The role of 5-α-reductase inhibition in supressing progression of male androgenetic alopecia − a postulate for further studies on possible application of saw palmetto extracts
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Perfect Hair Clinic, Katowice, Poland
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Marcin Piwecki   

Perfect Hair Clinic, ul. Fabryczna 15B, 40-611 Katowice
Ann. Acad. Med. Siles. 2023;77:190-196
The study presents the mechanism of male androgenetic alopecia (MAGA), with a focus on the role of the enzyme 5-α-reductase, which is responsible for converting testosterone, the primary male hormone, into its active form, dihydrotestosterone (DHT). The consequences of the DHT stimulation of androgen receptors (ARs) located in the X chromosome of dermal papilla cells (DPCs) are described. This leads to androgen-induced gene transcription, disrupted hair follicle nourishment, and most importantly, an accelerated transition from the anagen to the catagen phase. The study also discusses how this enzyme can be targeted by molecules acting as inhibitors. Furthermore, the justification for conducting more in-depth studies on the mechanisms of action involving extracts of saw palmetto (Serenoa repens) and their inhibitory effects on 5-α-reductase is presented. The study also advocates the identification and measurement of active substances present in saw palmetto extracts, with two promising phytosterolic compounds, stigmasterol and β-sitosterol, due to their demonstrated inhibitory activity on 5-α-reductase in extracts from other plant species. As part of the proposal to deepen the research, attention is drawn to the need to investigate the impact of saw palmetto extract on the hair growth cycle, hair follicle life cycle, various growth factors and angiogenesis, immune system activity, and oxidative stress. Other areas of observation for the action of saw palmetto extracts could include their use in combination with other plant extracts or therapeutic agents such as platelet-rich plasma or fibrin-rich plasma.
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