European Journal of Cardiovascular Medicine

Background: Continuous Tretinoin therapy has gained attention for its potential in treating various dermatological conditions, yet its underlying biochemical mechanisms remain insufficiently explored. This study aimed to elucidate the molecular changes induced by continuous retinoid therapy and identify potential biomarkers for treatment response. Methods: A randomized, double-blind, placebo-controlled trial was conducted with 120 participants from a tertiary care hospital. Molecular analyses, including transcriptomics and epigenomics, characterized gene expression and epigenetic modifications. Cytokine profiles were assessed, and clinical responses were rigorously evaluated using validated scoring systems. Data were analyzed using bioinformatics pipelines, statistical tests, and machine learning algorithms. Results: Significant upregulation of the "Keratinocyte Proliferation" pathway indicated cellular turnover enhancement. A moderate rise in the "Inflammation" pathway suggested immunomodulatory effects. IL-6 levels decreased significantly (p = 0.042), suggesting inflammation suppression. Clinical response was markedly higher in the treatment group at Week 4 (p < 0.001) and Week 8 (p = 0.018). Potential biomarkers, such as "Gene A" (p < 0.001), demonstrated predictive capabilities. Conclusion: Continuous Tretinoin therapy induces molecular changes related to enhanced cellular turnover and immunomodulation. IL-6 reduction aligns with observed clinical improvements. The study underscores the potential of biomarkers for treatment stratification and offers insights into the mechanisms of continuous retinoid therapy. Further investigations are warranted to validate and extend these findings.

Background: Alopecia areata is an autoimmune disorder characterized by sudden hair loss. The management of this condition is challenging due to its unpredictable nature and limited therapeutic options. Platelet-rich plasma (PRP) and intralesional triamcinolone acetonide (TA) have emerged as potential treatments, but a comprehensive comparison is lacking. Methods: A prospective, randomized, controlled clinical trial was conducted at a tertiary care hospital. Participants (n=120) aged 18-60 years with alopecia areata were randomized into PRP and intralesional TA groups. Primary outcomes included hair regrowth assessed through standardized photographs and the Severity of Alopecia Tool (SALT) score at baseline, post-third treatment session, and 6-month follow-up. Secondary outcomes comprised response rates, safety profiles, treatment response duration, and relapse rates. Statistical analysis employed appropriate tests. Results: Participants' baseline characteristics were comparable between groups. PRP demonstrated significantly higher hair regrowth rates at post-third session (55.3% vs. 41.2%) and 6-month follow-up (68.9% vs. 53.7%). Response rates were notably greater in the PRP group (83.3% vs. 67.5%). Safety profiles were similar. PRP treatment showed a longer treatment response duration (12.6 vs. 9.8 months) and comparable relapse rates (15% vs. 23.3%). Conclusion: This study highlights the superior efficacy of PRP over intralesional TA in alopecia areata treatment. PRP exhibited higher hair regrowth and response rates, longer treatment response duration, and comparable safety and relapse rates. PRP presents as a promising therapeutic option for managing alopecia areata.