Stem Cell Therapy for Alopecia: Gone Today Hair Tomorrow

Dr. Marhaen Hardjo, M. Biomed, PhD

1
Director of Stem Cell Center Hasanuddin University Hospital Makassar
2
Head of Biochemistry Department, Faculty of Medicine Hasanuddin University Makassar

Abstract

Hair loss or alopecia affects the majority of the population at some time in their life,
and increasingly, sufferers are demanding treatment. Three main types of alopecia
(androgenic [AGA], areata [AA] and chemotherapy-induced [CIA]) are very different,
and have their own laboratory models and separate drug-discovery efforts.
In this presentation, we review the biology of hair, hair follicle (HF) cycling, stem
cells and signaling pathways. AGA, due to dihydrotesterone, is treated by 5-
reductase inhibitors, androgen receptor blockers and ATP-sensitive potassium
channel-openers. AA, which involves attack by CD8+NK group 2D-positive
(NKG2D+) T cells, is treated with immunosuppressives, biologics and JAK inhibitors.
Meanwhile, CIA is treated by apoptosis inhibitors, cytokines and topical
immunotherapy.
The desire to treat alopecia with an easy topical preparation is expected to grow with
time, particularly with an increasing aging population. The discovery of epidermal
stem cells in the HF has given new life to the search for a cure for baldness. Drug
discovery efforts are being increasingly centered on these stem cells, boosting the hair
cycle and reversing miniaturization of HF. Better understanding of the molecular
mechanisms underlying the immune attack in AA will yield new drugs. New
discoveries in HF neogenesis and low-level light therapy will undoubtedly have a role
to play.
Keywords: 5- redutase inhibitor, alopecia areata, androgenic alopecia,
anti-androgen, baldness, chemotherapy-induced alopecia, hair follicle, low-level laser
(light) therapy, stem cells, topical immunotherapy