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HairSite: Is an Interview with Dr. Cotsarelis or Dr. Garza Possible?


#1

HairSite, would it be possible to arrange an interview with either Dr. Cotsarelis or Dr. Garza, to ask them some questions about PGD2 inhibition and PGD2 blocking? I think this would be very helpful to HairSite members.

I suggest that the questions be pre-arranged in advanced, carefully selected, and that anyone who is disrespectful towards these two doctors be removed from the interview and/or the forum.


#2

Good idea. If anything comes of this, my question for Dr. Cotsarelis would be:

Is it known if hairs from the back of the head lack the GPR44 receptor? If so, could this explain how transplanted hair is able to last in bald areas of the scalp (with presumably high levels of PGD2)?


#3

[quote][postedby]Originally Posted by walrus[/postedby]
Good idea. If anything comes of this, my question for Dr. Cotsarelis would be:

Is it known if hairs from the back of the head lack the GPR44 receptor? If so, could this explain how transplanted hair is able to last in bald areas of the scalp (with presumably high levels of PGD2)?[/quote]

I’m not an expert, but I can already tell you what I think the likely reply may be:

No, hair follicles in the back of the head aren’t missing the GPR44 receptor.

The issue is that the cells in the balding areas (especially in those follicles) make much more PGD2 than normal, essentially a non-stop flood of PGD2.

The cells and follicles in back of the head have the same number of GPR44 receptors, and a NORMAL amount of PGD2, like the follicles of a person without MPB.

Full disclosure for those who say my answer above isn’t sufficiently detailed: I should add that there is a possibility of upregulation of the GPR44 receptor in the balding areas, from overexposure to PGD2. This is only a possibility. It’s called a positive feedback loop. In some instances in biochemistry, the exact opposite can happen, and overexposure to a certain signaling molecule might cause a downregulation in a receptor, which would be a negative feedback loop.

But I agree, that question and others like it should be put directly to Drs. Cotsarelis and Garza, as they’re the true experts/visionaries in this stuff. My answer may be completely off.


#4

Your answer is feasible, and this could well be the case if the majority of PGD2 synthesis is localised in the follicle itself.

But note from the Garza et al paper: ‘We also detected PTGDS outside of the hair follicle epithelium, indicating potential sources of PGD2 in the dermis’

From this we may expect dermal derived PGD2 to inhibit transplanted and non-transplanted hairs alike - which of course, doesn’t happen.


#5

[quote]The issue is that the cells in the balding areas (especially in those follicles) make much more PGD2 than normal

[postedby]Originally Posted by walrus[/postedby]

Your answer is feasible, and this could well be the case if the majority of PGD2 synthesis is localised in the follicle itself.

But note from the Garza et al paper: ‘We also detected PTGDS outside of the hair follicle epithelium, indicating potential sources of PGD2 in the dermis’

From this we may expect dermal derived PGD2 to inhibit transplanted and non-transplanted hairs alike - which of course, doesn’t happen.[/quote]

Good point, and thanks for pointing that out. I think that most of the extra PDG2 that’s synthesized is right inside the follicle, in the follicle’s cells itself.

Some of the extra PGD2 found outside the follicles may be either from cells actually found in the tissue between follicles, or may also be “seepage” of PGD2 from the follicle.

In any event, ALL skin, all throughout the body, would be expected to have some native PGD2. PGD2 isn’t made just inside balding follicles on the scalp, it’s made throughout the whole body, especially in the skin, but also in the Central Nervous System, the brain, the heart, and other organs.

Remember, PGD2 is also part of the NORMAL hair growth cycle, even in non-balding follicles on your scalp, and even in every single person who doesn’t have MPB.

The only difference is, in the scalps of balding people, the synthesis of PGD2 is much greater than in the scalps of non-balding people.

The reason that transplanted follicles don’t (usually) miniaturize is that the small amount of PGD2 made or present in the tissues in-between balding follicles just isn’t enough to destroy the transplanted follicles.

Remember that PGD2 has a VERY short half-life after it is synthesized, maybe a few seconds. Therefore the action of PGD2 (like all prostaglandins) is VERY localized with respect to where it’s made. It can’t have an effect too far away from where it’s made. We’re talking very tiny distances.

IMO the reason an affected follicle miniaturizes but a neighboring transplanted one does not is because there is simply a non-stop flood of PGD2 being synthesized locally in the MPB follicle.

Picture a million little water faucets that are ALWAYS turned on, always gushing with water (PGD2), non-stop, from the time a follicle starts to bald until your death.

The effect is continuous and uninterrupted, but the distance of the effect from the source is very tiny, so the effect is extremely localized with respect to the source.


