficacy. Consequently, in recent years small biotechnology companies and academic research laboratories have begun to investigate new or improved treatment methods. Research and development approaches include improved formulations and modes of application for current drugs, new drug development, development of cell-based treatments, and medical devices for modulation of hair growth. Areas covered: Here we review the essential pathways of androgenetic alopecia pathogenesis and collate the current and emerging therapeutic strategies using journal publications databases and clinical trials databases to gather information about active research on new treatments. Expert opinion: We propose that topically applied medications, or intra-dermal injected or implanted materials, are preferable treatment modalities, minimizing side effect risks as compared to systemically applied treatments. Evidence in support of new treatments is limited. However, we suggest therapeutics which reverse the androgen-driven inhibition of hair follicle signaling pathways, such as prostaglandin analogs and antagonists, platelet-rich plasma (PRP), promotion of skin angiogenesis and perfusion, introduction of progenitor cells for hair regeneration, and more effective ways of transplanting hair, are the likely near future direction of androgenetic alopecia treatment development.
雄激素性脱发的治疗构成了一个价值数十亿美元的产业,然而,目前可用的治疗选择疗效各异。因此,近年来小型生物技术公司和学术研究实验室已开始研究新的或改进的治疗方法。研发途径包括改进现有药物的配方和应用方式、开发新药、开展基于细胞的治疗以及研发调节头发生长的医疗器械。涵盖领域:在此,我们回顾雄激素性脱发发病机制的关键途径,并利用期刊出版物数据库和临床试验数据库整理当前及新兴的治疗策略,以收集有关新治疗方法的积极研究信息。专家观点:我们认为,与全身应用治疗相比,局部应用药物、皮内注射或植入材料是更优的治疗方式,可将副作用风险降至最低。支持新治疗方法的证据有限。然而,我们认为能够逆转雄激素对毛囊信号通路抑制作用的疗法,如前列腺素类似物和拮抗剂、富血小板血浆(PRP)、促进皮肤血管生成和灌注、引入用于毛发再生的祖细胞以及更有效的毛发移植方法,可能是雄激素性脱发治疗发展在不久的将来的方向。