Sanford Burnham News

https://www.sbpdiscovery.org/news/beaker-blog/sbps-alexey-terskikh-advances-hair-growth-research

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Sounds great.
Let’s hope everything progress as thought by this guy.

Sounds promising but I guess we still have a long wait to see if anything pans out. 2 yrs for mouse studies, then at least 2 more years with human trials.

Earliest is probably 5 years from now but more likely it’ll take 10 yrs. I’m in my mid-40s now so I’ll be in my 50s assuming this succeeds. Not an exciting prospect but hopefully something else will come along sooner.

Thankfully I still have a lot of donor hair for a transplant so I think I’ll be doing that in the meantime since nothing better seems to be available now.

Interestingly, they are looking to use HT techniques to transplant newly grown follicles.
Looks like they are planning to grow hair in vitro and then ordinary HT. Just wondering why they are not confident growing follicles in vivo?
They talk about hair direction issues and some scaffolds. Sounds familiar?
Anyway, this is not going to happen in our life time.

Sounds like another dead end for the majority of people with MPB, it’ll be a niche treatment like current hair transplants.

@Otter I don’t think it will take a lifetime for us to see this on the market, but I do think it will be VERY expensive once it’s available. For several reasons:

  1. as you said, this is a lab procedure combined with a HT procedure, so it’ll combine the costs and overhead of both

  2. not only that, but Dr. Terskikh is talking about using induced pluripotent stem cells (iPSCs) instead of the more readily available embryonic or somatic stem cells. Creating custom iPSCs in the lab is a complex, cutting-edge procedure, as far as I know. This part likely can’t be done by the HT docs, so your donor cells will have to be sent out to a separate lab where this will be done, increasing the cost by a big factor.

I’m guessing, but I think all this will result in this procedure costing about 1.5 to 2 times (at least) the cost of an equivalent HT.

I should add some comparisons between Dr. Terskikh’s (Sanford Burnham) procedure and Dr. Tsuji’s…

  1. Tsuji’s is likely to be available much sooner than Terskikh’s. Why? Because Dr. Tsuji is using 2 types of cells which can be easily harvested from existing hair follicles on your head: Epithelial stem cells and DP cells. He’s putting these 2 cell types together, one on top of the other, as they develop in the embryo (when your hair follicles develop) and allowing them to undergo an embryonic-type induction of new follicles in vitro. Thus, the cells themselves don’t have to be manipulated or turned into something they’re not. On the other hand, Dr. Terskikh is taking cells from your body (I don’t know where he’ll be harvesting them from), and putting them through a very sophisticated (and very expensive) laboratory procedure in which they’re converted into “induced pluripotent stem cells” (iPSCs). Not only that, these iPSCs have to be of the specific type that will grow hair follicles. In my opinion, this is an extremely cutting-edge process which will take a very long time to be approved by the FDA and any other regulatory agencies around the world. So, when Otter says “not in our lifetimes”, I don’t agree with that, but I do agree that it would take a very long time, probably MUCH longer than Dr. Tsuji’s procedure.
  1. I think that one of the downsides of Dr. Tsuji’s procedure will be that the actual hair follicles grown might not all be “perfect” looking – in other words, they might not be very robust. They may be thinner, frailer and a bit weaker looking than regular, healthy hair follicles on a person who’s not suffering from MPB or alopecia. We’ve seen the HFs he’s grown on a mouse. They don’t exactly look thick and luxurious… they look wispy and kind of fine. I think this is happening because even though the process he’s developed can grow follicles in a similar way to follicles developing in an embryo (from epithelial and mesodermal cells), it’s still not EXACTLY like embryonic development… it’s an imperfect replica of it. In embryonic development you have a lot of complex interactions of all the different cell types and embryonic chemical signals, many of which which won’t be present (or feasible to replicate) in Dr. Tsuji’s lab procedure. Therefore, the product will be less than perfect. Don’t picture a thick, lush head of perfect hair with each strand of hair being thick and flowing. Instead, picture a full head of hair, but where each individual hair might be fairly thin (although not as thin as a vellus hair), and might be a little curly or might grow out of the scalp in random directions. I think this type of hair will look great when cut very short (you will essentially look like you have a full head of hair, and that’s what counts…) But if you attempt to grow it a bit longer, it may be evident that the individual hairs don’t look so healthy. Something that will make up for that weakness, though, is the fact that theoretically they can make the density of the hairs very high. There is no upper limit, as there is with conventional hair transplants. They can keep making new follicles.

  2. Because Dr. Terskikh plans to use iPSCs, the follicles he’s making may develop in a way more similar to embryonic development, and may produce more robust looking hairs (thicker hair shafts etc.) … But we won’t know this for a long time, because I think it will take MUCH longer for him to get his procedure approved and on the market… probably at least 5 years longer, if I had to guess.

I think it’s going to take more than 10 years to get this working. Let’s remember that he is already 3.5 years into this project and he is not entering clinical trials for at least another 2 years.
Also we have to realize how new this technology is. Dr. Paul Kemp has said once that when they started with Intercytex, they actually had to work with authorities in Britain to help establish guidelines and regulations for new at that time unheard cell manipulation. I believe Aderans did the same in US. To my knowledge, at the moment there is no treatment approved anywhere in the world that employs iPS cells. Most likely FDA doesn’t even have regulations regarding iPS cells. So Terskikh&Co. will have to help FDA to develop ones. It’s not like you have worked-out templates to follow.
I think regarding cells manipulation itself Terskikh approach might actually be cheaper than that of Tsuji or Shiseido. The last two have to isolate a few types of cells from existing healthy follicle, grow them, preserve their trichogenic properties, mix them together in particular order. Whereas Terskikh doesn’t even need existing follicles, he doesn’t have to isolate different cells within follicle. Once he gets a pool of iPS cells, than he can create any type of cell that he needs. He doesn’t need to address trichogenic properties of newly created cells. So far no one convincingly proved they solved this.
If he cracks this, it would be an ultimate cure not only for hair loss but perhaps for blind, deaf or disabled people as iPS cells, being close to embryonic state, can grow into any tissue or organ.

I believe the problem of addressing trichogenic properties applies only to procedures that use only one type of HF cell (like DP cells or DSC cells). That problem applies to methods like Aderans, Intercytex and Gho (all failed), Jahoda and Christiano (presumably failed or they’ve given up), and Replicel. But it does NOT apply to Dr. Tsuji. He’s doing something fundamentally different from all of those. He’s combining two distinct cell types (derived from ectoderm and mesoderm) in such a way that they duplicate what happens in the embryo. The 2 cell types need to have a direct interface, with one lying on top of the other. It’s the interface between these two cell types which actually induces the follicle to develop. Taken separately, the 2 cell types aren’t or don’t have to be very trichogenic. It’s physically juxtaposing them in a certain way that spontaneously induces the follicle.

I’m not super concerned about people who don’t have good donor hair who you say can’t be helped by Dr. Tsuji and Dr. Fukuda. Or, I am concerned about those people, but you have to remember, they are a very small minority of all patients. The vast majority of HT patients don’t let this stop them from getting a HT, and we know there’s a huge market for HT. If this were such an overwhelming concern, then nobody would get HT.

Any updates on Dr. Tsuji’s work?