When born, our genetic code dictates who we will be. Those who will develop MPB have a "programmed cell death" in their code. Barring genetic engineering to intervene, this process will happen at a certain time in our lives with a predetermined outcome. Our goal is to intervene in this process with certain substances and protocols.

In today's battle against Male Pattern Baldness (MPB), emphasis has been placed on certain aspects of hair follicle proliferation. As a result of this research, certain drugs have been developed in the fight. Though they have been successful to a certain point, they fall short in not addressing one of the significant causes of MPB, our immune system. In this article I will address the components of our body's attack on the hair follicle with a possible pending solution.

During ongoing research, scientists have discovered that under high powered magnification, the miniaturized hair follicles exhibited many of the changes prevalent of other tissues subject to organ rejection. This fact has led many to believe that it is our own immune system destroying the hair follicles which it views as "foreign invaders". This has further been validated by the fact that during clinical trials employing oral Cyclosporin A, an immune suppressant drug used with organ transplants, 80% of patients regrew hair. Unfortunately, this drug is extremely toxic, shuts down your immune system and may ultimately kill you. Further studies on a topical version were found to be only 20% effective, though not systematically absorbed, it was not financially worth pursuing.

It is a well know fact, that persons with MPB, have an increased number of DHT receptors in the thinning areas over those without MPB. These receptors bind with DHT in producing a number of undesireable consequences. One of these is the production of sebum at the follicle. Though a certain amount is necessary, the excess can be detrimental as it becomes a breeding ground for microorganisms. This is where the immune system comes into play. The immune systems only function is to keep us alive. In its overzealous attempt to destroy these organisms it will stop at nothing to eradicate them, including destroying the hair follicle in the process. An example of this indiscriminate assault would be a person with periodontal disease. When a persons gums become infiltrated with harmful bacteria, the immune system begins attacking them. The end result is not only the destruction of the bacteria but also of the underlying gums.

A key component of the immune systems fight is the production of inflammatory cytokines which act directly on the follicle. There are two main groups of these cytokines, pro inflammatory (bad) and anti-inflammatory(good). Within each group are numerous components, each with a specific directive. The role of these cytokines is to control the direction and magnitude of the immune response, modeling and possibly remodeling of the tissue in the process.

The cytokine system is an extremely potent force, contributing to inflammation and infection. It is believed that by these actions hair loss occurs. As previously stated, within each of the two groups of cytokines are numerous individual factions, by acting on these it is believed we can cause a down regulation of of the pro inflammatory cytokines while simultaneously up regulating the anti-inflammatory components. Ideally this will result in a homeostasis (no hair loss).

Therefore, as expected, some researchers have directed their attention to this previously untapped solution to MPB. They feel that by intervening in the process chemically, they will avoid the usual immune system attack on the follicle, thereby preserving it. One such ongoing trial is being conducted by Hamamatsu University in Japan. The drug currently under investigation is roxithromycin, a member of the erythromycin family. Thus far results are very encouraging, though complete findings will not be published until June 2007. Intermediate findings show a dramatic elongation of miniaturized hair follicles. Thus far safety has not been an issue, it does have a safe biological model.

Perhaps other research facilities will follow suit in this area and in time will ultimately present us with an additional weapons in this fight.

Below is preliminary information concerning the trial, as additional findings are published I will certainly update everyone on them.


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Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Placebo Control, Crossover Assignment, Safety/Efficacy Study
Official Title: The Study for New Effect of Roxithromycin on Androgenetic Alopecia.
Further study details as provided by Hamamatsu University:
Primary Outcomes: The hair elongation after 1 week of application. Cosmetical improvement. Evaluation by dermoscopy
Secondary Outcomes: Pathological study taken from lesional scalp skin.
Expected Total Enrollment: 20
Study start: May 2005; Expected completion: June 2007
Last follow-up: January 2007; Data entry closure: March 2007
The topical therapy for androgenetic alopecia is still not enough to improve cosmetically. Thereforem we try to find new effective and safe topical therapy for this disease. Roxithromycin has not only antibacterial action but also immunomodulatory and anti-inflamatory potency. For example, roxitromycin inhibits T cell responces to mitogens and production of cytokines, IL-2 and IL-5. We firstly found that roxitromycin increased human and murine hair elongation in vitro to inhibit apoptosis of hair bulb. Then, we wish to apply roxithromycin on the therapy for androgenetic alopecia.
Location and Contact Information

Taisuke Ito, M.D. 81-53-435-2303 itoutai@hama-med.ac.jp
Masahiro Takigawa, M.D., PhD 81-53-435-2303 takigawa@hama-med.ac.jp

Japan
Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan; Recruiting
Taisuke Ito, M.D. 81-53-435-2303 itoutai@hama-med.ac.jp
Masahiro Takigawa, M.D., PhD 81-53-435-2303 takigawa@hama-med.ac.jp
Taisuke Ito, M.D., Principal Investigator

Study chairs or principal investigators

Masahiro Takigawa, M.D., Study Chair, Hamamatsu University