hair loss

Cyclosporine for Hair Loss Revisited

Angela christiano alopecia., During the past many years, the single biggest breakthrough in hair loss treatment options has been in the form of Janus Kinase (JAK) inhibitors curing alopecia areata (AA), alopecia totalis and alopecia universalis in most test individuals. You can find several posts on that subject on this blog if you browse via the categories menu.

Although JAK inhibitors seem to be close to a remedy for a majority of patients suffering from alopecia areate (as nicely as from several other autoimmune connected problems such as vitiligo,  psoriasis and rheumatoid arthritis), their impact on sufferers with androgenetic alopecia (aka male pattern hair loss, which is by far and away the dominant range of hair loss in humans) is unproven and controversial to place it mildly. A US primarily based business named Aclaris Therapeutics (based on the perform of Dr. Angela Christiano) has claimed that there is a great opportunity that specialized covalently bound topical JAK inhibitors will remedy androgenetic alopecia (AGA) in many individuals (oral JAK inhibitors do not function for AGA but do operate for AA). The implication is that male pattern hair loss may possibly have a significant autoimmune element to it, a conclusion that it appears is not supported by many hair loss researchers. It is also achievable that topical JAK inhibitors could be assisting hair growth through a entirely different mechanism unrelated to the immune system.

Cyclosporine A and Hair Development

Some time ago, I described a study that showed oral cyclosporine A (also referred to as ciclosporin A or as CyA) to benefit scalp hair development in some males with androgenetic alopecia. I believed it substantial that effectively just before JAK inhibitors came on to the scene, there was already a drug int the kind of cyclosporine that targeted the immune system and that seemed to advantage scalp hair growth in some individuals. Even so, numerous bloggers pointed out that topical cyclosporine experiments by some hair loss sufferers did not look to lead to any decent benefits insofar as scalp hair regrowth goes. Moreover, the impact of JAK inhibitors versus that of cyclosporine is very various (a lot more on that additional beneath), and the past research linking cyclosporine and hair growth are somewhat ambiguous (a lot more on that additional beneath). I as a result decided to relegate cyclosporine to the backburner for a future post and forgot about it until….

RiverTown Therapeutics’ new Site

The biggest news in the hair loss planet this month has been RiverTown Therapeutics’ new site. I have typically not been also keen about this business even even though I have pointed out them several occasions in my weblog posts this year.

My two greatest reasons for becoming pessimistic about RiverTown are the information that:

  1. Minoxidil by itself can give wonderful final results in terms of hair development in some people (so their Minoxidil containing RT1640 item could just be glorified Minoxidil). And a organization named Follica (US) has already tried a wounding plus Minoxidil strategy that is most likely superior to just Minoxidil.
  2. RiverTown has not even conducted phase 1 clinical trials for RT1640 at present per their item pipeline web page, and by the time all 3 clinical trials are concluded, we could really properly have a couple of more superior treatments on the market place (Follica, Histogen, Tsuji, Shiseido and far more).

Adding to my skepticism about RiverTown are little information such as its actual property page still saying “under construction” as of today, and the CEO’s Linkedin profile not even having RiverTown listed in there (I thought it was there in the past?).

Getting stated that, I was pleased to learn that the respected hair loss researchers Dr. Elaine Fuchs and Dr. Maria Hordinsky (the former has been talked about on this weblog many occasions before) are each on RiverTown’s scientific advisory board. In addition, HLT forum member “Xaser94” produced an outstanding discovery that should have attracted far much more focus: RiverTown’s CEO David Weinstein was previously linked with a business named GliaMed, and they had a product known as GM1485 that by no means came to market place, but that supposedly (in animals) promoted “the regeneration of all elements of the skin following injury, including nerves, hair follicles, blood vessels, dermis and epidermis with minimal scarring”. Encouraging.

Hopefully the truth that last week the US House of Representative overwhelmingly supported the passage of the 21st Century Cures Act will assist RiverTown and other firms in the hair loss globe bring forth their goods to market drastically faster, without having getting to move to Japan.

In any occasion, receiving back to the topic matter of this post, the reason I mention RiverTown is since the new internet site clarifies that the company’s RT1640 hair loss item includes three components, one particular of which is cyclosporine A:

  • Minoxidil (currently FDA authorized).
  • Cyclosporine A (already FDA authorized).
  • RT175 (a proprietary chemical entity created by a single of Rivertown’s co-founders that has been tested in 600 humans).

