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Kenogen: A New Phase of the Hair Cycle?

Earlier this month, an interesting new study was published in the Experimental Dermatology journal by UK based scientists. The title of this study was “Hair regrowth in male and female pattern hair loss does not involve the conversion of vellus hair to terminal hair“.

Basically, the scientists found that when medications such as minoxidil, finasteride and anti-androgens were used to treat hair loss patients (both men and women), the resulting hair regrowth was almost entirely attributable to the reactivation of dormant non-vellus hair follicles (termed as “kenogen” hair follicles) rather than the conversion of fine miniaturized vellus hair into thick terminal hair.

This is a very surprising finding since in both male pattern hair loss (MPHL) and female pattern hair loss (FPHL), terminal hair miniaturizes via shorter and shorter growth cycles and finally becomes vellus almost invisible fine hair. I am pretty certain that it has long been assumed that hair loss medications cause some of these vellus hair to become terminal hair once again (if I have time later this week, I will try to find studies in support of such a theory). However, this latest study suggests something entirely different by concluding that:

We would propose there is a population of growth restricted (dormant/kenogen) non-vellus hair follicles, which are re-activated by effective medical treatments as an explanation for the increased hair growth observed in FPHL and MPHL. Our findings have a fundamental impact on the pathophysiology of hair changes occurring in patterned hair loss.

Hair Follicle Growth Cycle and Phases

We have all heard of the three main phases of the hair follicle growth cycle in anagen (growth), catagen (transition/regression) and telogen (resting). There is also a lesser known phase called exogen, which is when hair follicles undergo shedding

However, I had never heard of this new kenogen phase before. A basic google search showed that while this phase is almost never mentioned in literature, it was discovered as early as in 2002 when a study titled “Kenogen. A new phase of the hair cycle?” was published in Italy.

I am not sure if just several studies on this are sufficient to make any conclusions, but it is hard to believe that there could be some follicles in a dormant state that were previously unaccounted for and that are being reactivated by hair loss medications.

Brief Items of Interest, January 2017

Hair loss news first:

— Replicel’s CEO provided a detailed 2017 forecast, and this was followed up by the release of an important PowerPoint presentation in which the company summarized 6-month results of their RCH-01 product (Note: they also mention finalizing 5-year safety data in the first quarter of 2017, which makes sense since they started initial clinical trials in 2012). Key current finding: “mean change in total hair density at 6-months = 6.1% vs 5.0% target“. 70 percent of responders saw a 14.3% average increase in density at 6-months. While they did not mention 12-month RCH-01 results, they do point out 12-month results from Finasteride (7-14% increase in hair density) and Minoxidil (8-16% increase in hair density) for comparison. Also of note, Replicel partner Shiseido’s Japanese clinical research findings are expected in 2018 along with a potential product launch in the same year.

— Aclaris Therapeutics made yet another presentation (pdf downloadable from their press releases page — I did not listen to the webcast), this time at the 35th Annual JP Morgan Healthcare Conference. At the end of the report they mention that pre-clincial development is now underway for their topical ATI-50003 selective covalently binding JAK 3 inhibitor to treat androgenetic alopecia. However, nothing in the report mentions when they aim to start phase 1 clinical trials. I hope it will be before the end of 2017.

— Follicum announced patent approvals in Russia and in Japan. The company had earlier also announced that they were scheduled to complete the multiple dose part of their clinical phase I/IIa study in January 2017 at the prestigious Charité University Hospital in Berlin.

— Judging from the latest update from Fidia Farmaceutici (Italy), The Dr. Brotzu lotion will not come out as early as some people expected, and a lot of people on the forums got mad (but a few took it as a positive sign that Fidia is finally releasing dates even if ambiguous i.e., “development of the potential product candidate being completed by 2018“). Ever since I first wrote about Dr. Brotzu, I have not paid much attention to this product, but if you are inclined, go through the last 50 or so pages of this record breaking HLT thread and check out the various Italian hair loss forums out there.

— Also from Italy, some kind of PRP plus insulin type of treatment (hard to tell for sure after translation).

— Researchers identify how skin cells become hairy or sweaty during the embryonic stage of development. Actual study.

This guy got a hairpiece and over 2 million youtube views in the process. He is probably someone famous, but I did not feel like doing any background research or even watching most of the video.

And now on to medical items of interest:

— From a team led by the most famous hair loss researcher in the world Dr. George Cotsarelis (who has been at it for at least 20 years), comes a new study on how to heal wounds without leaving any residual scars. Key quote from Dr. Cotsarelis: “Essentially, we can manipulate wound healing so that it leads to skin regeneration rather than scarring. The secret is to regenerate hair follicles first. After that, the fat will regenerate in response to the signals from those follicles”. I have discussed the link between fat cells and hair cells many times on this blog, including in the last post on the arrector pili muscle. These latest findings were widely covered by the global media, with headlines such as “The End of Scars“. The Reddit thread on this blew up. However, as with all things Cotsarelis, headline grabbing findings, but one always gets the feeling that practical use will be at least a decade away unless other labs get in on the action.

Babies born without mothers (via embryos made from male skin cells) will come sooner than expected warn scientists. Surreal.

Designer babies: an ethical horror waiting to happen? I am all for it even if it turns out horrific.

Alzheimer’s drug “tideglusib” helps rotten teeth regenerate, reducing the need for fillings.

— Chinese company implants 3D prints blood vessels into monkeys.