Vol. 5, n. 1, January-March 2009 1th International ... - Salute per tutti

Paola Bezzola
Elisabetta Sorbellini
International Hair Research Foundation,
Milan, Italy.
Il ruolo della microinfiammazione
e dell’apoptosi nella alopecia
androgenetica: nuove strategie
terapeutiche
SU M M A R Y
I ntroduzione
Il follicolo pilifero è una struttura biologica
estremamente complessa, formata da un
sistema di interazioni tra la componente cellulare
epiteliale, neuro - e c t o d e r m i c a - m e s e n c h i m a l e ,
regolato da un complesso ricco di cellule staminali.
Il bulbo del capello e del pelo è anche l’unico
organo del corpo umano che è sottoposto alle
continue e cicliche fasi di vita, dallo stadio di
rapida crescita (anagen), a quello di re g re s s i o n e
The role of microinflammation and
apoptosis in androgenic alopecia:
new therapeutical strategies
The therapy with anti-5-!- reductase substances is definitely effective to treat andro g enetic
alopecia. Several studies have shown that the conversion of testosterone to dihyd
ro t e s t o s t e rone by hair follicle cells can be reduced by inhibiting the enzyme II – but
also I – receptors. This process generates a reduction in the gene expression of the factors
leading hair bulbs to miniaturize and die. Two studies have demonstrated that
finasteride can also reduce the gene expression of the caspase cascade activation and
especially of caspase 3, which induce the apoptosis of follicle keratinocytes and fibro blasts.
As already advanced by several Authors, we believe that the oxidative stre s s
induced by inflammatory factors and the oxidative stress-induced apoptosis of hair follicles
can participate in altering the physiological hair cycle clock of hair bulbs. Any
noxa underlying this alteration brings some damage to hair follicles, thus inducing
a n d rogenetic alopecia and some other trichological diseases, such as telogenic defluvium.
As already advanced by Mahè, Paus and Philpott, we believe the therapy of androgenetic
alopecia re q u i res a new and more complete approach, with the use of specific
substances to inhibit androgenic receptors and active principles to reduce the inflammation
process with the subsequent apoptosis of hair follicle cells. We have there f o re
tested two natural active principles whose use is known to be effective and safe, betaglucan
and superoxide dismutase, administered systemically in a complete pool in conjunction
with a specific polyunsaturated acid mixture with an anti-5-!- reductase action.
The results of this blinded randomized study have demonstrated that the anti-inflamm
a t o ry and anti-apoptotic action has a greater effect on the clinical symptoms of AGA
in comparison with the anti AR principle alone and, obviously, the placebo. More o v e r,
after the suspension of the therapy, this complete pool has resulted to bring a significant
reduction in the pro g ression of AGA (miniaturization, phlogosis) for a longer period
than the AR inhibitor alone and, obviously, the placebo.
KE Y W O R D S: Androgenic alopecia, Microinflammation, Apoptosis, Therapy
indotta dal meccanismo di apoptosi (catagen), al
periodo di relativa quiescenza (telogen). Tutto il
ciclo di attività, che Paus chiama l’orologio biologico
del ciclo del capello (Hair Cycle Clock,
H C C ) 1 , è regolato nelle strutture intrinseche del
follicolo, e al momento non è ancora stato evidenziato
con certezza quali meccanismi siano
c o i n v o l t i .
Una cosa sembra evidente dai vari studi condot-
Journal of Plastic Dermatology 2009; 5, 1 47