Alterations of gut microbiota composition in post-finasteride patients: a pilot study
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ORIGINAL ARTICLE
Alterations of gut microbiota composition in post‑finasteride patients: a pilot study F. Borgo1 · A. D. Macandog1,2 · S. Diviccaro3 · E. Falvo3 · S. Giatti3 · G. Cavaletti4,5 · R. C. Melcangi3 Received: 27 April 2020 / Accepted: 8 September 2020 © The Author(s) 2020
Abstract Purpose Post-finasteride syndrome (PFS) has been reported in a subset of patients treated with finasteride (an inhibitor of the enzyme 5alpha-reductase) for androgenetic alopecia. These patients showed, despite the suspension of the treatment, a variety of persistent symptoms, like sexual dysfunction and cognitive and psychological disorders, including depression. A growing body of literature highlights the relevance of the gut microbiota-brain axis in human health and disease. For instance, alterations in gut microbiota composition have been reported in patients with major depressive disorder. Therefore, we have here analyzed the gut microbiota composition in PFS patients in comparison with a healthy cohort. Methods Fecal microbiota of 23 PFS patients was analyzed by 16S rRNA gene sequencing and compared with that reported in ten healthy male subjects. Results Sexual dysfunction, psychological and cognitive complaints, muscular problems, and physical alterations symptoms were reported in more than half of the PFS patients at the moment of sample collection. The quality sequence check revealed a low library depth for two fecal samples. Therefore, the gut microbiota analyses were conducted on 21 patients. The α-diversity was significantly lower in PFS group, showing a reduction of richness and diversity of gut microbiota structure. Moreover, when visualizing β-diversity, a clustering effect was found in the gut microbiota of a subset of PFS subjects, which was also characterized by a reduction in Faecalibacterium spp. and Ruminococcaceae UCG-005, while Alloprevotella and Odoribacter spp were increased compared to healthy control. Conclusion Gut microbiota population is altered in PFS patients, suggesting that it might represent a diagnostic marker and a possible therapeutic target for this syndrome. Keywords Androgenic alopecia · Fecal microbiota · Gut microbiota-brain axis · Sexual dysfunction · Depression · 5alphareductase
Introduction
* R. C. Melcangi [email protected] 1
Department of Experimental Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
2
Department of Oncology and Hemato‑Oncology, Università Degli Studi di Milano, Milan, Italy
3
Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Via Balzaretti 9, 20133 Milan, Italy
4
Experimental Neurology Unit, Università di Milano-Bicocca, Monza, Italy
5
Milan Center for Neuroscience, Università di Milano-Bicocca, Monza, Italy
The post-finasteride syndrome (PFS) is an emerging clinical problem observed in a subset of patients treated with finasteride for androgenetic alopecia. These patients, despite the suspension of treatment, reported a variety of persistent symptoms, including sexual
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