Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model

Background: Finasteride, a 5α-reductase inhibitor commonly prescribed for androgenetic alopecia, has been linked to persistent adverse effects after discontinuation, known as post-finasteride syndrome (PFS). Symptoms include neurological, psychiatric, sexual, and gastrointestinal disturbances. Emerg...

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Main Authors: Silvia Diviccaro, Roberto Oleari, Federica Amoruso, Fabrizio Fontana, Lucia Cioffi, Gabriela Chrostek, Vera Abenante, Jacopo Troisi, Anna Cariboni, Silvia Giatti, Roberto Cosimo Melcangi
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Language:English
Published: MDPI AG 2025-07-01
Series:Biomolecules
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Online Access:https://www.mdpi.com/2218-273X/15/7/1044
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author Silvia Diviccaro
Roberto Oleari
Federica Amoruso
Fabrizio Fontana
Lucia Cioffi
Gabriela Chrostek
Vera Abenante
Jacopo Troisi
Anna Cariboni
Silvia Giatti
Roberto Cosimo Melcangi
author_facet Silvia Diviccaro
Roberto Oleari
Federica Amoruso
Fabrizio Fontana
Lucia Cioffi
Gabriela Chrostek
Vera Abenante
Jacopo Troisi
Anna Cariboni
Silvia Giatti
Roberto Cosimo Melcangi
author_sort Silvia Diviccaro
collection DOAJ
description Background: Finasteride, a 5α-reductase inhibitor commonly prescribed for androgenetic alopecia, has been linked to persistent adverse effects after discontinuation, known as post-finasteride syndrome (PFS). Symptoms include neurological, psychiatric, sexual, and gastrointestinal disturbances. Emerging evidence suggests that PFS may involve disruption of sex steroid homeostasis, neuroactive steroid deficiency (notably allopregnanolone, ALLO), and gut–brain axis alterations. Objective: This study aimed to investigate the effects of finasteride withdrawal (FW) in a rat model and evaluate the potential protective effects of ALLO on gut and hypothalamic inflammation. Methods: Adult male <i>Sprague Dawley</i> rats were treated with finasteride for 20 days, followed by one month of drug withdrawal. A subgroup received ALLO treatment during the withdrawal. Histological, molecular, and biochemical analyses were performed on the colon and hypothalamus. Gut microbiota-derived metabolites and markers of neuroinflammation and blood–brain barrier (BBB) integrity were also assessed. Results: At FW, rats exhibited significant colonic inflammation, including a 4.3-fold increase in Mφ1 levels (<i>p</i> < 0.001), a 2.31-fold decrease in butyrate concentration (<i>p</i> < 0.01), and elevated hypothalamic GFAP and Iba-1 protein expression (+360%, <i>p</i> < 0.01 and +100%, <i>p</i> < 0.01, respectively). ALLO treatment rescued these parameters in both the colon and hypothalamus but only partially restored mucosal and BBB structural integrity, as well as the NF-κB/PPARγ pathway. Conclusions: This preclinical study shows that FW causes inflammation in both the gut and hypothalamus in rats. ALLO treatment helped reduce several of these effects. These results suggest ALLO could have a protective role and have potential as a treatment for PFS patients.
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spelling doaj-art-77d43046ecc64cb5bbc27876f90eba7c2025-08-20T03:36:14ZengMDPI AGBiomolecules2218-273X2025-07-01157104410.3390/biom15071044Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat ModelSilvia Diviccaro0Roberto Oleari1Federica Amoruso2Fabrizio Fontana3Lucia Cioffi4Gabriela Chrostek5Vera Abenante6Jacopo Troisi7Anna Cariboni8Silvia Giatti9Roberto Cosimo Melcangi10Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyTheoreo Srl., Via Degli Ulivi 3, 84090 Montecorvino Pugliano, ItalyTheoreo Srl., Via Degli Ulivi 3, 84090 Montecorvino Pugliano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyDepartment of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milano, ItalyBackground: Finasteride, a 5α-reductase inhibitor commonly prescribed for androgenetic alopecia, has been linked to persistent adverse effects after discontinuation, known as post-finasteride syndrome (PFS). Symptoms include neurological, psychiatric, sexual, and gastrointestinal disturbances. Emerging evidence suggests that PFS may involve disruption of sex steroid homeostasis, neuroactive steroid deficiency (notably allopregnanolone, ALLO), and gut–brain axis alterations. Objective: This study aimed to investigate the effects of finasteride withdrawal (FW) in a rat model and evaluate the potential protective effects of ALLO on gut and hypothalamic inflammation. Methods: Adult male <i>Sprague Dawley</i> rats were treated with finasteride for 20 days, followed by one month of drug withdrawal. A subgroup received ALLO treatment during the withdrawal. Histological, molecular, and biochemical analyses were performed on the colon and hypothalamus. Gut microbiota-derived metabolites and markers of neuroinflammation and blood–brain barrier (BBB) integrity were also assessed. Results: At FW, rats exhibited significant colonic inflammation, including a 4.3-fold increase in Mφ1 levels (<i>p</i> < 0.001), a 2.31-fold decrease in butyrate concentration (<i>p</i> < 0.01), and elevated hypothalamic GFAP and Iba-1 protein expression (+360%, <i>p</i> < 0.01 and +100%, <i>p</i> < 0.01, respectively). ALLO treatment rescued these parameters in both the colon and hypothalamus but only partially restored mucosal and BBB structural integrity, as well as the NF-κB/PPARγ pathway. Conclusions: This preclinical study shows that FW causes inflammation in both the gut and hypothalamus in rats. ALLO treatment helped reduce several of these effects. These results suggest ALLO could have a protective role and have potential as a treatment for PFS patients.https://www.mdpi.com/2218-273X/15/7/1044intestinal macrophagesNF-κBPPAR-αPPAR-γacetatebutyrate
spellingShingle Silvia Diviccaro
Roberto Oleari
Federica Amoruso
Fabrizio Fontana
Lucia Cioffi
Gabriela Chrostek
Vera Abenante
Jacopo Troisi
Anna Cariboni
Silvia Giatti
Roberto Cosimo Melcangi
Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model
Biomolecules
intestinal macrophages
NF-κB
PPAR-α
PPAR-γ
acetate
butyrate
title Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model
title_full Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model
title_fullStr Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model
title_full_unstemmed Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model
title_short Exploration of the Possible Relationships Between Gut and Hypothalamic Inflammation and Allopregnanolone: Preclinical Findings in a Post-Finasteride Rat Model
title_sort exploration of the possible relationships between gut and hypothalamic inflammation and allopregnanolone preclinical findings in a post finasteride rat model
topic intestinal macrophages
NF-κB
PPAR-α
PPAR-γ
acetate
butyrate
url https://www.mdpi.com/2218-273X/15/7/1044
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