Donor Regeneration

http://www.ncbi.nlm.nih.gov/pubmed/19438685

This is the article Dr. Wesley posted awhile ago, it seems as if pilofocus could easily do this, it would just be about finding the optimal depth to cut the follicle horizontally. If there are indeed stem cells on both halves of the follicle, as supported by this article, then regeneration will occur. If you add acell under the skin to support the growth, I bet a higher percentage of regeneration could occur. I'm very excited to see what becomes of pilofocus.

Stem cell therapies evolve last 10 years, but there are so many, many, many puzzles to be solve. We are still on the begining. It will need probably decades to cure some diseases like cancer, heart failure, androgenic alopecia...

Yes, clearly, but your comment isn't really relevant to this study. They've already proved it works here, it just needs to be fine-tuned.

Scientists need to understand how stem cells work, how to multiply and which stem cells are the best to use.

In recent years we have learned a lot as a function, but still have a lot to explore and improved.

Whether it comes to research on cancer, heart failure, hair loss or other things they are related to each other when it comes to stem cell science.

Everything new about how we can improve use of stem cell is benefical for hair loss even if its not related to androgenic alopecia research.

I personally believe pilofocus can prove to make this science a reality in day to day hair transplants. If each half is growing 70% of the time, when removed and split, then re implanted, I bet leaving one half in its natural habitat and addin a cell could make that 70% move closer to 90%+. So maybe we could be getting a lot better hair transplants that could be considered a surgical cure for some, with fine tuning down the road.

Quote:

---

Originally Posted by FearTheLoss

I personally believe pilofocus can prove to make this science a reality in day to day hair transplants. If each half is growing 70% of the time, when removed and split, then re implanted, I bet leaving one half in its natural habitat and addin a cell could make that 70% move closer to 90%+. So maybe we could be getting a lot better hair transplants that could be considered a surgical cure for some, with fine tuning down the road.

---

Nice study FearTheLoss, I agree. The artistry of skilled hair surgeons nowadays is so good that only donor limits are the problem. But if we can fix that with doubling that would be damn awesome. I would really like to know if more people actually proceed to further innovate and tweak this treatment. I really bet the HT industry is actually going to provide the first functional cure. Hopefully other people will stand up too and try to innovate in terms of doubling also. The beauty of it too is that you will basically have androgen resistant hairs. The concept is shown, that's very important.

Has the concept really ever been shown? I'm not talking about splitting a DP to make two smaller hairs, I'm talking about splitting it and having it grow back to the same size...without that, it is not doubling.

Quote:

---

Originally Posted by KO1

Has the concept really ever been shown? I'm not talking about splitting a DP to make two smaller hairs, I'm talking about splitting it and having it grow back to the same size...without that, it is not doubling.

---

This is what Blake_Boxham had to say from HTN;

Quote:

---

He literally cut them in half. The upper portion contained the bulge stem cells in the outer root sheath (ORS) and the lower portion contained the dermal papilla stem cells from the bulb region. This was done under a microscope with a standard scalpel - as far as I understand it.

---

Quote:

---

You are referring to the Italian donor doubling study, right? I think he further proved the theory behind donor dominance: both the bulge stem cells and dermal papilla stem cells are capable of regenerating some type of functioning follicle. Unfortunately, these studies continue to confirm the fact that these bisected follicles grow thinner hairs. The structure of these follicles, and whether or not they can be extracted, split, implanted, and still show growth, remains unknown.

I think donor doubling is going to be my initial research focus when I start my clinical practice a bit down the road!

---

You are right maybe it's not doubling. But would it really need much more tweaking to get those hair follicles the same size as they were? I'm still kinda amazed that Jahoda induced a whole hair follicle only of his fresh dermal sheath cells. Aaron Gardner mentioned too that the DP and and dermal sheath were both capable of inducing de-novo morphogenesis. I don't know on what he did base that, but still it's realistic to expect that this would be a possibility in the near future imo.

That's the problem though, we have no way of making the DP bigger, AFAIK. If not, we're just left with thinner hairs to spread.

Well there's a few things that come into play:

These hairs were extracted and then split, anytime a hair is extracted, even the whole follicle, it grows back SLIGHTLY thinner in caliber. With a method like Dr. Wesley's, only the lower portion of the follicle would be removed, and the upper portion would remain in it's original atmosphere. Therefore, we have reason to believe that the chances of it growing back with caliber close to normal could be higher. If you add ACell to this, supporting growth on both ends, which we know it does to some extent (proven by Cooley's work), the chances of 100% caliber regeneration only increase. Also, without handling the graphs and splitting them under a microscope (this doesn't need to be done, because Piloscopy could split them as needed under the skin), there isn't as much damage done to each follicle and each portion of the follicle. This only supports stronger regeneration and regrowth. This, SCIENCE, is why I have high hopes for Pilofocus and what it could do for anyone suffering from hair loss. I think Dr. Wesley is an absolute genius and we really need more proactive doctors like him.

