Arthritis drug spurs hair growth in man with alopecia universalis(news.yale.edu)
news.yale.edu
Arthritis drug spurs hair growth in man with alopecia universalis
http://news.yale.edu/2014/06/19/hairless-man-arthritis-drug-spurs-hair-growth-lots-it
48 comments
Immunosuppressants can have a whole load of side-effects since you're effectively nuking the body's natural defence mechanism. The ones I've used (Prednisone, for asthma and allergies) have always been in pill form which is untargetted, so whilst you may knock off the immune response causing the primary symptom, you also shut down a whole host of other systems too. This has been one of the biggest side-effects for me.
What will be interesting is whether a topical cream can perform targetted application of this - shove it on your scalp for a few months and it locally modulates the immune response to the follicles and allows for hair growth. I'm not nearly familiar enough with the medical processes behind this to know whether you can do this or whether it has to be regulated at some other location.
As an aside, the whole field of computational medical research excites me. Folding@Home and the like have been the first foray into this, but I suspect we'll see a continued rapid expansion of this as we harness huge computational capability to explore modifications to processes to discover a whole host of unknown but useful side-effects from existing medications. I suspect it's likely the next big field.
What will be interesting is whether a topical cream can perform targetted application of this - shove it on your scalp for a few months and it locally modulates the immune response to the follicles and allows for hair growth. I'm not nearly familiar enough with the medical processes behind this to know whether you can do this or whether it has to be regulated at some other location.
As an aside, the whole field of computational medical research excites me. Folding@Home and the like have been the first foray into this, but I suspect we'll see a continued rapid expansion of this as we harness huge computational capability to explore modifications to processes to discover a whole host of unknown but useful side-effects from existing medications. I suspect it's likely the next big field.
Steroids like Prednisone were the recommended course of treatment by doctors when I was first diagnosed -- a massive dose of oral steroids for months. Rheumatologists said in no uncertain terms that this was likely going to have complications and long-term health consequences. I decided it wasn't worth it for what amounts to a cosmetic change.
From what I've read, tofacitinib is a a JAK inhibitor (http://en.wikipedia.org/wiki/Janus_kinase_inhibitor), as opposed to a cortoicosteroid like Prednisone. It inhibits the activity of a very specific family of enzymes that play a part in regulation of the immune system (cytokine signalling).
It makes a ton of sense to dispense it as a topical cream to limit the potentially complex side effects. I'm also curious whether it's more or less effective for scarring vs. non-scarring alopecia, since scarring alopecia is characterized by active inflammation, and tofacitinib is supposed to be successful in reducing inflammation at the right dosage.
If someone has more background in this area, I'd appreciate more details. JAK inhibitors seem like an exciting area of research!
From what I've read, tofacitinib is a a JAK inhibitor (http://en.wikipedia.org/wiki/Janus_kinase_inhibitor), as opposed to a cortoicosteroid like Prednisone. It inhibits the activity of a very specific family of enzymes that play a part in regulation of the immune system (cytokine signalling).
It makes a ton of sense to dispense it as a topical cream to limit the potentially complex side effects. I'm also curious whether it's more or less effective for scarring vs. non-scarring alopecia, since scarring alopecia is characterized by active inflammation, and tofacitinib is supposed to be successful in reducing inflammation at the right dosage.
If someone has more background in this area, I'd appreciate more details. JAK inhibitors seem like an exciting area of research!
I'm sure that whoever is making this drug is already 10 times ahead of any of us in monetizing this for commercial hair loss applications.
I'll give it my best shot. The reason steroidal creams work is because the steroids are lipid soluble and their mechanism of action involves penetrating cell membranes and bindings to transcription factors in the cytoplasm/nucleus.
A tyrosine kinase inhibitor wouldn't be lipid soluble and therefore wouldn't be able to diffuse across the skin or into the capillaries feeding the hair follicles which is where I'm assuming the positive effect is coming from. (Turning off White Blood Cells).
I'll give it my best shot. The reason steroidal creams work is because the steroids are lipid soluble and their mechanism of action involves penetrating cell membranes and bindings to transcription factors in the cytoplasm/nucleus.
A tyrosine kinase inhibitor wouldn't be lipid soluble and therefore wouldn't be able to diffuse across the skin or into the capillaries feeding the hair follicles which is where I'm assuming the positive effect is coming from. (Turning off White Blood Cells).
