磺基转移酶预测米诺地尔治疗雄激素性秃发疗效的研究  

Study on using sulfotransferase to predict minoxidil efficacy for androgenetic alopecia

作　　者：吴桥芳 邓豫豫 孙蔚凌[1] 雎恒春[1] 徐宇轩 曹春育 丁琦 刘静静 范卫新[1] WU Qiao-fang;DENG Yu-yu;SUN Wei-ling;JU Heng-ehun;XU Yu-xuan;CAO Chun-yu;DING qi;L;FAN Wei-xin(Department of Dermatovenereology, the First Affiliated Hospit（d of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院皮肤性病科,江苏南京210029

出　　处：《临床皮肤科杂志》2018年第6期345-349,共5页Journal of Clinical Dermatology

摘　　要：目的:评价磺基转移酶的活性及其mRNA表达量指标用于预测米诺地尔治疗雄激素性秃发(AGA)疗效的可行性。方法:(1)研究选取135例米诺地尔治疗组和10例手术治疗组AGA患者。米诺地尔治疗组患者拔取生长期头发,测量磺基转移酶的活性(用吸光度A值表示)并予以2%米诺地尔于脱发区连续治疗6个月,在初诊和治疗6个月时进行全头毛发照相评估,根据患者治疗前后脱发面积和程度的变化判断疗效,根据疗效进一步分组为改善组98例,控制组23例,无效组14例;(2)手术组AGA患者拔取生长期头发,并用环钻打孔法取其毛囊;米诺地尔组AGA患者只拔取生长期头发,均用实时荧光定量聚合酶链反应(q PCR)检测磺基转移酶的mRNA表达量(用B值表示)。结果:(1)米诺地尔治疗组患者中的改善组、控制组与无效组两两比较,磺基转移酶活性的差异均有统计学意义(P=0.000,P=0.000,P=0.036),(2)预测2%米诺地尔疗效的磺基转移酶活性的最佳阈值是0.430,灵敏度为83%,特异度为95%;(3)毛囊和头发中的磺基转移酶mRNA表达量呈正相关(r=0.703,n=10,P=0.023)。磺基转移酶mRNA表达量和就诊时脱发严重程度呈正相关(r=0.320,n=47,P=0.028)。磺基转移酶mRNA表达量和疗效积分、磺基转移酶的活性均无相关性(r=0.038,n=29,P=0.846;r=-1.515,n=47,P=0.311)。结论:(1)磺基转移酶的活性可以预测2%的米诺地尔治疗AGA的疗效;(2)无创的拔发法可取代传统有创的环钻打孔取毛囊法来检测磺基转移酶mRNA的表达量;(3)磺基转移酶mRNA可能存在转录后水平、翻译水平和翻译后水平的修饰,从而影响了磺基转移酶的活性。Objective： To determine whether the sulfotransferase activity and its mRNA expression levels can serve as biomark-ers for predicting the therapeutic efficacy of minoxidil for androgenic alopecia（AGA）. Methods： ①135 AGA patients treated with miuoxidil（minoxidil group） and 10 surgically treated AGA（operation group） were enrolled ira this study. In the minoxidil group, hairs at anagen phase were pulled ouk and sulfotransferase activity was measured（a value of absorbance）. 2% of minoxidil was applied the alopecia area for 6 months. Global photography assessment was conducted at initial visit and sixth months of treatment. According to the changes in the affected area and extent of hair loss following the treatment, therapeutic efficacy was graded as impruved （98）, under control（23） and ineffective groups（14）; ②In operation group, hairs at anagen phase were also pulled out, but hair follicles were obtained using the drill punch nletho＆ Hair follicles at anagen phase were also obtained from 47 patients in minoxidil group. Expression levels of sulfotransferase mRNA were assessed by real-lime fluorescence quantitative polymerase chain reaction （qPCR）. Results： ①In minoxidil group, sulfotransferase activity differed significantly among improved, under control and the ineffec-tive groups（P=0.000, P=0.000, P=0.036）; ②The best threshold of sulfotransferase activity in predicting efficacy of 2% minoxidil was 0.430, with sensitivity of 83%, and the specificity of 95%; ③Expression levels of sulfotransferase mRNA in hair follicles and hairs correlated positively（r=0.703, n=10, P=0.023）. Expression levels of sulfotransferase mRNA correlated positively with the severity of hair loss prior to the treatment（r=0.320, n=47, P=0.028）. But there was no association among expression levels of sulfotransferase mR-NA, cumulative scores of efficacy and sulfotransferase activity（r=0.038, n=29, P=0.846; r=-1.515, n=47, P=0.311）. Conclusions： ①Sulfotransferase activity can be

关 键 词：磺基转移酶 米诺地尔 雄激紊性秃发 疗效 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]