ACell, a Current Review of Applications in Hair Transplant Surgery

[Jerry Cooley, MD]

Westonci and HairRobinHood

Thank you for the lively discussion of WNT. Doubtlessly the WNT pathway is critical in the formation of hair follicles. In fact, I wouldn't be surprised if the WNT pathway is activated when ACell coated plucked hair is implanted in the skin. However, I would be very cautious about adding exogenous WNT proteins as this may disturb the delicate balance of stimulatory/inhibitory factors present in this context. For example, it is well known that activation of WNT/beta-catenin is associated with tumor formation, which is why Cotsarelis' approach is requiring such careful animal studies and will be subjected to close regulatory scrutiny. In the past, some thought that Sonic Hedgehog stimulation had potential for hair loss treatment, but I believe that tumor formation occurred which shut down any further work on this. It may be that the Histogen approach, which uses a mix of embryonic proteins secreted by neonatal fibroblasts, is more desirable because that stimulatory/inhibitory system is already built in.

Regardless, use of either approach would require FDA supervised studies and should not be done by the surgeon at this time just to 'see what happens'. ACell is already FDA approved for wound healing and can be safely used as an adjunct to transplanting plucked hairs.

Thanks again for the thought provoking discussion.