Ann Dermatol. 2013 Feb;25(1):12-6. doi: 10.5021/ad.2013.25.1.12. Epub 2013 Feb 14.

Combination therapy with cyclosporine and psoralen plus ultraviolet a in the patients with severe alopecia areata: a retrospective study with a self-controlled design.

Park KY, Jang WS, Son IP, Choi SY, Lee MY, Kim BJ, Kim MN, Ro BI.

Source

Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND:

Alopecia areata (AA) is believed to be an organ-specific autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no definitive therapy for AA.

OBJECTIVE:

We sought to determine whether the combination therapy of cyclosporine and psoralen plus ultraviolet A (PUVA) could be an effective treatment for severe AA.

METHODS:

A total of 41 patients with severe AA were treated with oral cyclosporine and topical PUVA. Cyclosporine was given at an initial daily dose of 200 mg for adult and 100 mg for children for periods of up to 16 weeks. Eight-methoxypsoralen (Methoxsalen) was applied topically 20 minutes prior to ultraviolet A (UVA) exposure, and the patients were irradiated with UVA twice a week for 16 weeks.

RESULTS:

Of the total 41 patients, 2 (7.3%) patients were lost to follow-up, and 1 (2.4%) patient discontinued the treatment due to abdominal discomfort. Six (14.6%) patients were treated for less than 12 weeks. Of remaining 32 patients, 3 (9.4%) showed excellent response, 3 (9.4%) showed good response, 12 (37.5%) showed fair response, and 14 (43.7%) showed poor response.

CONCLUSION:

Although limited by its uncontrolled character, this study shows that the combination therapy with cyclosporine and PUVA may be an additional choice for severe and recalcitrant AA.

Organic semiconductors are an imnportan area of Dr Proctor’s research

Organic Semiconductors

Eur J Dermatol. 2013 Feb 18

Oxidative stress and autoimmune skin disease.

Shah AA, Sinha AA.

Abstract

Antioxidants play the important role in our body of neutralizing free radicals and peroxides that are formed during normal physiologic events. While these reactive oxygen species are necessary for numerous biological processes, when created in excess they can have deleterious effects. The skin as an organ is constantly under attack by reactive oxygen species from both endogenous and exogenous sources. The pathophysiology of many autoimmune diseases is unknown and recently oxidative stress has come to light as a possible triggering mechanism. Recent investigations attempting to link autoimmune skin diseases and oxidative stress have had varying degrees of success. In this article, we review the current literature regarding antioxidants in alopecia areata, pemphigus vulgaris and other blistering diseases, vitiligo, and psoriasis, and suggest possible future studies and treatment options.

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J Pharm Sci. 2013 Feb 28. doi: 10.1002/jps.23485. [Epub ahead of print]

Iontophoresis-targeted, follicular delivery of minoxidil sulfate for the treatment of alopecia.

Gelfuso GM, et al

Abstract

Although minoxidil (MX) is a drug known to stimulate hair growth, the treatment of androgenic alopecia could be improved by delivery strategies that would favor drug accumulation into the hair follicles. This work investigated in vitro the potential of iontophoresis to achieve this objective using MX sulfate (MXS), a more water-soluble derivative of MX. Passive delivery of MXS was first determined from an ethanol-water solution and from a thermosensitive gel. The latter formulation resulted in greater accumulation of MXS in the stratum corneum (skin’s outermost layer) and hair follicles and an overall decrease in absorption through the skin. Anodal iontophoresis of MXS from the same gel formulation was then investigated at pH 3.5 and pH 5.5. Compared with passive delivery, iontophoresis increased the amount of drug reaching the follicular infundibula from 120 to 600 ng per follicle. In addition, drug recovery from follicular casts was threefold higher following iontophoresis at pH 5.5 compared with that at pH 3.5. Preliminary in vivo experiments in rats confirmed that iontophoretic delivery of MXS facilitated drug accumulation in hair follicles. Overall, therefore, iontophoresis successfully and significantly enhanced follicular delivery of MX suggesting a useful opportunity for the improved treatment of hair loss.

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Hair Loss treatment at the Proctor Clinic.

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Dr Proctor: Being able to induce the growth and regrowth of Hair follicles is the ultimate goal of hair loss treatment research. This paper represents a step in this direction.