#6

I need two questions answered, Is PGD2 preventing stem cells from making progenitor cells? Does PGD2 caused hair follicles to gradually degenerate and form oily cysts, indicating that the HFSCs adopted a sebaceous gland fate and failed to self-renew.


#7

The most interesting question of all to me would be whether or not Cots has tested available substances on animal or human models to examine what happens when PGD2 or the GPR44 is inhibited.


#8

This is a very good idea


#9

It’s probably also quite unrealistic that Cots or Garza will be interested in answering our queries. At least up until now they have not been very forthcoming with information.

[quote][postedby]Originally Posted by HairlossCurse[/postedby]
This is a very good idea[/quote]


#10

[quote]It’s probably also quite unrealistic that Cots or Garza will be interested in answering our queries. At least up until now they have not been very forthcoming with information.

[postedby]Originally Posted by HairlossCurse[/postedby]
This is a very good idea

[postedby]Originally Posted by hairman2[/postedby][/quote]

Dr. Cotsarelis sometimes does interviews. I seem to remember he even appeared here on HairSite very briefly a few times to contribute a bit to the forums.

What I object to, and I think this might be the primary reason he might be reluctant to appear here, is that a lot of the people on these boards are loose cannons and can be really rude and insulting, rather than respectful, to these doctors.

For instance, when a few people recently called Dr. Cole a racist, I think that was outrageous and completely uncalled for. Primarily because the statement by Dr. Cole they were criticizing was, on its face, not even racist.

Look, we can criticize these doctors all we want, regarding their technical abilities or their claims. That’s part of what this forum is for.

But to make ad hominem attacks against people, which have absolutely nothing to do with the issues at hand (hair loss and treating hair loss), I think that is the main reason researchers would refrain from interacting with forum members in real time.

I would suggest a “virtual interview” by the moderator, a list of clear-cut questions, prepared in advance and presented to the doctors.

A real-time interview would be even better (it would be great because there could be greater interaction and back-and-forth), but I don’t know if some people here could be trusted to be polite and respectful to the docs.

Sorry if I’ve indirectly insulted anyone here but that’s just the way it is. I’m just telling the truth.


#11

Firstly, I certainly do not recall Cotsarelis ever having been on HairSite. I would be reaaaaaaaally surprised if someone proved me wrong on that.

Secondly, I did not call Dr Cole a racist, I said his comments were racist - and I stick to that. He may have said it without giving it much thought and maybe at the root of things a very open minded person. However, if your first and only association with a nation is to describe and refer to it as a treatment resistant disease infested sh*thole, then I think it is safe to say that that is a very negative stereotype and generalization of a whole nation and its people. How anyone can argue that such a negative generalization of a nations people does not constitute racist behavior, is beyond me. Anyway Dr Cole issued an apology which I think we should be willing to accept for the benefit of progress.

Back to the subject at hand however, the available interviews with Dr. Cotsarelis appeared very staged to me. Judging from the responses Dr Cotsarelis gave, it appeared that the inquiries were previously disclosed and that the interviewers posed no inconvenient or invasive questions (purely speculative). Everything he responded to seemed to be deliberately superficial.

[quote]It’s probably also quite unrealistic that Cots or Garza will be interested in answering our queries. At least up until now they have not been very forthcoming with information.

[postedby]Originally Posted by HairlossCurse[/postedby]
This is a very good idea

[postedby]Originally Posted by hairman2[/postedby]

[postedby]Originally Posted by roger_that[/postedby]

Dr. Cotsarelis sometimes does interviews. I seem to remember he even appeared here on HairSite very briefly a few times to contribute a bit to the forums.

What I object to, and I think this might be the primary reason he might be reluctant to appear here, is that a lot of the people on these boards are loose cannons and can be really rude and insulting, rather than respectful, to these doctors.

For instance, when a few people recently called Dr. Cole a racist, I think that was outrageous and completely uncalled for. Primarily because the statement by Dr. Cole they were criticizing was, on its face, not even racist.

Look, we can criticize these doctors all we want, regarding their technical abilities or their claims. That’s part of what this forum is for.

But to make ad hominem attacks against people, which have absolutely nothing to do with the issues at hand (hair loss and treating hair loss), I think that is the main reason researchers would refrain from interacting with forum members in real time.

I would suggest a “virtual interview” by the moderator, a list of clear-cut questions, prepared in advance and presented to the doctors.

A real-time interview would be even better (it would be great because there could be greater interaction and back-and-forth), but I don’t know if some people here could be trusted to be polite and respectful to the docs.

