I have rarely discussed hair follicle keratinocytes on this blog. However, a new study published by EpiBiotech CEO Jong-Hyuk Sung in collaboration with researchers from Seoul National University College of Pharmacy has given me the opportunity.
Keratinocytes of the Hair Follicles and Skin
The new December 2024 study (that is not yet available in full) is titled:
“Differential expression of androgen receptor and 5-α reductase isoforms in skin cells“.
A summary of its findings can be read here (h/t “Ben”). Interestingly, an older 2014 study that I came across while writing this post is titled: “Differential expression of 5-alpha reductase isozymes in the prostate and its clinical implications.”
The researchers used single-cell RNA sequencing technology to identify the expression sites of androgen receptors and 5-α reductase in human and mouse skin cells. They analyzed all three isozymes of 5α-reductase (encoded by the genes SRD5A1, SRD5A2, and SRD5A3). Past research has found that SRD5A2 is not expressed in the skin and hair follicles.
The study confirms that dihydrotestosterone (DHT) biosynthesis (the cause of pattern hair loss) is produced in the keratinocytes of skin and hair follicles. And not in dermal papilla cells (or dermal sheath cup cells) which are the main focus of hair multiplication research.
EpiBiotech CEO Seong-Hyeok Sung said:
“This study suggests a new mechanism for androgenetic alopecia treatment and opens up the possibility of a new approach targeting hair follicle keratinocytes, moving away from the existing dermal papilla cell-centered treatment method.”
Considering the diverse range of hair loss treatments and research that Epibiotech is focusing on (in a rapid manner), I am reluctant to put too much stock into their findings as yet.
Past Discussions of Keratinocytes on this Blog
When I started writing this post, I did a search of the past mentions of keratinocytes on this blog. Lo and behold, I found something unusual right off the bat.
- In my 2020 update to an old post on research from Dr. Jeff Bernaskie’s team from the University of Calgary, I came across the following text from this source:
“For decades, researchers studying aging and hair loss have focused on keratinocytes, the cells that make up the bulk of the hair follicle and eventually give rise to the hair fibre. But a study from the University of Calgary Faculty of Veterinary Medicine (UCVM) has found that it’s actually a small population of specialized cells within the hair follicle called fibroblasts, and the dermal stem cells that maintain them, that may cause hair loss.”
This says the opposite of what Jong-Hyuk Sung said in regards to the lack of importance given to keratinocytes in the past. My personal feeling is that Mr. Sung is correct and the importance given to keratinocytes has been less than that given to dermal stem cells. However, Dr. Bernaskie is a highly respected researcher, and perhaps the above pasted statement is not a direct quote from him.
- In my 2017 interview with Stemson Therapeutics co-founder Dr. Alexey Terskikh, he said the following:
“Then DP cells will be mixed with keratinocytes within a specialized matrix scaffold and transplanted back into the same patient’s skin.”
- When discussing fibroblast growth factors in past posts, I have noted that FGF7 (also called keratinocyte growth factor, or KGF) is required for hair growth. The much discussed and maligned Histogen (no longer active) was developing a Hair Stimulating Complex that included KGF as a key ingredient.
After understanding the content of this study, I have reached the same conclusion as you, administrator. It is a very interesting study, but it is not something new. That is, the mechanisms of action that are currently developing do not interfere with the fact that androgen receptors are found in keratinocytes, that is, although the cells of the dermal papilla do not contain androgen receptors, these cells are. genetically programmed to be affected by DHT in the case of those affected by alopecia, and the opposite in those of the donor area. Therefore, after understanding it, I believe that the Shiseido or Hairclone method does work…, in which cells from the dermal papilla of the donor area would be transplanted, they would not be affected by DHT because there would be no interaction between the keratinocytes and DP or DSC cells. I don’t know if I explain myself.
Just give up on this. It’s not going to help you.
I found that testosterone and DHT showed similar effects in inducing androgenic alopecia. Therefore, I was curious about where DHT comes from surrounding hair follicle.
5-alpha reductase is not expressed in DPC and DSCs, but AR is expressed in mesenchymal part of hair follicle. In addition, type2 5-alpha reductase is not expressed in hair.
Is this really Mr. CEO?!
