The use of oral pioglitazone in the treatment of lichen planopilaris

Mesinkovska, Natasha Atanaskova; Tellez, Alejandra; Dawes, Danyelle; Piliang, Melissa; Bergfeld, Wilma F.

doi:10.1016/j.jaad.2014.10.036

Cited by 50 publications

(46 citation statements)

References 3 publications

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“…In recent years, a growing body of evidence has emanated that PPAR‐γ modulators impact on HF growth, cycling and protein production, namely keratin expression, and epithelial stem cell homeostasis, as well as mitochondrial activity/function (Table ) . Gene expression abnormalities related to PPAR‐γ signalling in patients with lichen planopilaris (LPP) and preliminary evidence from off‐label use of PPAR‐γ agonists like pioglitazone in selected patients with LPP or frontal fibrosing alopecia (FFA) also have suggested possible beneficial effects of PPAR‐γ stimulation in scarring alopecia, such as LPP. In the following, we shall explore this by zooming in on the role of PPAR‐γ signalling in epithelial HF stem cells and anagen hair matrix KCs.…”

Section: Overview: Ppar‐γ and The Human Pilosebaceous Unitmentioning

confidence: 99%

PPAR‐γ signalling as a key mediator of human hair follicle physiology and pathology

Ramot

Bertolini

Boboljova

et al. 2019

Experimental Dermatology

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Peroxisome proliferator‐activated receptors (PPARs) are abundantly expressed in human skin, with PPAR‐γ being the most intensively investigated isoform. In various ex vivo and in vivo models, PPAR‐γ‐mediated signalling has recently surfaced as an essential element of hair follicle (HF) development, growth and stem cell biology. Moreover, the availability of novel, topically applicable PPAR‐γ modulators with a favourable toxicological profile has extended the range of potential applications in clinical dermatology. In this review, we synthesize where this field currently stands and sketch promising future research avenues, focussing on the role of PPAR‐γ‐mediated signalling in the biology and pathology of human scalp HFs, with special emphasis on scarring alopecias such as lichen planopilaris and frontal fibrosing alopecia as model human epithelial stem cell diseases. In particular, we discuss whether and how pharmacological modulation of PPAR‐γ signalling may be employed for the management of hair growth disorders, for example, in scarring alopecia (by reducing HF inflammation as well as by promoting the survival and suppressing pathological epithelial‐mesenchymal transition of keratin 15 + epithelial stem cells in the bulge) and in hirsutism/hypertrichosis (by promoting catagen development). Moreover, we explore the potential role of PPAR‐γ in androgenetic alopecia, HF energy metabolism and HF ageing, and consider clinical perspectives that emanate from the limited data available on this so far. As this field of translational human hair research is still in its infancy, many open questions exist, for which we briefly delineate selected experimental approaches that promise to generate instructive answers in the near future.

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Section: Overview: Ppar‐γ and The Human Pilosebaceous Unitmentioning

confidence: 99%

PPAR‐γ signalling as a key mediator of human hair follicle physiology and pathology

Ramot

Bertolini

Boboljova

et al. 2019

Experimental Dermatology

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“…However, other properties of PPARγ activity (ie anti‐inflammatory effects and epithelial to mesenchymal transition inhibition) are also likely play an important role in disease development . Interestingly, the PPARγ agonist pioglitazone is now being successfully used to treat this disorder, with response rates of over 50% reported . Together, these results suggest a more detailed examination of the role of PPARγ in intrafollicular cholesterol homeostasis is warranted, which may provide pointers towards the development of other therapeutic targets for these disorders.…”

Section: Associations Between Cholesterol and Hair Pathologiesmentioning

confidence: 99%

Cholesterol homeostasis: Links to hair follicle biology and hair disorders

Palmer

Blakeborough

Harries

et al. 2019

Experimental Dermatology

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Lipids and lipid metabolism are critical factors in hair follicle (HF) biology, and cholesterol has long been suspected of influencing hair growth. Altered cholesterol homeostasis is involved in the pathogenesis of primary cicatricial alopecia, mutations in a cholesterol transporter are associated with congenital hypertrichosis, and dyslipidaemia has been linked to androgenic alopecia. The underlying molecular mechanisms by which cholesterol influences pathways involved in proliferation and differentiation within HF cell populations remain largely unknown. As such, expanding our knowledge of the role for cholesterol in regulating these processes is likely to provide new leads in the development of treatments for disorders of hair growth and cycling. This review describes the current state of knowledge with respect to cholesterol homeostasis in the HF along with known and putative links to hair pathologies.

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“…Mesinkovska et al has illustrated oral pioglitazone, a peroxisome proliferatoractivated gamma (PPAR-γ) agonist to be effective in treatment of LPP based on recent evidence implicating the dysfunction of PPAR-γ in cicatrical alopecias. 5,6 However, this has not been replicated elsewhere.…”

Section: Figuresmentioning

confidence: 91%

Apremilast for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Case Series

Hadi¹,

Lebwohl²

2017

J of Skin

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Importance: Lichen planopilaris and frontal fibrosing alopecia are characterized by scarring alopecia associated with pruritus, inflammation, and pain of affected areas. There is a paucity of data on treatment options for these disorders. The available management options are associated with significant adverse effects and poor efficacy. Objective: To explore apremilast as a treatment option for refractory lichen planopilaris and frontal fibrosing alopeciaDesign: This is a retrospective case series analyzing the outcomes of four patients with refractory lichen planopilaris or frontal fibrosing alopecia treated with apremilast.

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The use of oral pioglitazone in the treatment of lichen planopilaris

Cited by 50 publications

References 3 publications

PPAR‐γ signalling as a key mediator of human hair follicle physiology and pathology

PPAR‐γ signalling as a key mediator of human hair follicle physiology and pathology

Cholesterol homeostasis: Links to hair follicle biology and hair disorders

Apremilast for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Case Series

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