Sorry if I’ve indirectly insulted anyone here but that’s just the way it is. I’m just telling the truth.[/quote]


#12

OK, I agree that Dr. Cole’s statement was a stereotype, but I don’t think it was a racial stereotype, nor an ethnic one. It was more of a geographical and socioeconomic stereotype, something like “First World” vs. “Developing World”.

I also think the statement was inappropriate in this context, and also, as Dr. Nigam correctly pointed out, inaccurate, coming from an American, when antibiotic restistant bacteria, including TB bacilli, are becoming more and more common in the USA, in large part due to overprescription and incorrect prescription of antibiotics by American doctors.

However, it’s quite a jump from that to saying the statement was racist. The environment a people live in, the standards of health and prevalence of disease they’re exposed to, are not caused by the race or ethnicity of the people.

Since Dr. Cole is a graduate of medical school and also has advanced clinical training, I would expect that he knows these things, and I’m sure he does. Therefore to instantly label his comments “racist” is to me, a ridiculous and inappropriate leap, and is quite irresponsible and destructive to the spirit of dialogue we’re trying to foster here.

That is why, while I highly respect you, hairman, I referred to that kind of comment as “loose cannon” type of talk that is counterproductive and will only alienate these doctors from contributing to and cooperating with these forums.

I know you know better than that.


#13

Will see what I can do, but cannot guarantee anything.

Thanks


#14

[quote][postedby]Originally Posted by roger_that[/postedby]
Since Dr. Cole is a graduate of medical school and also has advanced clinical training, I would expect that he knows these things, and I’m sure he does. Therefore to instantly label his comments “racist” is to me, a ridiculous and inappropriate leap, and is quite irresponsible and destructive to the spirit of dialogue we’re trying to foster here.
[/quote]

agreed, which is why I didn’t broach the topic until you called me out on it. Discussing it any further serves no purpose, particularly as Dr. Cole himself accepts that it was inappropriate.

Anyway it’s cool that Dr Cole is keeping an open-minded and is willing to investigate Dr Nigams technique. If such a respected surgeon as Dr Cole were to promote Dr Nigams donor doubling, then I think that that might lead to the long awaited breakthrough for this technique for the entire HT industry.

I wonder if Dr Cole is only interested in the donor doubling techniques or if he is also interested in Dr Nigams cell based treatments as well.


#15

[quote]Anyway it’s cool that Dr Cole is keeping an open-minded and is willing to investigate Dr Nigams technique. If such a respected surgeon as Dr Cole were to promote Dr Nigams donor doubling, then I think that that might lead to the long awaited breakthrough for this technique for the entire HT industry.

I wonder if Dr Cole is only interested in the donor doubling techniques or if he is also interested in Dr Nigams cell based treatments as well.[/quote]

I think he’s interested in all of it. Anything Dr. Nigam has to offer. Also, these doctors all know that in most developed countries (the USA, Europe, etc. – I don’t know about India), use by a doctor of a medical procedure discovered by another doctor (even if it has been granted a patent) no longer constitutes patent infringement, so even if a doctor takes an entire medical procedure discovered and patented by someone else, and uses it on his patients, he cannot be successfully sued for infringement.

I think a lot of the general public, including most people on these hairloss forums, don’t know that. In the US, that law was passed by Congress in 1996 and signed into law by President Clinton in 1997.

Dr. Cole and Dr. Nigam are not really competitors, since they operate in two entirely different regions of the world. The overlap of their prospective patients is nominal. If Dr. Cole were able to start a successful practice in Atlanta using Dr. Nigam’s techniques, he would not be significantly harming Dr. Nigam’s practice. Dr. Nigam is probably the most visible and successful aesthetic surgeon in Mumbai, the biggest city in a country of 1 billion people. It’s not like Dr. Cole is going to take his patients away.


#16

[quote][postedby]Originally Posted by HairSite[/postedby]
Will see what I can do, but cannot guarantee anything.

Thanks[/quote]

Thank you from all of us!


#17

This is a great idea Roger.

There was some talk by Dr. Nigam & others at stop aga.com about bringing them in as members after bringing the hair societies in as members that Garza was Pres.& Cotsarelis belongs to, to provide a base to help meet its objectives of promoting the dissemination of state of the art knowledge on hair biology and to establish links with other international hair research societies and to arrange combined meetings on a periodic basis to educate both colleagues and the public on hair biology and the pathophysiology and treatment of hair related conditions.
With the idea to foster greater enhanced communication between bench scientists, clinicians, industry, patient support societies. — I read. However this is an actual call to action on part of administration here at hairsite that we hope to find out the reply on this during the upcoming week I expect here at hairsite, bravo to admin of hairsite!:slight_smile:

Obviously what would be of interest is that there has been much experimentation with OC already in the experimental room at hlh forum, they may not be aware of as well as TM and it would be interesting to find out how they account for the lack of results from such, particularly since the chemical was tested at a lab and trialed, (granted I never saw a reading of the tests performed professionally for verification but that can easily be done).