Hello Mr. CEO – could you give us a comprehensive update of your companies‘ plans? Trials? Antibodies?
Would be great to hear from you – your company was founded 10 years ago and sometimes Epibiotech seems to become obscure and lost in translation.
His company was developing a technique for multiplying and injecting cells from the dermal papilla of the donor area. How would its discovery affect the effectiveness of this technique? Do you think that after making an injection of this type in the hair miniaturized by alopecia, the new cells will take the place of the lost ones, making the treated follicles resistant to DHT?
I didn’t know where to post this comment. So feel free to send it somewhere else (or even the bin).
But I was wondering if someone can help answer this for me. I assume when you transplant a follicular unit from your donor area to a punch hole on top the scalp it barely leaves any scar tissue as the punch hole is filled with said punched follicular unit that fits nicely. However the punched out donor area is left to scab over and scar. Would it not make sense to take punches from an area of the body that is less of a concern to have punch hole scars and implant those punches into the donor area to reduce scarring and allowing shorter hair cuts after FUE. Or what makes even more sense to me if its do-able is to punch out body hair grafts, perhaps chest and back etc to implant into the donor area tp lesson the thinning effect but also increase healing times and reduce scarring. The added bonus being the body hair grafts would give a much better look on a grade 0-2mm grade cut than punch hole scars.
I just dont understand why this isnt the norm, its certainly possible.
Unfortunately, I can’t shift comments between posts.
Will keep it here, but would be better suited in a past hair transplant or body hair transplant related post.
Any thoughts on my question? I would think the process might even allow you to take a higher graft yield from the donor considering there would be less scarring and the body hair grafts would be negligable on a 0-2mm grade cut. Even a 10% graft yield would be positive. In reality in order to have a decent hair transplant as a NW5-6 you need minimum 9,000 grafts but more likely 12,000. It’s possible even in hair butcher clinics to get 6,000 from the donor with scarred puncture holes and we’ve all seen certain surgeons doing 11-12k even without using beard hair. I like a grade 0-1 on the sides and back with it long ontop which now I cant as I’m somewhere between NW5-6 but if implanting into the donor area puncture holes was feasible then even I could return to my old hairstyle. I have a good donor and plenty of beard grafts to draw upon but can’t commit to a HT if I can’t get 9k or upwards grafts. Has anyone ever tried this strategy for reduced donor scarring? It would be as good as a cure for most people. Hypothetically speaking I think most people would relocate 100% of their donor if it was possible, I certainly would.
is your original question related to body hair transplants to the head?
Beard hair is the most suitable, and it seems like most graft extraction scars in the beard area seem negligible. which pleasantly surprises me.
It is a very popular choice in India, but I would still be wary of scarring.
Sorry if I’m not clear I can often over labour a point let me break it down.
A hole gets punched in the bald scalp and a graft from the donor gets pushed inside the punch hole, this area has no visible and possibly minimal microscopic scarring? As the new graft fills the punch hole. However the punch hole in the donor area scars.
Therefore it makes sense to use an FUT method somewhere on the body to create a small linear scar somewhere less noticeable for example the back of the calf maybe and then punch skin grafts from this FUT strip to place inside the punch holes in the donor area, this way the scarring will potentially be drastically reduced allowing you to draw upon more grafts from the donor area over multiple surgeries as there is less scarring to fuse together. It would also be more suitable for people who prefer a low grade cut and also you have the benefit of implanting body hairs into the donor area punches so that if you have a grade 1 or 2 on the back and sides the body hair would contribute some stubble to this cut and improve appearance.
It would also improve a hair transplant clinics capital so seems a win win to me?
FUE donor area to balding scalp
FUT body hair to punch holes in donor area = drastically reduced scarring + overall hair count increase great for low grade cuts (of course its not scalp hair so will stay short) but I would move 100% of my donor to my top scalp if it was possible and I’d be happy with chest hair around my entire donor as I’d just shave it on a grade 1 anyway. An exaggerated example as 100% of course wouldn’t be possible but I believe a higher percentage is possible than we’re currently achieving.
Interesting thought Viking. Now I understand.
Most likely, the better surgeons have not had too many patients with really bad donor area scarring, but this idea is still worth considering.
