

Arthritis drug spurs hair growth in man with alopecia universalis - mhb
http://news.yale.edu/2014/06/19/hairless-man-arthritis-drug-spurs-hair-growth-lots-it

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mglukhovsky
I've had alopecia universalis for the past two years, so it's exciting to see
new research in this area. However, the drug in question (tofacitinib) is
still an immunosuppresant, with some serious side effects
([http://www.fda.gov/downloads/Drugs/DrugSafety/UCM330702.pdf](http://www.fda.gov/downloads/Drugs/DrugSafety/UCM330702.pdf))
-- so I'll be watching the clinical trials closely.

The original paper that's been submitted to Nature is worth a read:
[http://www.nature.com/jid/journal/vaop/naam/pdf/jid2014260a....](http://www.nature.com/jid/journal/vaop/naam/pdf/jid2014260a.pdf)

~~~
NamTaf
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.

~~~
mglukhovsky
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](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!

~~~
med_student
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).

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Mizza
This is for alopecia universalis - don't get your hopes up, gents!

~~~
jaynos
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.

~~~
krisgee
Not trying to be a jerk, but why don't you just intentionally shave the rest
of your head?

~~~
lbotos
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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HarlowDuDy
Can I participate as a female volunteer for this study?? Me and my "eyebrows"
are up for the challenge!

~~~
toomuchtodo
You should call and ask.

[http://medicine.yale.edu/dermatology/people/brett_king-2.pro...](http://medicine.yale.edu/dermatology/people/brett_king-2.profile)

~~~
leke
Thanks, I was just about to look for this.

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sakopov
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.

~~~
hackinthebochs
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.

~~~
awalton
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.)

~~~
hackinthebochs
Thanks for the info. My obsession with MPB has waned over the years so my
information is no doubt out of date.

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specialist
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](http://en.wikipedia.org/wiki/Ciclosporin)

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spankalee
I have a friend with alopecia. This would be awesome if gives her an option
for reversing it.

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taeric
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.

~~~
minton
I believe "male pattern baldness" is known as androgenic alopecia.
Unfortunately, I don't think this research applies to those with androgenic
alopecia.

~~~
taeric
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! :)

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electronous
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.

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pessimizer
Hope for George Dawes!

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ThreeFinger
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.