#18

The problem with that is, all that experimentation with OC is unauthorised at best. My take is that it’s an experimental drug that’s not yet on the market, or rather one company is synthesizing this drug and it may or may not be an authentic version thereof. Then there are several complicated questions about the legality of these experiments.

If Dr. Cotsarelis, for instance, were to visit a forum and forum members informed him that they were testing OC on themselves, number one, that would be an admission of guilt by these members of violating several laws. Second, it would put Dr. Cotsarelis in a very sticky situation of having to respond to a forum member discussing illegal activities with respect to a drug that’s only in the clinical trials phase and hasn’t yet been approved. The fact that it happens to be a drug or a class of drugs that Dr. Cotsarelis is currently trying to get approved just complicates things further.

Furthermore we don’t know if this “OC” stuff being used in experiments is the real thing, or a poor facsimile of the drug, with for instance, an incorrect double bond in the molecule or something. Getting even one chemical bond wrong, or halogenating the wrong carbon atom is about 99% guaranteed to nullify the efficacy of the drug, period.

The other thing we don’t know about is, is this “OC” being delivered with the right vehicle to ensure absorption through the skin.

Big questions and we don’t have all the answers.

I think the questions posed to these doctors will have to be carefully considered and screened before the interview. A free-for-all format will not do.

(The other thing I should point out from your post is that I believe OC has been “tested at a lab and trialed”, but for allergy, not for hair loss. I’ve heard of no results for hair loss trials of OC yet.)


#19

by OC tested at a lab, I mean poster mlouis of hlh and private forum, paid for testing of the OC being produced by Kane. This is the same OC members at hlh experimental were using on that huge thread there and continue with a thread now in the private forum on.
That test is posted on a thread in hlh experimental and perhaps in the private forum and can be found also by private messaging mlouis in the private forum for more details. So it is not for allergy but for verification that what they were using on their head was the real thing. Again reading of the test is important.t I understood OC to have been approved for human use, and the TM( a competing chem. that they are trialing now, not to be).

(roger, some members have sent you relevant material related to this in your private message box on the private forum, you may want to check, as they are following this thread you created)

TO HAIRSITE ADMIN and/or Roger_that and others setting this up, to have any hope of getting decent reliable message through to Dr. Cotsarelis may I suggest you contact by phone the Perlman Medical Center in Philadelphia and speak to the office Manager there where he works, they should be able to assist, emails I wouldn’t waste your time http://www.med.upenn.edu/apps/faculty/index.php/g275/p19946
For Garza contacts for him and staff are here http://www.hopkinsmedicine.org/dermatology/research/basic_science/garza_lab/staff.html


#20

I know that certain internet vendors like the Kane Shop state that their products are tested in labs to validate the chemical composition, and they post graphical results of tests like gas chromatography and mass spectroscopy.

According to what you’re saying, the testing paid for by mlouis was done privately and independently. Are there graphical results of the lab tests?

No, as far as I know, OC000459 is currently in trials for allergy and asthma, but has not yet been approved for any use.

Furthermore, it looks like one of their main markets for this drug will be Russia and the former Soviet Union states (CIS).

See the homepage of the manufacturer, Oxagen (a UK firm) which also holds the patent rights to this drug:

http://www.oxagen.co.uk/about.htm

This is an excerpt from their website:

Oxagen owns[, and will actively enforce and defend,] intellectual property rights relating to OC000459. Except for nominated sub-contractors, no company other than Oxagen has any rights to manufacture, market, use or sell OC000459, anywhere in the world.

Oxagen has no data at all, either pre-clinical or clinical, to support the therapeutic use of OC000459 in male-pattern baldness.

My take on this is that they will not take kindly to the unauthorised synthesis or use of this molecule, if they were to discover instances of it.

On the other hand, if it turns out the drug does work for MPB, I’m confident that they’d want to pursue that market aggressively.

It looks like Oxagen assigned all non-Russia/CIS rights to this drug to another UK firm, Atopix Therapeutics, Ltd:

http://www.atopixtherapeutics.co.uk/

They are currently nearing Phase III clinical trials for OC000459:

http://www.atopixtherapeutics.co.uk/04_02_pipeline.html

If this drug were already approved, doctors would be prescribing it (including as an off-label use for MPB) and people would be buying it on the open market right now.