Not only were there likely to be side effects of the Prednisone, it didn't really work. Only plus side, for me, was that the side effects didn't hit me hard. When I paid attention and realized there were long term consequences, I stopped.
So, good choice in not doing it. :)
So, good choice in not doing it. :)
It does look like it has some serious side effects, including an FDA blackbox warning. You can find a more readable version of this FDA product label here: http://www.iodine.com/label/xeljanz (shameless plug)
I was curious about that. Seems somewhat obvious that an immunosuppresant would work, I guess it is the potency that is impressive?
For disclosure, I don't have universalis, yet, so I'm not overly concerned with hair growth at my age. However, I do sometimes worry that I passed this on to my daughters. While I don't think alopecia is the worst thing in the world, it would ease my mind to know that my daughters might not ever even have to worry about it.
For disclosure, I don't have universalis, yet, so I'm not overly concerned with hair growth at my age. However, I do sometimes worry that I passed this on to my daughters. While I don't think alopecia is the worst thing in the world, it would ease my mind to know that my daughters might not ever even have to worry about it.
As I understand, what's exciting is that tofacitinib isn't a corticosteroid that we're used to seeing, but a JAK inhibitor -- a class of potential drugs that have a very different approach towards suppressing immune function (specifically targeting cytokine signaling.) Tofacitinib was the first JAK inhibitor to be approved by the FDA. This was a super-interesting paper from 2012 that goes into more detail on JAK inhibitors and why they're interesting: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419278/
I completely understand your concern about your daughters. I'm lucky that baldness is culturally accepted for adult men (and even encouraged), so I don't feel too self-conscious about alopecia. Hopefully we'll get a better handle on autoimmune conditions with this new class of drugs. Until then, organizations like NAAF (http://www.naaf.org/) are wonderful in helping people with alopecia cope with its medical, emotional, and psychological impact.
I completely understand your concern about your daughters. I'm lucky that baldness is culturally accepted for adult men (and even encouraged), so I don't feel too self-conscious about alopecia. Hopefully we'll get a better handle on autoimmune conditions with this new class of drugs. Until then, organizations like NAAF (http://www.naaf.org/) are wonderful in helping people with alopecia cope with its medical, emotional, and psychological impact.
Makes some sense.
Same for me on the cultural acceptance. Though, I was very hesitant to bite the bullet and shave my head completely. I just know that even for me, it was somewhat stressful to have random parts of my hair go missing. Doesn't help that I rarely look at myself in a mirror, so I wouldn't even always know when I was missing more hair. Would just get the occasional, "why did you shave right above your ear?"
Nowdays, though, it is just funny. My legs have spots where I have lost a lot of hair. Some folks assume it is because I bike. Explaining that I will likely lose all of my hair is one that I don't think most folks believe.
At any rate, if it were stressful for me, I can only imagine it would be worse for my daughters. Luckily, to date they have had absolutely none of my difficulties growing up. No allergies or anything.
Same for me on the cultural acceptance. Though, I was very hesitant to bite the bullet and shave my head completely. I just know that even for me, it was somewhat stressful to have random parts of my hair go missing. Doesn't help that I rarely look at myself in a mirror, so I wouldn't even always know when I was missing more hair. Would just get the occasional, "why did you shave right above your ear?"
Nowdays, though, it is just funny. My legs have spots where I have lost a lot of hair. Some folks assume it is because I bike. Explaining that I will likely lose all of my hair is one that I don't think most folks believe.
At any rate, if it were stressful for me, I can only imagine it would be worse for my daughters. Luckily, to date they have had absolutely none of my difficulties growing up. No allergies or anything.
I've had AU for the past 4 years, progressed from AA onset in 2006 (i think). It's good to see something in teh pipeline, but jeeze the side effects are serious. Though, I'll bet those are folks on all kinds of other meds at the same time.
I'll also be keeping a close eye on the trials... in the end, it's not worth catching skin cancer just to have to pay for haircuts again.
I'll also be keeping a close eye on the trials... in the end, it's not worth catching skin cancer just to have to pay for haircuts again.
This is for alopecia universalis - don't get your hopes up, gents!
As someone that has had alopecia aereata in the past, I will get my hopes up! There are definitely worse fates in the world than alopecia aereata, but not having people ask if I intentionally shaved a random section of my head would be nice.
I've had success mixing Rogaine foam (for blood flow) with max-strength hydrocortisone cream (for local immunosuppression) and applying 2-3x/day to the affected spot.