Well, I hope you are right. That said, pre-Pilofocus, why aren't doctors doing this more often? I know Cole uses a partial extraction protocol, but shouldn't that mean that even NW7's should be getting interesting results? I have been hearing about donor regeneration/Acell for years but haven't really seen any "wow" results.

Quote:

---

Originally Posted by FearTheLoss

Well there's a few things that come into play:

These hairs were extracted and then split, anytime a hair is extracted, even the whole follicle, it grows back SLIGHTLY thinner in caliber. With a method like Dr. Wesley's, only the lower portion of the follicle would be removed, and the upper portion would remain in it's original atmosphere. Therefore, we have reason to believe that the chances of it growing back with caliber close to normal could be higher. If you add ACell to this, supporting growth on both ends, which we know it does to some extent (proven by Cooley's work), the chances of 100% caliber regeneration only increase. Also, without handling the graphs and splitting them under a microscope (this doesn't need to be done, because Piloscopy could split them as needed under the skin), there isn't as much damage done to each follicle and each portion of the follicle. This only supports stronger regeneration and regrowth. This, SCIENCE, is why I have high hopes for Pilofocus and what it could do for anyone suffering from hair loss. I think Dr. Wesley is an absolute genius and we really need more proactive doctors like him.

---

Interesting. What I was thinking though, how about the time involved? Thing is if you go splitting under a microscope hair follicle by hair follicle, I would imagine that it would be extremely time invasive. Do you have any idea of the time involved in Pilofocus in comparison with normal FUE?

Regeneration can be a real solution, even on short term imo. The broad concept is there already indeed, it just needs tweaking and more "stability".

Quote:

---

Originally Posted by Swooping

Interesting. What I was thinking though, how about the time involved? Thing is if you go splitting under a microscope hair follicle by hair follicle, I would imagine that it would be extremely time invasive. Do you have any idea of the time involved in Pilofocus in comparison with normal FUE?

Regeneration can be a real solution, even on short term imo. The broad concept is there already indeed, it just needs tweaking and more "stability".

---

In the last presentation that Dr. Wesley's assistant uploaded, it stated pilofocus could do 1000+ grafts an hour while regular fue can only do 300-400max

Has Cooley produced any "wow" results from doubling?

No, he doesn't do it in practice I believe. He's just been studying it and trying to perfect it. The problem is I don't believe it's perfectable with modern fue techniques. Doctor Cole said the problem he has with regeneration becoming consistent is the ACell leaks and doesn't stay where it needs to be. Hence, this problem could be solved with pilofocus as ACell could be placed under the skin where it couldn't leak.

Quote:

---

Originally Posted by FearTheLoss

No, he doesn't do it in practice I believe. He's just been studying it and trying to perfect it. The problem is I don't believe it's perfectable with modern fue techniques. Doctor Cole said the problem he has with regeneration becoming consistent is the ACell leaks and doesn't stay where it needs to be. Hence, this problem could be solved with pilofocus as ACell could be placed under the skin where it couldn't leak.

---

Thanks for the info.

No problem. I'm anxious to see what becomes of this. I'm also curious as to what Dr. Mwamba's protocol is for hair regeneration. I wonder if he is using information from this study or what? It's discouraging to see that not many doctors are apt to take information like this, proven science, and try to put it into practice. However, it is encouraging to see that Dr. Wesley and Dr. Mwamba are working to advance the field.

Quote:

---

Originally Posted by FearTheLoss

In the last presentation that Dr. Wesley's assistant uploaded, it stated pilofocus could do 1000+ grafts an hour while regular fue can only do 300-400max

---

That's extremely important imo, time means money.

Dr. Mwamba mentioned this like 2 months ago btw;

Quote:

---

When you poke a hair bulb , you can get a lot of free stem cells in your solution ( hundred of thousand ).If you can culture them , you can go up to million cells .DP cells are trichogenic but they loose their trichogenicity with time .
We want to take advantage of the period when they are trichogenic and expect them to communicate with existing stem cells around miniaturized hairs and influence them positively .That's our goal .

We know that cells at that level communicate through signals .I do agree that culturing cells ( DP cells , Epidermal cells , and cells from blood vessel ) , you will get a better chance to grow hairs .( Study of prof. GERD in Germany ) .

