Investigation of the Association between the Oral and the Gut Microbiome in Glaucoma

Journal of Clinical and Experimental Ophthalmology is an open access peer reviewed journal which publishes articles bi-monthly. Journal provides rapid peer review process. Recently journal has published its 2nd bi-monthly issue of its 11th volume with 6 regular articles and an editorial note.
In its 2nd issue of 11th volume Journal of Clinical and Experimental Ophthalmology has published an article the Investigation of the Association between the Oral and the Gut Microbiome in Glaucoma.
Androgenic alopecia (AGA) (also known as pattern alopecia) is the most common form a chronic non-scarring hair loss, affecting both men and women. AGA is characterized by progressive hair loss, especially of scalp hair, and has distinctive patterns of loss in women versus men, but in both genders the central scalp is most severely affected. Follicular miniaturization and local high dihydrotestosterone (DHT) activity are considered the main pathological mechanisms involved in AGA. Microinflammation is also a relevant pathogenetic mechanism involved in this clinical condition. Approved therapeutic options are limited to topical minoxidil for both men and women and oral finasterided for men. However, both drugs possess side effects and are effective in less than 50% of treated patients. Autologous Platelet-Rich Plasma (PRP) dermal injection is an additional therapeutic option for the medical treatment of AGA [8]. However, clinical efficacy of this approach in some cases could be disappointing, Positive effects of PRP in AGA seem correlated, at least in part, with a growth factors mimicking action.
PRP is rich in growth factors like PDGF (platelet derived growth factor), TGF (transforming growth Factor Beta) and VEGF (Vascular endothelial growth Factor) [11]. A hair scalp lotion containing high-purified, growth factors-like polypeptides (octapeptide 2, acetyl decapeptide 3, oligopeptide 20 and copper tripeptide) with the addition of glycine and taurine (GFM-L) is available. Copper tripeptide has shown to have antioxidant [12], antiinflammatory and blood vessel growth promoting action [13]. Copper tripeptide can increase the activity of FGF (Fibroblast Growth Factor) and VEGF [14]. Interestingly, copper tripeptide decreases the secretion of TGF-β [15] from dermal fibroblasts. TGF-β is involved in inducing catagen phase [16]. Copper tripeptide can also interfere with the activity of 5-αreductase, therefore reducing the production of DHT [17]. Finally, this peptide is also able to stimulate the production of decorin [18]. Decorin, at scalp level, improves the anagen phase [19] and consequently hair growth [20]. The acetyl decapeptide is a synthetic peptide that mimics the action of two growth factors: the keratinocyte growth factor (KGF) and the epidermal growth factor (EGF), which acts on the follicle, promoting the anagen growth phase, through an antiapoptotic effect [21], maintaining the bulge stem cells active [22]. Another component of the growth factor like mixture, octapeptide 2, is able to promote hair growth [23], to reduceapoptosis and to increase keratinocyte proliferation [24]. In this formulation all the 4 oligopeptides are vehiculated in nanosomes of 250 nm in diameter. Published data state that nanosomes with a diameter<500 nm can transport molecules deep in the hair bulb, after topical application [25]. Taurine is a relevant amino acid with interesting hair growth promoting mechanisms [26]. This lotion has shown to be effective as stand-alone approach in the treatment of excessive hair loss in men and women [27]. The peculiar composition of this lotion (mixture of growth factor like peptides and taurine) suggests a potential synergistic effect on hair growth with other therapeutic strategies like PRP treatment. So far, no data regarding the potential synergistic effect of autologous PRP treatment combined with GFM-L are available. We therefore conducted a prospective, randomized, assessorblinded trial to compare the efficacy and tolerability of PRP alone vs. PRP and GFM-L treatment in men and women with AGA.
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