The only issue with body hair is that most types do not do well on the scalp (and it would not change even if moved to the donor area). The body hair life cycle, texture, length, curl etc… are all different from scalp hair. Perhaps keeping a very short cut would solve some of those issues.
I would happily settle for a low grade cut for the rest of my life considering I’m currently a grade 0 all over and getting fed up with shaving every single morning (facepalm) the question I thought was if AA only effected the sides and back of the head and the top of your scalp was immune, would that be worse or better. I personally would be fine with it and everyone has enough grafts in the donor if they were all accessible even a NW7. Current hair loss researches seem to be hitting block walls to my amazement, as I understand its complicated but I would imagine in someone who’s hair is miniaturising but not dead that a reversal process shouldn’t be so evasive. I mean we see the process of miniaturisation and know how to halt it for the best part so how can it be so difficult to improve follicular health and improve hair shaft diameter and length?
If we question whats the time line for a real treatment, that would return someone who is a NW5-7 to full scalp coverage with an acceptable naturaly density and not just illusionist trickery then realistically I think we are 20 years away but I hope not. But given that its so far away, the next best step to me is to say okay we won’t be able to make net new hairs for a long time so lets improve on the amount of grafts we are able to draw upon as a 100% transfer from donor area to scalp I think would be acceptable to most men who would have no other option anyway and SMP around the donor would be fine compared to the other way around trying to fill out a thin scalp with SMP.
It would offer a real option to men that otherwise would go untreated and probably be the fastest option to a decent result, I would bet it would be do-able much much sooner than net new hairs will be and I would have it done myself. We know the scarring pathway and that verteporfin can delay scarring to some degree and as far as I’m aware verteporfin isnt very expensive. If I was working in the field I would be looking into the effects of FUE transplant with FUT skin grafts placed inside the donor punch holes (with or without body hair on them) and verteporfin used to study how much scarring is visible, I would bet on virtually nothing. If you have 20-25k grafts in your donor (about the amount for a NW6) and with modern techniques most clinics will take up to around 7,000 max over 2 surgeries. The reason you cant take more is because of the scarring but if there was no scarring at all or very minimal and you weren’t concerned for donor hair thinning then you could in theory take another 7,000 grafts. If you have a hair transplant you would know better than me, if you shave the area thats been transplanted into with a grade 0 or 1 are there any visible scars? But if you shave the donor area it doesnt matter if youve had fut or fue there will be visible scars so this seems to me to be the only hurdle to increasing graft count. Unless I’m missing something it seems painfully obvious to implant into the donor area punch hole and essentially move the scar to somewhere else on the body.
If we can find a good surgeon who’s willing to do it sign me up I will happily pay.
I just don’t understand why I haven’t heard about this being done, unless I’m missing something.
But friend, what you are talking about has been going on for more than 20 years… There are professionals who work with BHT for people who do not have enough donor area, but this publication does not correspond to the topic you are dealing with.
Yes I posted in the wrong post depending on subjectivity. I posted here because its about restoring hair follicles and I’m saying I believe restoration of existing/creating new follicles appears to be many years away probably 20 realistically so its relevant in that respect. And I’m not talking about using body hair on people who don’t have a good enough donor. What I’m suggesting is completely different, I’m suggesting implanting skin into the punch holes in the donor area to reduce scarring for a more aesthetic look on low grade haircuts and also you could utilise body hair in the donor, not the scalp, to improve this effect. The point being that reduced scarring may allow a higher graft extraction from the donor meaning even a Norwood 5-7 could achieve a good full density (50-60 cm2 grafts on the top scalp) instead of the standard 40-60 in the front and diminishing grafts to the crown leaving the patient looking like they are still profusely thinning.
As far as I’m aware I’ve never seen anyone implanting into the fresh donor punch holes, and I’ve been watching hair loss discussions for a long time including coming here I just refrained from commenting in the past.
Is there any argument against implanting into the donor punch holes? Except it costs more as it is essentially a double transplant. I’d be interested to see the results with regards to scarring/overall healing/a low grade cut such as 1mm to see if its noticeably different pot hole wise to standard FUE and if the body hair grafts benefit the overall aesthetic.