Proliferation, DNA repair and apoptosis in androgenetic alopecia

Background: Androgenetic alopecia is a common hair disorder, resulting from interplay of genetic, endocrine and ageing factors. Meanwhile, it is unclear if an altered degree of proliferation or increased apoptosis could contribute to its pathogenesis. Objective: To evaluate the role of proliferation, DNA damage and apoptosis in the pathogenesis of androgenetic alopecia. Methods: Thirty biopsies were taken from the frontal (bald) area and occipital (hairy) area of 15 male patients with androgenetic alopecia, as well as five specimens from frontal area of five age-matched controls. These specimens were used for immunohistochemical staining of cell proliferation [proliferating cell nuclear antigen (PCNA)] and DNA repair markers (XRCC1, APE1, PARP-1) as well as apoptosis regulatory protein p53. Results: The frontal bald area of patients showed significantly higher levels of X-ray Cross Complementing-1 (XRCC1; P < 0.001) and p53 (P < 0.001) expression when compared with occipital hairy area of patients and frontal area of controls (P = 0.003 and 0.04, respectively). On the other hand, there were significantly lower expression of PCNA (P < 0.001) and apurinic/apyridinic endonuclease 1 (APE1; P = 0.001 and 0.02) when compared with the frontal area of controls and occipital area of patients, respectively. Meanwhile, APE1 showed significant inverse correlation with p53 overexpression (P = 0.03). Conclusion: The frontal bald area of patients with androgenetic alopecia has lower proliferation rate that result in follicular miniaturization. There is increased DNA damage that would be beyond the capacity of cells to repair in advanced cases. An alternative pathway would take place in order to eliminate the damaged cells through apoptosis. © 2008 The Authors.