Dear Dr Kemp.
Thank you for your response.
I agree there are complications and contradictions in the data about hair follicle miniaturisation, and the associated local tissue changes. Thats why we have to look for a possible common factor, that could make sense of the data. I suggest once you apply the principle of pressure based spatial growth controls to hair follicles, a common factor in the data becomes clear.
I argue in my article that the changes of the hair cycle and the follicle structure, are perfectly adapted to be manipulated by even small pressure changes in the dermal tissue. This has important purpose in evolution. The common factor in most types of hair loss, is an increase in the dermal pressure for whatever reason. Hormonal actions, immune responses, toxic effects, radiation effects, and chemotheropy.
IN MPB we are all aware of the increased tightness of the scalp. In MPB there are associated immune changes, hypoxia, fibrosis, increased mast cell activation (PGD2), and significant sweating changes. All of these factors are recognised in tissues subject to increased fluid pressures, like lymphedema.
This in-vivo growth control also makes sense of the contradictions in the in-vitro and organ culture studies, that do not translate into effective MPB treatments. These studies cannot replicate the pressure conditions in the Human MPB scalp, and so are misleading.
This is an issue that any cell based treatment intended to regrow large follicles in the MPB scalp, will just not get around without creating dangerous tissue growth. In my opinion the only way forward is to deal with the external pressure conditions more effectively.