Selective BET Inhibition as Potential Hidradenitis Suppurativa Treatment

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

Hair follicles cannot be desensitized to DHT like allergies; treatments focus on reducing DHT levels or blocking its effects using methods like finasteride, GT20029, or PROTACs. Topical treatments like ceterizine and BPA application are also mentioned.

The conversation discusses the need for a localized 5-alpha reductase inhibitor that only affects the scalp without systemic side effects, similar to pyrilutamide's approach. Current treatments like topical liposomal finasteride and dutasteride are mentioned, but concerns about their systemic effects and lack of research are highlighted.

Topical dutasteride may have limited absorption due to its higher molecular mass compared to finasteride, potentially affecting its efficacy in suppressing DHT locally. Microneedling might enhance dutasteride absorption, possibly offering stronger local DHT suppression with fewer systemic effects.

Exploring a potential hair loss treatment using the enzyme AKR1C2 to locally reduce DHT levels. Challenges include enzyme delivery through the skin and high production costs, with gene therapy or stem cells suggested as future alternatives.

HMI 115 is being discussed as a potential hair loss treatment, with skepticism due to past disappointments like cosmeRNA, brezula, and pyrilutamide. The user is questioning if they should be hopeful for new developments in the next six years.