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Prostaglandin E2 prevents radiotherapy-induced alopecia by attenuating transit amplifying cell apoptosis through promoting G1 arrest

  • Shih-Fan Lai
    Affiliations
    Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan

    Department of Radiation Oncology, National Taiwan University Cancer Center, Taipei, Taiwan

    Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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  • Wen-Yen Huang
    Affiliations
    Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
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  • Wei-Hung Wang
    Affiliations
    Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
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  • Jin-Bon Hong
    Affiliations
    Department of Dermatology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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  • Sung-Hsin Kuo
    Affiliations
    Department of Radiation Oncology, National Taiwan University Cancer Center, Taipei, Taiwan

    Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan

    Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan

    Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
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  • Sung-Jan Lin
    Correspondence
    Corresponding author at: Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
    Affiliations
    Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan

    Department of Dermatology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan

    Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan

    Center for Frontier Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Published:February 20, 2023DOI:https://doi.org/10.1016/j.jdermsci.2023.02.005

      Highlights

      • PGE2 pretreatment attenuates radiotherapy-induced hair loss.
      • Locally administered PGE2 reduces the radiosensitivity of HF TACs by transiently arresting them in G1 phase.
      • TACs are protected from radiation-induced apoptosis when radiation is delivered in the time window of higher radioresistance.
      • Preservation of more TACs converts a dystrophic catagen to a dystrophic anagen response, and thus reduces hair loss.

      Abstract

      Background

      Growing hair follicles (HFs) harbor actively dividing transit amplifying cells (TACs), rendering them highly sensitive to radiotherapy (RT). Clinically, there is still a lack of treatment options for radiotherapy-induced alopecia (RIA).

      Objective

      Our present study aimed to investigated the effect and mechanism of local prostaglandin E2 (PGE2) treatment in RIA prevention.

      Methods

      We compared the response of growing HFs to radiation with and without local PGE2 pretreatment in a mouse model in vivo. The effect of PGE2 on the cell cycle was determined in cultured HF cells from fluorescent ubiquitination-based cell cycle indicator mice. We also compared the protective effects of PGE2 and a cyclin-dependent kinases 4/6 (CDK4/6) inhibitor against RIA.

      Results

      The local cutaneous PGE2 injection reduced RIA by enhancing HF self-repair. Mechanistically, PGE2 did not activate HF stem cells, but it preserved more TACs for regenerative attempts. Pretreatment of PGE2 lessened radiosensitivity of TACs by transiently arresting them in the G1 phase, thereby reducing TAC apoptosis and mitigating HF dystrophy. The preservation of more TACs accelerated HF self-repair and bypassed RT-induced premature termination of anagen. Promoting G1 arrest by systemic administration of palbociclib isethionate (PD0332991), a CDK4/6 inhibitor, offered a similar protective effect against RT.

      Conclusions

      Locally administered PGE2 protects HF TACs from RT by transiently inducing G1 arrest, and the regeneration of HF structures lost from RT is accelerated to resume anagen growth, thus bypassing the long downtime of hair loss. PGE2 has the potential to be repurposed as a local preventive treatment for RIA.
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