We keep trying at our level as we can not culture cells to work with fresh DPcells .We do not waste grafts .We usually take 100 grafts , poke them with a needle and reimplant them.Studies demontrated in the past that transection beneath the lower third of the hair shaft can generate a new follicles .So we expect the poked grafts to grow , especially if you boost them with growth factors and nutrients .
Thank you for your comments .

---

It's going to be interesting to see if Mwamba's studies become of anything. However, I have a lot more hope for Dr. Wesley's method. It just seems so simple.

I think less handling of the graphs that are split is something that could dramatically increase the percentage of regeneration. If you are splitting the hairs and getting about 70% regrowth from each side of the extremely fragile, split hair, then you should expect a lot better percentage when you keep one half in its original atmosphere and add growth factors.

I don't want to be over optimistic, but I'd expect the portion of the follicle that's staying where it is with added growth factors to regenerate at 90+% based on the science that's behind it already.

So I'm not too familiar with the regeneration science, so what parts of the HF are to be bisected? Are we bisecting the DP, or cutting out the DP entirely, and letting the bulge regenerate the follicle?

There is some mention of it in this study, however, Dr. Gardner could probably clarify that, and I believe he did in a thread on here some time ago. I don't recall what the name of the thread was though.

Swooping, I think we have it right that the first "cure" will come in this form. Or at least the biggest advancement in the industry for some time to come. If this study is in fact accurate, Dr. Wesley's method can only improve upon their results. I'm excited for what's to come, and I'm grateful we have a doctor like Dr. Wesley working on this exact topic.

Dr. Cole claims to get regeneration from 20-70% when taking the follicle out in it's entirety, because of the stem cells that are left there. His hypothesis is that the reason there is such a difference in success rate is because of ACell leaking as the extraction sites ooze differently in individual patients. If ACell was placed below the skin with nowhere to ooze, this would fix that problem. Furthermore, if we aren't extracting the entire follicle, I think we could expect much greater results, as I have stated already.

I'm trying to remain cautiously optimistic, however, all this factual evidence supports Pilofocus potential to be HUGE in the regeneration game. It's hard to contain such excitement after digging into all the evidence and research done thus far.

Quote:

---

Originally Posted by KO1

So I'm not too familiar with the regeneration science, so what parts of the HF are to be bisected? Are we bisecting the DP, or cutting out the DP entirely, and letting the bulge regenerate the follicle?

---

"Expression of CD200, p63, and b1-integrin was detected in both portions, whereas K19 and CD34 stained different cell populations in the upper and lower fragment, respectively."

Quote:

---

Originally Posted by FearTheLoss

"Expression of CD200, p63, and b1-integrin was detected in both portions, whereas K19 and CD34 stained different cell populations in the upper and lower fragment, respectively."

---

Source?

There have been some papers that specifically stated that miniaturized follicles lack CD200 and CD34+ progenitor cells.

Quote:

---

Originally Posted by hellouser

Source?

There have been some papers that specifically stated that miniaturized follicles lack CD200 and CD34+ progenitor cells.

---

The paper I linked first page. This is the same research report Dr. Wesley posted.

Quote:

---

Originally Posted by KO1

So I'm not too familiar with the regeneration science, so what parts of the HF are to be bisected? Are we bisecting the DP, or cutting out the DP entirely, and letting the bulge regenerate the follicle?

---

This is wat Dr Aaron Gardner (who works with Jahoda) said:

https://www.baldtruthtalk.com/showth...l=1#post175095
https://www.baldtruthtalk.com/showth...ht=#post175294

Basically he thinks it's possible but too expensive to perform.

Quote:

---

Originally Posted by Arashi

This is wat Dr Aaron Gardner (who works with Jahoda) said:

https://www.baldtruthtalk.com/showth...l=1#post175095
https://www.baldtruthtalk.com/showth...ht=#post175294

Basically he thinks it's possible but too expensive to perform.

---

Exactly, but Pilofocus could split the lower half in two, like the study posted, during the actual extraction. We are talking horizontally.

Quote:

---

Originally Posted by FearTheLoss

Exactly, but Pilofocus could split the lower half in two, like the study posted, during the actual extraction. We are talking horizontally.

---

I haven't read their study. but they supposedly did that 'blindly', just like Gho claimed ? If so I'd say that it's most probably a lie, just like Gho's BS. It's very important to split it correctly under a microscope. This isnt something you can do blindly.

Quote:

---

Originally Posted by Arashi

I haven't read their study. but they supposedly did that 'blindly', just like Gho claimed ? If so I'd say that it's most probably a lie, just like Gho's BS. It's very important to split it correctly under a microscope. This isnt something you can do blindly.