Best prevention I've found is to minimize stress levels, though. Haven't had any issues since I left my old job a couple years ago (used to find a new bald spot once every few months).
Best prevention I've found is to minimize stress levels, though. Haven't had any issues since I left my old job a couple years ago (used to find a new bald spot once every few months).
Not trying to be a jerk, but why don't you just intentionally shave the rest of your head?
As someone who has it, it's not that simple. Imagine a quarter sized bald spot somewhere random on your head. Maybe it goes away in a month. The next time imagine 3 dime sized spots on the edge of your hair line. It's one of those "going full bald " seems like overkill when you are so close to "normal" in most cases. Also, I can't speak for his experience but that's a lot harder when it's an eyebrow, which is my current situation... Maybe it will come back, maybe it won't.
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Shut up and give me arthritis pills :P
But you're right, if it really was this simple we would have found it..
Is it made from cat sweat?
My wife has alopecia universalis, so I'm going to get my hopes up ;)
anything for gray hair yet? :)
Several years ago (07) when resveratrol seemed to hold promise, I tried 300mg/day for a few months. I gave it up after the only benefit I noticed (ok, maybe better sleep) was that I stopped growing gray hairs.
I went prematurely gray due to being very ill. I was told that PABA (a B vitamin that often is not part of B complex supplements) and adrenal support can sometimes reverse gray hair. I am now 49. I still have some gray at the temples but I think it is less than it used to be (in my mid thirties). I took a boatload of supplements for a long time (for health reasons, not vanity -- I figured if gray hair was caused by adrenal stress and vitamin deficiency, then it was an indicator of what to treat for).
It's relatively cheap if you want to try it and see if it does anything for you.
It's relatively cheap if you want to try it and see if it does anything for you.
You have any before and after photos?
Unfortunately, not really (in part because I sort of have no old photos of myself).
I have some recent-ish photos (made in the last two to three years) on my blog. But I have located only one photo from a few years ago. It was made under very dark conditions and really does not show anything. For one thing, it is too small. A confounding factor is that my hair goes readily blonde, so I look wildly different from one photo to the next, depending on a lot of factors.
This is the only old photo of me that I know I have: http://2.bp.blogspot.com/-v4b3_qtrnP8/UvlaGATv1UI/AAAAAAAAAQ...
This should be all the posts with pics of me on my blog: http://micheleincalifornia.blogspot.com/search/label/Selfie
I have some recent-ish photos (made in the last two to three years) on my blog. But I have located only one photo from a few years ago. It was made under very dark conditions and really does not show anything. For one thing, it is too small. A confounding factor is that my hair goes readily blonde, so I look wildly different from one photo to the next, depending on a lot of factors.
This is the only old photo of me that I know I have: http://2.bp.blogspot.com/-v4b3_qtrnP8/UvlaGATv1UI/AAAAAAAAAQ...
This should be all the posts with pics of me on my blog: http://micheleincalifornia.blogspot.com/search/label/Selfie
I will additionally clarify that "gray at temples" may be misleading. It is more like on either side of my forehead, along the edge of the hairline. So the old photo of me where I kind of have bangs -- those bangs would obscure any gray hair. Newer photos where my hair is swept back would be much more inclined to reveal gray hair against the brunette -- at least in photos where I am not so blonde that you can't really tell the difference between the blonde strands and the gray ones.
Some people say astaxanthin helped them.
Can I participate as a female volunteer for this study?? Me and my "eyebrows" are up for the challenge!
You should call and ask.
http://medicine.yale.edu/dermatology/people/brett_king-2.pro...
http://medicine.yale.edu/dermatology/people/brett_king-2.pro...
Thanks, I was just about to look for this.
Still patiently waiting for a miracle in the area of male pattern baldness... That is, something other than a can of crap you sprinkle on your head. Sigh.
Actually I'm optimistic for this drug's use in regular MPB. It has been observed in the past that those on immunosupressant drugs or otherwise severely immuno-compromised do not get MPB. Another article I read mentioned that a doctor who dissected dormant hair follicles from MPB noted that it looked exactly like transplanted tissue that is being rejected in its new host.
So yes, there are many good reasons to be cautiously optimistic. Of course the side effects of an untargetted immunosuppresant drug is likely too great for general MPB, but it may lead to further research. As it stands most companies do not do research directly for drugs targetting MPB because past drugs have been market failures.
