Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia

Abstract

Two percent topical minoxidil is the only US Food and Drug Administration-approved drug for the treatment of female androgenetic alopecia (AGA). Its success has been limited by the low percentage of responders. Meta-analysis of several studies reporting the number of responders to 2% minoxidil monotherapy indicates moderate hair regrowth in only 13-20% of female patients. Five percent minoxidil solution, when used off-label, may increase the percentage of responders to as much as 40%. As such, a biomarker for predicting treatment response would have significant clinical utility. In a previous study, Goren et al. reported an association between sulfotransferase activity in plucked hair follicles and minoxidil response in a mixed cohort of male and female patients. The aim of this study was to replicate these findings in a well-defined cohort of female patients with AGA treated with 5% minoxidil daily for a period of 6 months. Consistent with the prior study, we found that sulfotransferase activity in plucked hair follicles predicts treatment response with 93% sensitivity and 83% specificity. Our study further supports the importance of minoxidil sulfation in eliciting a therapeutic response and provides further insight into novel targets for increasing minoxidil efficacy.

Clinical utility and validity of minoxidil response testing in androgenetic alopecia

“…, Roberts et al. , and data from 15 new patients all show similar accuracies of 95.8%, 95.3%, and 100%, respectively, for ruling out nonresponders.…”

“…Data from 70 patients was used in meta‐analysis (55 patients from two previously published studies and 15 patients from our ongoing study). All patients were treated with 5% minoxidil therapy (twice daily) for a minimum duration of 6 months.…”

“…Minoxidil is converted to its active form, minoxidil sulfate, in the outer root sheath of the hair follicle by endogenous sulfotransferase enzymes . Previously, two studies have reported a correlation between sulfotransferase activity in plucked hair follicles and minoxidil response for AGA patients . Combined data from both studies demonstrates the diagnostic is 94% sensitive and 76% specific for predicting response to minoxidil treatment for AGA.…”

Hair growth promoting effects of emodin in telogenic C57BL/6 mice

“…This compound effectively promotes hair growth by dilating blood vessels and opening potassium channels in both males and females with androgenic alopecia [6,14]. It is generally well maintained, but side effects including severe allergic reaction, hypertrichosis, and temporary hair loss have been reported [2,15].…”

Minoxidil: a final judgment or a hope?

“…Дальнейшее изуче-ние эффективности прогнозирования ответа на ле-чение миноксидилом в четко определенной группе провели J. Roberts и соавт. [28]. Пациентки женско-го пола с андрогенетической алопецией (АГА) ис-пользовали миноксидил 5%.…”