---

No, they did it horizontally under a microscope.

"Approximately 100 hair follicles from each patient were horizontally sectioned under light microscope below the origin of the arrector pili muscle. The procedure was standardized by cutting all follicles at one-third of their length from the papilla. The two portions were implanted in androgenetic alopecia bald sites"

They were even planted into two separate bald spots, so one could hypothesize, if one portion was left in it's original atmosphere, surrounded by all the stemcells and influenced by ACell under the skin with nowhere to leak, we could see a very high percentage of regeneration.

Quote:

---

Originally Posted by FearTheLoss

No, they did it horizontally under a microscope.

"Approximately 100 hair follicles from each patient were horizontally sectioned under light microscope below the origin of the arrector pili muscle. The procedure was standardized by cutting all follicles at one-third of their length from the papilla. The two portions were implanted in androgenetic alopecia bald sites"

---

Ok that sounds hopeful then ! Going to read their paper, thx

Would Follicept's transdermal technology be a benefit in delivering Acell? Sorry if that's a stupid question, but I had to throw it out there.

Quote:

---

Originally Posted by willy

Would Follicept's transdermal technology be a benefit in delivering Acell? Sorry if that's a stupid question, but I had to throw it out there.

---

No, not at all.

Interesting. I was surprised by the Italian study actually that a horizontal split could regenerate hair follicles even if they grow thinner/smaller. Basically that means that also the bulge is capable of generating de-novo morphogenesis. I'll go over the whole study this week. The possibility is there no doubt, some problems I foresee though;

- Speed. Assuming the hair follicle could be split with a "harsh" cut either through a horizontal axis or vertical axis this shouldn't be a problem. However if it is really needed to properly dissect cell lines from each other that is going to be pretty damn time invasive under a microscope. Time means money. It isn't a realistic scenario to work 10 minutes per graft. It would be hugely expensive and no way the hair transplant industry would innovate on such a thing even if the possibility would be there? They are pretty damn protective already.

- Harsh environment recipient. This is another problem. Normal FUE survival rates assuming you go with a good surgeon are 90%+. When you cut a hair follicle you basically induce mechanical trauma. This means that the tissue itself is already broadly way more susceptible to environmental stress and oxidation stress outside of the body. One would almost have to ensure that the splitted hair follicle would be needed to be place back as soon as possible into the recipient. However the recipient itself is a problem also indeed as Gardner said. This isn't exactly a embryogenesis environment. There are indeed many bad factors expressed in bald scalp. No wonder that even with normal FUE when you induce mechanical trauma to the hair follicle even a fully intact hair follicle can easily fail to grow. FUE is just so good nowadays because the transection rates are very low and subsequently good mediums like hypothermosol + ATP are used and delicate handling is performed. Overall the best surgeons just have everything lined out in an excellent protocol.

Nonetheless these are all things that can probably be tweaked. And the good thing about it all that with such practice you can work in vivo with direct observational experience. This is the best thing you can do/have in science. Plus you can work on humans, not on mice ;).

FearTheLoss do did you watch the bald truth? Do you have a recap of what Dr. Wesley said there?

With regards to splitting the follicle horizontally, what I gathered was this split would be done as the actual extraction, so there would be no need to dissect the follicle under a microscope after extraction. I did watch the show, Dr. Wesley answered all of the questions I had posted, and assumptions I made, and I was pretty much correct in what he is aiming to do. Although he doesn't think ACell will play as big of a role in the outcome as I had initially hypothesized.

What I gathered is he thinks the top portion of the follicle staying in it's original environment will be the most important thing in regards to regeneration. He seems to really believe in the regeneration aspect of the surgical procedure. I think it's also important for everyone to recognize, there are many studies done on donor regeneration and follicle duplication, this is not something Dr. Wesley has made up, he's just one of the few doctors that has decided to use the science and information at hand from various researchers. These are independent studies done by researchers and doctors he has no affiliation with.

I continue to have very much respect for Dr. Wesley and was again impressed by everything he had to say last night on the show. We as a community should be thankful that he is taking hours out of his day to keep us up to date on his work.

People who are frustrated with the timeline need to recognize the complexity behind designing technology like this, and be thankful that Dr. Wesley is doing extensive trialling before he uses this in practice. Dr. Wesley is a great man, and an exceptional doctor and has nothing but his patients' best interest at heart.


Swooping- you should really listen to the show when it becomes available online. It's pretty interesting stuff.

Arashi- what do you think of the study?

Does anyone pay attention to afirm.mil ? http://www.wakehealth.edu/Research/W...and-Tissue.htm

Thanks for the information FTL will definitely watch it when it will be released.