Cyclosporine A and Hair Loss Studies from the Previous

So now I had to appear up all the previous studies that mention Cyclosporine and hair in the identical page. Below is a chronological list of the most crucial such research, with my notes in blue.

  • Cyclosporine and Male-Pattern Alopecia, 1987 (US). Just 1 patient, but a very positive outcome with new hair growth in the temporal region of the scalp when on cyclosporine, which then went away when off the drug. An exciting quote: “Hypertrichosis has been reported to happen in 60% of kidney transplant recipients treated with cyclosporine”. Hypertrichosis means excessive physique hair. If anything can grow new body hair (or convert vellus body hair to terminal body hair), it is certainly not out of the realm that it can also grow new scalp hair? It ought to be noted, nevertheless, that cyclosporin may possibly be increasing DHT levels and that could be escalating physique hair.
  • Topical Cyclosporine in Male Pattern Alopecia, 1990 (Israel — from the prestigious Technion University). The now deceased forum member Bryan pasted the whole study for is on HLH. two out of 8 human subjects who suffered from AGA saw significant growth when on topical cyclosporine for four months. One 1 of these 2 saw cosmetically evident development. Exact same authors have yet another study from 1988 based on transplanted human hair onto mice, and they concluded that cyclosporine A may be effective in the remedy of alopecia.
  • Effects of Cyclosporin A on Hair, 1994 (Germany). A very exciting statement in “One of the most typical dermatological side effects of oral CyA is dose-dependent hypertrichosis”. It seems like CyA causes new physique hair to develop from vellus hair. Also, the conclusion is that oral application of CyA proved profitable in treating AA as nicely as AGA (!). Nevertheless, the topical application failed to treat either condition.
  • Hair Development-Stimulating Effects of Cyclosporin A and FK506, Potent Immunosuppressants,  1994 (Japan). A bit confusing in that they look to discuss physique hair and scalp hair alternately. In any case, they state that “the hair development stimulating impact of CsA is observed not only in regular but also in pathological conditions of hair development, i.e. in sufferers with alopecia areata and also in some patients with male-pattern alopecia“.

Cyclosporine A Versus JAK inhibitors

angela christiano alopecia

Whilst cyclosporine A and JAK inhibitors both have immunosuppressive properties, their mechanism of action is various.

According to the earlier talked about Japanese study, cyclosporine A inhibits T-cell activation by “interfering with the production of interleukin-two (IL-two) by inhibiting IL-two gene expression, probably through the inhibition of calcineurin, a Ca2+/calmodulin-dependent phosphatase”. A bit tough but not impossible to realize. Cyclosporine is used for a quantity of inflammatory skin conditions, specially psoriasis.

JAK inhibitors are a type of medication that inhibit the activity of 1 or more of the Janus kinase household of enzymes (JAK1, JAK2, JAK3, TYK2). In the procedure, they interfere with the crucial JAK-STAT signaling pathway. Aclaris is working on a  topical covalently binding, very selective JAK3 inhibitor to cure AGA.

I hope the 5 or so scientifically very astute commentators that we have had on this weblog to date can additional compare and go over JAK inhibitors versus CsA, since my expertise in this area is very restricted.

My Hypothesis

More than the years, I have read quite a few on the internet forum posts from folks stating that when they began losing their hair, they also started getting a lot of scalp itching (largely in the very same places exactly where they have been also experiencing hair loss). I have witnessed the exact same phenomenon on my own scalp and use Nizoral to tackle the difficulty anytime it arises.

This has led me to wonder no matter whether men and women who have male pattern hair loss combined with a lot of connected itching, inflammation and dandruff also have an autoimmune component to their hair loss? Maybe males with male pattern hair loss can be divided into two broad categories: these with an autoimmune element to their hair loss (and itchy scalps), and those without any autoimmune component (and regular scalps with no itching) ? The reality that both the immunosuppressive drugs CsA and JAK inhibitors can help some males with male pattern hair loss makes this hypothesis much less far fetched than it might have originally seemed in my opinion.

The Finish of Hair Loss and Balding by 2020

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