What's on the horizon?

I’ve had my hopes up that SkinTE was going to be a breakthrough for regeneration - hair and otherwise. But they posted some new pictures on their website, and let’s just say, I am loosing hope. They don’t look very good.
https://ir.polarityte.com/sec-filings-email/content/0001493152-18-005038/ex99-1.htm

So I wanted to ask those of you that have been in this circle following all of these different companies and researchers for a while… What else do I have to look forward to near term? What is the current status of the most promising new treatments?

I have read about a few that look like they could produce something pretty soon. Namely, Replicel, Shiseido, Dr. Tsuji, and Dr. Fukuda.

I assume many of you have been hearing about ‘breakthroughs’ for years and nothing actually comes from them. So I was curious… Do any of the aforementioned companies/doctors appear to be different? Something that might actually work in the near future? What are the current statuses of those that I mentioned?

I didn’t think SkinTE would be a solution to hair loss from the beginning. Their approach to this technology has a long way to go to produce cosmetically useful hair on the scalp. They are touting “polarization” as their approach to regenerating “full-thickness skin” – meaning the cells are aligned along a “pole” with certain cells at the top and certain cells at the bottom – like in real skin… but they admit in their own patent that their product is “minimally polarized”. The problem is that to get working hair follicles you need fully polarized tissue, at least for the hair follicles. The degree of “polarization” in SkinTE is almost negligible. I think they’re touting this to get a market position as a solution for skin grafting which is marginally better than the alternatives that are on the market right now… But it will be a long time until they turn this approach into viable hair follicles, if they ever do it.

My understanding of Dr. Tsuji and Dr. Fukuda’s work is that they actually ARE creating fully polarized “hair follicle germs”… that is, they are placing epithelial cells on the bottom and cultured HF stem cells on the top. In order to reliably induce a brand new working follicle, apparently you have to have both types of cells, and they need to be positioned exactly like that (a layer of HF cells on top of the layer of epithelial/DP cells), oriented in that way with respect to the skin and the dermal-epidermal junction.

So, SkinTE is basically a medical startup that produces marginally better skin grafts (with a lot of similar competition on the market in that field), and they’re trying to turn it into a money-making proposition to license to hospitals and practitioners, and hair regeneration is a lower priority for them… while Drs. Tsuji and Fukuda are concentrating 100% on building new hair follicles.

Which do you think is more promising?

'Which do you think is more promising?'
Is that rhetorical? Haha.

So… When I first read about Dr. Tsuji, it seemed everyone was really excited about it. It looked very promising. Is that still the general consensus? Or has hype fizzled out like it usually does? I remember reading they were shooting for a 2020 commercial release… Too good to be true?

Which looks more promising to you… Tsuji or Fukuda? And also, which looks like it could realistically be available soon?

I see only Shiseido in the foreseeable future. But we don’t know anything about their results at the moment. And perhaps we won’t hear them before (if) they decide to go ahead with commercialization. If those results turn out to be as “good” as Replicel’s, then they will ask more time for research. And it’s going to be another intercytex, aderans, histogen and perhaps follica.
Never put much hope in skinTE. Simply because their prime goal is not hair.
I think, what Tsuji’s doing, is very complicated procedure. He has to process every single follicle separately. That is insanely labour intensive process. Hence the initially projected price for the procedure. Plus, we yet to see that technology is working on humans, not only mouse.
If Shiseido comes out with decent results and can offer compounded treatment, I will be on my way to Japan at the first opportunity.

From what little I know (because little information has actually been released), Dr. Tsuji has an advantage in that he’s been researching this longer and has not only research facilities through Riken (a Japanese biomedical institute) but also funding through Meiji Seika Pharma, which plans to license and market the technique once it’s validated in humans. Dr. Fukuda works for Yokohama University, and it looks like his research is quite similar, plus he’s found a way to mass produce these hair follicle germs (using a chemical which as was widely reported, is an additive in McDonalds french fries an a number of other foods). So that’s a big advantage on his side.

I don’t know of the degree to which they share their findings or collaborate. But if they did, my guess is that it would speed up the process.

Sure, but Dr. Tsuji has announced a timeline of Spring 2019 for human clinical trials of his procedure. And Dr. Fukuda apparently has a way of mass-producing these hair follicle germs.

I don’t know who this guy is in the video, but this gives a basic rundown of what Dr. Tsuji is doing.

I wonder whether Tsuji managed to solve trichogenic cells properties?
He has to multiply and grow more types of cells than aderans or intercytex did.

The way I see it, Tsuji does not need to solve the trichogenic problem. He is creating brand new follicles – at least “follicle germs” which are like “baby follicles”, outside of the body.

Trichogenicity is a problem when injecting dissociated cells into the skin. The problem happens because the cultured DP cells lose a lot of their inductive (trichogenic) abilities in the culturing process. That means that the injected cells have a hard time influencing existing miniaturized follicles in the skin.

With Tsuji’s and Fukuda’s work, as I see it, they won’t have this problem because they’re not trying to enlarge existing miniaturized follicles in the skin. We can forget about those MPB miniaturized follicles – they’re not important to Tsuji and Fukuda’s work.

Dr. Tsuji and Dr. Fukuda are putting cells together to make brand new infant follicle germs. So first a new follicle is actually formed in the lab. Then they implant those follicle germs into the skin.

In tsuji procedure they have to expanding cells (it means culturing or multiply). You can check the procedure here 理化学研究所 器官誘導研究グループ

As of september 2016 they said the expansion of epithelial cells “remains a significant challange globally”.
As of july 2017 they said they could expanding “hair follicle-derived stem cell” and the next challange will be the “expansion of human-derived cells”.
So I think they dont have figure out how to culture human cells properly yet (as of july 2017).

I dont know if this was the same issue had aderans and intercytex, but in another forum as of may 2014 there was a Q&A with Aaron Gardner (team jahoda) and he said:
“Epithelial cells are more tricky as they tend to terminally differentiate in culture (they are alive, but they do not multiply, they are also less likely to respond to inductive stimuli)”

I wonder how tsuji know they can fix the problem by march 2019 (when they will start human test).
It’s like to say: “We’ve been failing for the last ten years but just need one more”

That statement actually came from a lay person who emailed Dr. Tsuji and asked him about it. Dr. Tsuji didn’t state that himself. Here is Dr. Tsuji’s answer, posted by that person on another website, on July 18, 2017:

Thank you for your contact regarding our work.

I am grateful that you had read my book and have interests to our hair follicle regeneration. Recently, we successfully developed an expansion method of hair follicle-derived stem cells, although the results are unpublished. We are now trying to challenge of the expansion of human-derived cells and plan to do the clinical application in human at March 2019.

I appreciate that you will continue to watch our study.