Dr Ken Washenik - Medical Director of the Aderans Research Institute.

PART 3

HAIRLOSSHELP: Are Tom Barrows and his team going to use their polymer matrix to implant these cells into the skin?

DR WASHENIK: Yes and that’s an area that’s been worked on for some time. The problem of if you are going to put cells into the skin, what are you going to put them in. And yes you need some type of matrix or scaffold to introduce the follicle progenitor into the skin. You are almost making your own hair bud, so there needs something to give cohesiveness to the cells.

HAIRLOSSHELP: Assuming that you get that going, how do you know you will get the signaling you need to get the whole process started?

DR WASHENIK: A big concern is if you have all the parts together will it work. Its almost like if you put all the parts of a car together in a garage will you have a car forming, or just a pile of parts. So everyone from a research perspective is depending on nature to fix that because right now everyone is betting that when you put these cells together in the correct way, they will know how to take care of it. If that’s not true and you have to start introducing regulatory substances, then it will be a lot more complicated and more difficult to predict which way to go. There are a lot of growth factors that have been uncovered over the years like Wnt and Beta-catenin and Lef-1 and others like Noggin and Sonic Hedgehog, which have all been implicated in hair growth. So each of these have a role in hair follicle formation but we are hoping that when you put the cells together they will decide how to start that cascade of regulatory substances that are needed.

HAIRLOSSHELP: Is there any concern of skin cancers forming from the introduction of these cells?

DR WASHENIK: The concern of skin cancers with tissue engineering comes from concerns about some of those regulatory factors. For example we know that Sonic Hedgehog expression, which is known to be important in hair follicles, is also known to be a factor in people who have a disease called Basal cell nevus syndrome. These people grow countless numbers of basal cell skin cancers and Sonic Hedgehog has been implicated in that. And then there is work being done with the Wnt pathway with Beta-catenin and Lef-1 where they show if you over express the regulatory proteins you can gets these growths called Pilomatricomas. So it would be problematic if you have to introduce regulatory molecules from outside the body because its very hard to deliver them at the right time and in the right amounts when the cells need them. That’s why the work that has been done with tissue engineered hair growth based on cellular technology assumes that you wont have to deliver those growth factors and the body will produce them in the correct fashion so there won’t be any of these concerns. How you pull that off in terms of how you package those cells may be very dependent on how those cells interact in culture with one another before you even put them into the skin.

HAIRLOSSHELP: Have they done a lot of research on what happens when you put those cells together in culture?

DR WASHENIK: Yes there have been people who have worked on that and one of the things that is being studied is if you put together fibroblasts and keratinocytes in culture what starts to happen; you know, which chemicals are being exchanged back and forth. We need to see which regulatory pathways are being initiated by these cells and could you start to get hair follicle induction in culture and a lot of that work is ongoing as we speak.

HAIRLOSSHELP: Some people have diffuse loss and some have pattern loss, who are the best candidates for this follicular neogenesis or hair cloning technology?

DR WASHENIK: Early on, the way this has been looked at is a system that’s called autologous where you take cells from one person, culture them, and put them back into the same person. In that case it probably won’t have any use for patients with alopecia areata, alopecia universalis and alopecia totalis because that’s an immune system disease and not a disease of the hair. But for people with scars or androgenetic alopecia or people with congenital lack of hair, burn victims; people who just have areas where they cant grow hair, it should work fine for all those. In fact it would even work for people who don’t even have a medical condition and just want more dense and thicker hair.

The dilemma however, with diffuse loss is that you may select cells from the back of the head that may still be subject to thinning. However it’s not necessarily that bad because you may just be able to buy them some additional years of hair even if it’s not permanent. Its often 20 years before you go bald from puberty, so these people may still he able to benefit for a long time.

Continue to Part 4