So yes, there are many good reasons to be cautiously optimistic. Of course the side effects of an untargetted immunosuppresant drug is likely too great for general MPB, but it may lead to further research. As it stands most companies do not do research directly for drugs targetting MPB because past drugs have been market failures.
I'm not optimistic at all. It cured this one type of baldness because the baldness was a symptom of the underlying autoimmunity.
If MPB were a classical autoimmunity, it would have already been "cured" (as in, an effective treatment protocol would be laid out). Instead, it seems to be some not so subtle side effect of hormonal nuclear war, and scientists have spend decades hunting down the various little side chains to the main problem.
The best hope yet for MPB seems to be PGD2 formation inhibitors or GPR44 antagonists which are still undergoing characterization. But my bet is that like DHT, PGD2 overexpression in scalps is simply yet another side effect of the greater convoluted underlying process, and that treating it directly won't be as effective as promised. (Or worse; GPR44 is implicated in some kinds of asthma as well, which means that a drug that targets the receptor might have a wider spectrum of activity -> worse side effects.)
If MPB were a classical autoimmunity, it would have already been "cured" (as in, an effective treatment protocol would be laid out). Instead, it seems to be some not so subtle side effect of hormonal nuclear war, and scientists have spend decades hunting down the various little side chains to the main problem.
The best hope yet for MPB seems to be PGD2 formation inhibitors or GPR44 antagonists which are still undergoing characterization. But my bet is that like DHT, PGD2 overexpression in scalps is simply yet another side effect of the greater convoluted underlying process, and that treating it directly won't be as effective as promised. (Or worse; GPR44 is implicated in some kinds of asthma as well, which means that a drug that targets the receptor might have a wider spectrum of activity -> worse side effects.)
Thanks for the info. My obsession with MPB has waned over the years so my information is no doubt out of date.
>As it stands most companies do not do research directly for drugs targetting MPB because past drugs have been market failures.
Can you elaborate on how that is possible? Surely a cure for MPB would be a guaranteed billion dollar product.
Can you elaborate on how that is possible? Surely a cure for MPB would be a guaranteed billion dollar product.
I don't have any more specific information as my obsession with MPD has waned over the years, but the rationale for drug companies is basically if a drug doesn't make some Billions of dollars than its considered a failure. With limited money to spend for research it makes financial sense to spend it on drugs with the highest potential. Hairloss drugs haven't done well in the marketplace mainly because their effectiveness is limited along with a difficult regimen. But that is enough to deter drug companies from continued research.
Taking Ciclosporin turned all of us patients into Sasquatch. I had to shave my ears. Even bald people sometimes get their hair back after a bone marrow transplant.
I once met a pharma research guy working on hair growth. I told this dude that if they isolated the hows and whys, they'd make a mint.
http://en.wikipedia.org/wiki/Ciclosporin
I once met a pharma research guy working on hair growth. I told this dude that if they isolated the hows and whys, they'd make a mint.
http://en.wikipedia.org/wiki/Ciclosporin
I have a friend with alopecia. This would be awesome if gives her an option for reversing it.
The title really should refer directly to alopecia. Those of us that have it likely know the name. For everyone else, they don't realize that "male pattern baldness" is completely different.
Ok, we changed the title.
I believe "male pattern baldness" is known as androgenic alopecia. Unfortunately, I don't think this research applies to those with androgenic alopecia.
Indeed, though I think most people don't know that. My thoughts are with this new title fewer folks with receding hair lines will get their hopes up.
Granted... I am not exactly sure this was a problem. So, apologies if I made it sound like this was a dire concern. And thanks to the mods for changing the title! :)
Granted... I am not exactly sure this was a problem. So, apologies if I made it sound like this was a dire concern. And thanks to the mods for changing the title! :)
23 From there Elisha went up to Bethel. As he was walking along the road, some boys came out of the town and jeered at him. “Get out of here, baldy!” they said. “Get out of here, baldy!” 24 He turned around, looked at them and called down a curse on them in the name of the Lord. Then two bears came out of the woods and mauled forty-two of the boys.
Hope for George Dawes!
I have alopecia, dont be a pussy who use drugs with side effects. Take it like a man. No Hair, No Problem i can deal with it.
The original paper that's been submitted to Nature is worth a read: http://www.nature.com/jid/journal/vaop/naam/pdf/jid2014260a....