Hair Regeneration from bisected hair follicles in vitro with progenerator epithelial stem cells and isolated DP cells: Rate of success and character of bisected hairs.
DR. VIVEK NIGAM, MD, DR. NIGAM’S CLINIC, DR. PARMAR, DERMATOLOGIST, DR. GARG, PLASTIC SURGEON, McH, MR. RAGHU, CHIEF BIO-TECH
BACKGROUND:
In Vitro bisection of hair follicle has been reported before by Reynolds, et. al. by ERGIN ER, et. Al. Marco Toscani, et. Al. But we are the first to attempt addition of progenrator stem cells from mid-follicle bulge, outer root sheath, derma sheath, derma papilla and isolated DP cells with human extra cellular matrix.
Human Hair Follicle Regeneration from the Amputation and Grafting into the Nude Mouse
Colin A.B. Jahoda,* Roy F. Oliver Amanda J. Reynolds, et. al.
In this study we are investigating the capacity of bisected Derma Papilla Follicle with additional follicle with additional bulge stem cells, outer root sheath stem cells. We are also investigating the capacity of bisected upper hair follicle with limited derma papilla cells and complete outer root sheath & bisected stem cells to re-grow the complete derma papilla. We are also investigating the diameter & rate of hair growth and will check whether the injured hair follicle will go into the regression phase or no if not when, as against the traditional FUT & FUE graft transplantation.
We are hoping that on getting together the derma papilla and bisected stem cell, the de-novo communication and talk between them should start as in embryonic stage, new hair follicle should form one or more than one hair follicle with the same diameter and growth. The key event in the process of formation of new derma papilla from the bisected derma papilla, this has been already proven in mouse by Jahoda et al, 1992; Oliver, 1966b).
PROPOSED OBJECTIVE:
To evaluate bisected follicle’s percentage re-growth rate, diameter & length in hair regeneration with donor scalp and / or body hair.
PROPOSED METHOD:
10 patients will undergo Hair Doubling TM procedure ranging from 5 speciens follicles to 2000 follicular unit. Specimen hair follicles will be extracted from FUE 0.7 / 0.8 mm punch. Bisection of each follicle will be done at the level of Derma Papilla obliquely and both the bisected parts of the follicle will be implanted back to the recipient scalp in few studies and in one study one bisected back to the donor area and other part implanted into the recipient area. Activated stem cells CD200, CD34, K19, derma sheath cells, outer root sheath cells, derma papilla cells will be injected into the both the bisected part of the follicle with isolated derma papilla cells.
RESULTS:
Will be submitted at the end of 10 case studies.
CONCLUSION:
Will be submitted at the end of the 10 case studies.
The author has no significant interest with commercial supporters and has approval from independent institutional committee on stem cells research & therapy and independent ethic committee on stem cells research & therapy.
The hair follicle tissue used for study is derived from donor and who have signed informed consent with outline of detail of the procedure and purpose. The “Human Tissue Act” Published in 2004, “The Declaration of Helsinki” & “The Convention Of Human Rights & Biomedicine” guidelines has been followed.
MATERIAL AND METHOD:
Total 10 patients were selected, 8 men and 2 women who have enrolled. Different numbers of follicles will be taken were taken from different donors including donor area from the body and from the back of the scalp and obliquely bisected follicle will be implanted into the recipient area and in one case studies, one part of the bisected follicle will be implanted on the recipient are and the other part of the bisected follicle will be implanted back into the donor area of the scalp.
Specimen of hair follicle were obtained from FUE 0.7 mm punch for scoring and 0.9 mm punch for extraction of follicle / follicle needles from body (chest, arms, legs & back) and from back of the scalp in different 10 cases studies. The department of the extraction went up to the level of dermis subcut junction. Isolated Derma Papilla cell will be injected into the epidermis & dermis junction. The donor area were trimmed for extraction and for body hair extraction the patient were asked to shave the body and only Anagen growing hair follicle were taken. In the recipient area incisions were made 4 to 5 hrs before the implantation of the follicles which is called premade incision technique with 0.7 mm blade in coronal and triangular pattern.
All the procedures will be standardized by cutting all the follicles and follicular units below the line of Auber at the level of Derma Papilla.
The two portions will be implanted in androgenic alopecia bald area choosing right upper or left lower of selected marker such as tattoo, scar, mole, distance from hairline, top of the ear lobule, mid-vertex point, occipital protuberance, etc. Percentage of pre-existing terminal hair and vellus hair photographs will be taken from Cannon DSRL camera with Macro Lense and will be counted with video-scope and will be marked as dark blue and light blue in the follow up study. The Percentage of growing bisected hair follicle will be marked as Red Circle with numeric numbers. Percentage of not growing bisected hair follicles will be marked at Green circle with numeric number. 12 months follow-up is planned on these 10 case studies. Diameter of 10 Terminal Hair Follicle and Vellus Hair Follicle and bisected growing Hair Follicle will be measured in micron. Growing length will be measured in millimeter.
RESULTS AND DISCUSSION:
The results will be submitted at the end of the case studies.
First case studies of 2013 on hair doubling has already shown the generation of 13 follicles from 4.5 follicles on the recipient area from 24 years male donor with good rate of growth exact growth rate will be mentioned subsequently as the data comes.
Preliminary results of first case study shows growth of of 13 follicle from 4.5 follicles on the recipient area and day 0 and day 1 growth showing intact double follicles from 482 single graft that is 964 bisected single follicles.
Table 1: Hair Regeneration in 10 patients undergoing
Mean percentage +/- Standard Deviation
1 month, 6 months, 9 months, 12 months
Upper follicle –
Lower follicle –
Donor area follicle –
As the study of the bisected hair follicle will be conducted by the extraction from the recipient area, to study the character of the bisected hair follicle under different parameters, will be detail out later.
Table 2: Caliber of hair regenerated after bisection procedure
Donor Hair Caliber, Mean Percentage +/- Standard Deviation
Entire follicle
Upper follicle
Lower follicle
Donor area follicle
REFERENCES:
Published and unpublished paper referred will be mentioned at the end of the study which are in public domain and others were purchased.
PICTURES:
http://www.drnigams.net/images/cell_bobilli_1.png
http://www.drnigams.net/images/cell_bobilli_2.png
http://www.drnigams.net/images/cell_bobilli_3.png
http://www.drnigams.net/images/cell_bobilli_4.png
BLUE CIRCLE REPRESENTS EXISTING HAIR AT RECIPIENT.
RED CIRCLE REPRESENT GROWING BISECTED FOLLICLES
GREEN CIRCLE DENOTES NOT GROWING BISECTED FOLLICLES.