Regen Med. 2009;4:667

Hair follicle neogenesis induced by cultured human scalp dermal papilla cells.
Qiao J,-et al

AIM: To develop a method by which human hair follicle dermal papilla (DP) cells can be expanded in vitro while preserving their hair-regrowth potential for use in follicular cell implantation, a cellular therapy for the treatment of hair loss. DP cells were isolated from scalp hair follicles in biopsies from human donors. DP cell cultures were established under conditions that preserved their hair-inductive potential and allowed for significant expansion. The hair-inductive potential of cells cultured for approximately 36 doublings was tested in an in vivo flap-graft model. In some experiments, DiI was used to label cells prior to grafting. RESULTS: Under the culture conditions developed, cultures established from numerous donors reproducibly resulted in an expansion that averaged approximately five population doublings per passage. Furthermore, the cells consistently induced hair formation in an in vivo graft assay. Grafted DP cells appeared in DP structures of newly formed hairs, as well as in the dermal sheath and in the dermis surrounding follicles. Induced hair follicles persisted and regrew after being plucked 11 months after grafting. A process for the propagation of human DP cells has been developed that provides significant expansion of cells and maintenance of their hair-regrowth inductive capability, overcoming a major technical obstacle in the development of follicular cell implantation as a treatment for hair loss.

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Dr Proctor comments: Substance P is released by capciacin, the active ingredeiont in peppers.

Am J Pathol. 2003 Mar;162(3):803-14.

Title: Stress inhibits hair growth in mice by induction of premature catagen development and deleterious perifollicular inflammatory events via neuropeptide substance P-dependent pathways.

Arck PC, et al

Department of Internal Medicine, Charite School of Medicine, Humboldt University, Berlin, Germany.

Comment in:

Am J Pathol. 2003 Mar;162(3):709-12.

Abstract

It has been much disputed whether or not stress can cause hair loss (telogen effluvium) in a clinically relevant manner. Despite the paramount psychosocial importance of hair in human society, this central, yet enigmatic and controversial problem of clinically applied stress research has not been systematically studied in appropriate animal models. We now show that psychoemotional stress indeed alters actual hair follicle (HF) cycling in vivo, ie, prematurely terminates the normal duration of active hair growth (anagen) in mice. Further, inflammatory events deleterious to the HF are present in the HF environment of stressed mice (perifollicular macrophage cluster, excessive mast cell activation). This provides the first solid pathophysiological mechanism for how stress may actually cause telogen effluvium, ie, by hair cycle manipulation and neuroimmunological events that combine to terminate anagen. Furthermore, we show that most of these hair growth-inhibitory effects of stress can be reproduced by the proteotypic stress-related neuropeptide substance P in nonstressed mice, and can be counteracted effectively by co-administration of a specific substance P receptor antagonist in stressed mice. This offers the first convincing rationale how stress-induced hair loss in men may be pharmacologically managed effectively.

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This paper relates to hair loss treatment using laser light–I have modified it slghtly for hair-loss blog use. Dr Proctor

Tsitologiia. 2010;52(3):204-10.

[Reparative regeneration of rat skin under influence of hollow cathode lamp (HCL) with manganese and copper line spectrum emission]

Mel’nikova VI, Izvol’skaia MS, Voronova SN, Sharipova MM, Rukin EM, Zakharova LA.

Abstract
Influence of local light exposure by hollow cathode lamp with typical manganese and copper (HCL-Mn, Cu) line emission spectrum on posttraumatic regeneration rate of rat skin has been investigated. We performed the comparative analysis of the morphology and the differentiation ability of rat skin on the 15th and 24th days after full-thickness skin wound had been inflicted on rat dorsums. On the 15th day after injury, the experimental group (daily 30 s exposure for two weeks) showed scab loss, re-epithelialization, and hair regrowth, in contrast to the control rats, where scabs were still observed on the 24th day. Histological analysis revealed that in contrast to the control group the treatment with HCL-Mn, Cu resulted in the increased number of hair follicles and sebaceous glands, the decreased number of blood vessels and horizontal orientation of collagen fibers. The immunohistochemistry for OX-62 revealed that the number of dermal dendritic cells in the experimental groups was maximal on the 15th day, and then decreased to the 24th day after injury. The number of dermal dendritic cells was significantly lower in the control group. The immunohistochemistry for pan-keratins in the control animals revealed a high number of cells expressing different types of keratins, distributed in the main part of the epidermis on the 15th day after surgery, whereas in the experimental group the number of such cells was significantly lower and the cells were concentrated more close to the external part of the epidermis. The number of cells stained for keratin 19 was higher in the experimental group on the 15th day after surgery, whereas this number decreased in this group on the 24th day after surgery as compared to the control group. Thus, typical manganese and copper line spectrum emission emitted by hollow cathode lamp stimulates innate immunity, accelerates restoration of derma, skin epithelium and other skin derivates, and stimulates wound healing in general.

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