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

PART 2

HAIRLOSSHELP: When was this procedure done and was it performed on one of their staff members?

DR WASHENIK: No this was a patient and it was done just over a year ago.

HAIRLOSSHELP: Have they been following the progression of this hair since this time?

DR WASHENIK: No, the hair is gone. It was cut out and analyzed because of the need for information so it was studied and not left in the patient to grow.

HAIRLOSSHELP: Would it not be important to leave it in the patient's head to see if it will cycle?

DR WASHENIK: Absolutely. There is no doubt that the next step is to let hair continue to grow. When it becomes routine to grow hair you won't be so excited that you will want to remove the follicle and study it. In the future it should happen in such a consistent fashion that you could take half of the new follicles out and leave the rest in and watch the hairs to see if they cycle. The big question is what will happen after the 3-year cycle of anagen, catagen and telogen, will it then go back into anagen again.

HAIRLOSSHELP: In that experiment, what cells were used as the progenitor of the hair follicle?

DR WASHENIK: The cells in that experiment were dermal papilla cells or dermal follicular fibroblasts.

HAIRLOSSHELP: Is that what they are using now in the current research?

DR WASHENIK: The current work involves looking at a number of different cell types and combinations of cell types as opposed to just picking one set of cell types. We are looking at what will most consistently grow hair as opposed to what will once in a while grow hair.

HAIRLOSSHELP: Is it your personal opinion that it’s a combination or cocktail of cells that will work best?

DR WASHENIK: Yes, I think there has to be an exchange between the cells. What we are really trying to do it to duplicate what happens when hair follicles are first created in a fetus. And that happens as a result of an interaction or exchange of cytokines, or chemicals, between different cells. So chemicals are exchanged between keratinocytes in the epidermis and the fibroblasts in the dermis. They communicate back and forth and several of those molecules have been identified and several have not. And how you deliver those is a problem.

Most likely you are going to have to get those keratinocytes and fibroblasts to communicate. So what’s the most sensible way? One of the ways is getting those cells together to see how much or what percentage you need of each of them. The other possibility is can you introduce a pure population, like in this case the fibroblasts of the dermal papilla and have it communicate with keratinocytes that are already there. And that’s what needs to be better studied. You may need to place both together, or you may just need to have one so it can communicate with the cells already in your skin.

HAIRLOSSHELP: At what point in the development of the fetus does the development of the hair follicle take place? And I know it’s a controversial idea, but is there any way you can learn something from studying fetuses themselves?

DR WASHENIK: (Laughs) Its more than controversial, it just cannot be done. It’s very early in the pregnancy. And there is just no way it can be done. But we should not need to; we should be able to learn all we need from cell culture in a laboratory.

HAIRLOSSHELP: I just thought that if they could examine the tissue at the appropriate time of follicle formation, they could tell exactly what was going on instead of just speculating.

DR WASHENIK: Well that was actually done years and years ago by studying fetuses that died at different time points so they pretty much know the morphology, the histology and the anatomy of what’s happening. The thing that you can’t tell is what chemical exchange is going on. If you look at dermatology textbooks the follicle formation is really well documented. Its starts out where there is nothing, just flat skin, and then what you have next is a condensation of cells in the dermis which is really just a vague gathering of cells just under the flat epidermis in what we call the ectoderm. So that’s called the dermal condensation and that’s the very beginning of the dermal papilla. And when that starts, its like the chicken and egg scenario because no one is sure if the epidermis dictates the formation of the condensation, or of the condensation just occurs on its own and then starts to dictate to the epidermis. But the first thing you can see morphologically in the formation of a hair follicles is the condensation. Then you get what’s called the bud formation which is just a downgrowth of skin which is called the hair peg. This is a very early finger-like indentation in the epidermis which grows down towards this condensation of fibroblasts, and then that combines and gradually matures into the dermal papilla and the hair follicle.

Continue to Part 3